Elevated cytokine levels in peritoneal fluid from burned patients with intra-abdominal hypertension and abdominal compartment syndrome.
BACKGROUND
Burn patients with intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) undergo vigorous resuscitation and accumulate peritoneal fluid (PF) that is a plasma ultra-filtrate. This study compared antithrombin (AT) and cytokine levels in burn patient plasma and peritoneal fluid (PF).


METHODS
Twenty-nine patients were studied: 22 developed IAH and 9 progressed to ACS. Burn + inhalation injury was present in 22 patients; 5 had burn only and 2 had inhalation only. Sixteen patients died: of these, 9 survived less than 48 h due to the severity of their injuries. Flow cytometry utilized the Cytometric Bead Array kit for Human Th1/Th2 cytokines. AT levels were determined by the Accucolor method spectrophotometrically.


RESULTS
All cytokine levels were significantly elevated in burn plasma and PF compared to normal plasma, p < 0.001. AT plasma levels were decreased compared to normal. AT and cytokines were present in peritoneal fluid of burn patients with IAH and ACS. Patients who died had decreased plasma levels of AT and increased IFN-gamma, IL-10, IL-6, IL-4, IL-2 peritoneal fluid levels compared to survivors.


CONCLUSIONS
Peritoneal fluid may be a reservoir for cytokines during initial resuscitation and contributes to homeostatic perturbations in burn patients.
Kowal-Vern
Areta
A
Department of Trauma, Summer L. Koch Burn Center, John H. Stroger Jr. Hospital of Cook County, 1901 W. Harrison Street, Chicago, IL 60612, USA. akvern@comcast.net
Ortegel
John
J
Bourdon
Paul
P
Chakrin
Alan
A
Latenser
Barbara A
BA
Kimball
Douglas
D
Casey
Larry C
LC
D000005:Abdomen; D000328:Adult; D000991:Antithrombins / Q000378:metabolism; D001202:Ascitic Fluid / Q000378:metabolism*; D002056:Burns / Q000097:blood / Q000378:metabolism*; D003161:Compartment Syndromes / Q000097:blood / Q000175:diagnosis*; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000378:metabolism
D000991:Antithrombins; D016207:Cytokines