title: Perioperative diclofenac application during video-assisted thoracic surgery pleurodesis modulates early inflammatory and fibrinolytic processes in an experimental model.
abstract: OBJECTIVE
  It has been substantiated that the quality of pleurodesis is reduced when non-steroidal anti-inflammatory drugs (NSAIDs) are used perioperatively. The effects of NSAID administration on the early inflammatory and fibrinolytic processes after mechanical pleurodesis were investigated in an established pig model.
  
  
  METHODS
  Left-sided mechanical pleural abrasion was performed on 24 pigs assigned to either an NSAID or a control group. Pleural fluid and blood samples were analysed over a 24-hour period. Histological evaluation of neutrophil influx at the site of pleural abrasion was performed.
  
  
  RESULTS
  The volume of pleural effusion was significantly decreased in the diclofenac group at 10 and 24 h, and the protein content was significantly lower. The diclofenac group at 24 h had a diminished total number of white blood cells and a reduced content of transforming growth factor-β. Moreover, the diclofenac group had a reduced percentage of neutrophils at 6 h. Significantly increased levels of D-dimers and tissue plasminogen activator were measured at 6 h and of interleukin-10 at 24 h. Neutrophils at the site of pleural abrasion were significantly reduced.
  
  
  CONCLUSIONS
  Systemic application of diclofenac led to a local enhancement of fibrinolysis and attenuation of pro-inflammatory and fibrotic processes necessary for adhesion formation in our model.
authors: Division of Thoracic Surgery, University Hospital Zürich, Zürich, Switzerland.
authors: Isabelle
authors: I
authors: Opitz
authors: Stephan
authors: S
authors: Arni
authors: Birgit
authors: B
authors: Oberreiter
authors: Lars M
authors: LM
authors: Asmis
authors: Peter
authors: P
authors: Vogt
authors: Valentin
authors: V
authors: Rousson
authors: Walter
authors: W
authors: Weder
authors: Didier
authors: D
authors: Lardinois
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016207:Cytokines / Q000097:blood; D004008:Diclofenac / Q000009:adverse effects*; D005342:Fibrinolysis / Q000187:drug effects*; D018836:Inflammation Mediators / Q000097:blood; D010994:Pleura / Q000276:immunology; D018700:Pleurodesis; D013552:Swine; D020775:Thoracic Surgery, Video-Assisted
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016207:Cytokines; D018836:Inflammation Mediators; D004008:Diclofenac