engleski

Time course of changes in serum concentration of procalcitonin, interleukin-6 and c-reactive protein after abdominal surgery.

Postoperative increase in procalcitonin (PCT) serum concentration is associated with a nonspecific inflammatory response to a surgical injury. Type and extensiveness of surgery affect the intensity of PCT secretion. We investigated the time course of changes in serum concentrations of PCT, CRP and IL-6 after abdominal surgery with an emphasis on the behaviour of these markers for the occurrence of complications during surgery and postoperative period. Study included 41 patients who had undergone elective abdominal surgery. Perioperative complications, including hypovolemia during surgery and SIRS (systemic inflammatory response syndrome) were monitored throughout the postoperative period. Concentrations of PCT, IL-6 and CRP were measured in all patients before surgery, and 24, 48 and 72 hours after the intervention. Most respondents (80%) had undergone surgery due to diseases of the digestive organs, while 67.9% of treated patients underwent bowel resection. Intraoperative complications were noted in 49.08% and postoperative in 19.5% of cases. There was no statistically significant difference in PCT, IL-6 and CRP increase in patients with intraoperative complications and those without complications. A larger increase of all markers was found in patients with SIRS compared to those without. The results confirm the assumption that transient intraoperative hypovolemia caused by loss of fluid or blood is not a strong enough incentive to increase the secretion of PCT, unlike the factors that encourage SIRS. Unexpectedly high PCT in cases with a normal perioperative course was probably caused by transient endotoxemia, which was not accompanied by any other clinical or laboratory noticeable changes, or biosynthesis of PCT in cancer cells.

bacteremia-complications ; C-reactive protein ; digestive system surgical procedures ; endotoxemia-complications ; infection-complications ; interleukin-6 ; intraoperative complications ; systemic inflammatory response syndrome ; postoperative complications ; procalcitonin

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