title: Predictive value of pleural and serum interleukin-6 levels for pneumonia and hypo-oxygenations after esophagectomy.
abstract: OBJECTIVE
  Pulmonary complications after esophagectomy continue to be a significant cause of morbidity and mortality. Although several factors have been implicated to be associated with pulmonary complications after esophagectomy, the prediction of pulmonary complications remains a challenge. The purpose of this study was to evaluate the predictive value of cytokine levels in sera and pleural drainage fluid for pneumonia and hypo-oxygenations following esophagectomy.
  
  
  METHODS
  A total of 66 patients who underwent esophagectomy for esophageal cancer were retrospectively evaluated for preoperative status, surgical procedures, and postoperative systemic response and laboratory data up to postoperative day (POD) 7. Interleukin-6 (IL-6) and IL-8 levels were also examined in patient sera and pleural drainage fluid until POD 5.
  
  
  RESULTS
  Eighteen patients (27.3%) had pneumonia following esophagectomy. Patients with pneumonia had significantly more frequent intraoperative blood transfusions, more frequent re-intubation, longer hospital stays, and higher hospital mortality than those without pulmonary complications. Patients with pneumonia had significantly higher levels of serum and pleural IL-6 immediately after surgery and on POD 1 than those without pneumonia. Univariate and multivariate analyses revealed higher pleural IL-6 levels were associated with postoperative minimum PaO2/FiO2 ratio.
  
  
  CONCLUSIONS
  The elevation of pleural IL-6 levels immediately after surgery and on POD 1 may predict the incidence of pneumonia and the levels of postoperative impaired oxygenation following esophagectomy.
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Japan. tsujihi@ndmc.ac.jp
authors.forename: Hironori
authors.initials: H
authors.lastname: Tsujimoto
authors.forename: Risa
authors.initials: R
authors.lastname: Takahata
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nomura
authors.forename: Isao
authors.initials: I
authors.lastname: Kumano
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hiraki
authors.forename: Suefumi
authors.initials: S
authors.lastname: Aosasa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D010994:Pleura / Q000737:chemistry*; D011014:Pneumonia / Q000175:diagnosis*; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D015850:Interleukin-6; D010100:Oxygen