Microdialysis: a new technique to monitor perioperative human peritoneal mediator production.
BACKGROUND
Standardized methods to measure peritoneal cytokine production do not exist. This feasibility study examines the use of microdialysis to monitor perioperative peritoneal mediator production in patients following abdominal surgery for infective or non-infective conditions.


METHODS
At the beginning of the operation, a microdialysis catheter was placed between the patient's parietal peritoneum and the muscular fascia of the abdominal wall in the connective tissue bed. The device was irrigated (18 microL/h, Ringer's solution/0.05% albumin) for up to 7 days. Samples of the dialysate were collected at least twice a day, and concentrations of interleukin (IL)-6 and monocyte chemoattractant protein (MCP)-1 were measured by an ELISA technique. Four of the nine patients included had proved intra-abdominal infections.


RESULTS
In uninfected patients, IL-6 concentrations peaked 8 h after skin incision (mean +/- SEM): 1696 +/- 1292 pg/mL and dropped rapidly to significantly lower concentrations (less than 400 pg/mL) thereafter. MCP-1 concentrations also peaked at 8 h (12787 +/- 6893 pg/mL). In the following days, MCP-1 concentrations were variable between 1000 and 5000 pg/mL. In infected patients, early IL-6 production tended to be higher and that of MCP-1 tended to be lower than in uninfected patients. Catheters were removed between day four and day seven when the system failed or when the patients became mobile without any clinical symptoms of complications.


CONCLUSIONS
The samples derived from microdialysis were suitable to measure sub-peritoneal mediator profiles during surgery and up to 7 days postoperatively. Microdialysis data should be validated for a potential correlation with the clinical course.
Department of Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
Jutta
J
Riese
Stefanie
S
Boecker
Werner
W
Hohenberger
Peter
P
Klein
Werner
W
Haupt
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D018932:Chemokine CCL2 / Q000032:analysis / Q000378:metabolism; D016207:Cytokines / Q000032:analysis / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005240:Feasibility Studies; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis / Q000378:metabolism; D007432:Intraoperative Period; D008297:Male; D017551:Microdialysis / Q000379:methods*; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D019990:Perioperative Care; D010537:Peritoneum / Q000378:metabolism*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis; D011184:Postoperative Period; D012494:Sampling Studies; D012680:Sensitivity and Specificity
D018932:Chemokine CCL2; D016207:Cytokines; D015850:Interleukin-6