Plasma concentration of procalcitonin and systemic inflammatory response syndrome after colorectal surgery.
BACKGROUND
To study whether plasma concentrations of procalcitonin (PCT), interleukin-6 (IL-6), complement 3a (C3a), C-reactive protein and white blood cell count (WBC) correlate with the presence of systemic inflammatory response syndrome (SIRS) during the early post-operative period after major colorectal surgery.


METHODS
Prospective, observational study during the first 24 h post-operatively. The setting for the study was the operating theatre and the recovery unit at the university hospital. Fifty consecutive patients, operated on electively with major resection of the large bowel or rectum. PCT levels increased significantly to the maximum level 18 h postoperatively. PCT levels were significantly higher in the SIRS group in comparison to the non-SIRS group of patients 6 and 12 h after surgery (P < 0.05). The IL-6 levels were increased directly after the surgery and then decreased gradually in both study groups. Twenty-four hours after the surgery, C3a levels decreased and then returned to normal levels. Twenty-four hours post-operatively, patients with SIRS had a higher plasma concentration of C3a compared with patients without SIRS (P < 0.05). CRP and WBC increased during the study period in both groups (P < 0.05).


CONCLUSIONS
During the early post-operative period after uncomplicated major abdominal surgery, SIRS was reflected by the increase in plasma PCT and C3a concentrations. IL-6, CRP and WBC increased to the same extend in both the SIRS and the non-SIRS group of patients.
Sarbinowski
R
R
Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital/East, Göteborg, Sweden. roman.sarbinowski@vgregion.se
Arvidsson
S
S
Tylman
M
M
Oresland
T
T
Bengtsson
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D003106:Colon / Q000601:surgery*; D015926:Complement C3a / Q000378:metabolism; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012007:Rectum / Q000601:surgery*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood*; D013997:Time Factors
D015415:Biomarkers; C000606589:CALCA protein, human; D015850:Interleukin-6; D011498:Protein Precursors; D015926:Complement C3a; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide