TY - JOUR
T1 - Early induction of IL-6 in infants undergoing major abdominal surgery
AU - Sweed, Yechiel
AU - Puri, Prem
AU - Reen, Denis J.
PY - 1992/8
Y1 - 1992/8
N2 - Cytokines are immunoregulatory molecules that are important mediators of the host response to stress and infection. Infants and children undergoing major surgery are particularly at risk of developing sepsis and have altered metabolic responses to surgical stress compared to adults. We have investigated the temporal sequence of cytokine responses in six infants (mean age, 11 ± 7.5 months) undergoing pull-through operation for Hirschsprung's disease and correlated them with hemodynamic and biochemical parameters. Tumor necrosis factor (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) were measured by ELISA preoperatively, intraoperatively (hourly), and 24 and 48 hours postoperatively. IL-6 levels increased significantly in all cases within 2 hours of commencement of the operation (P < .01) and were maximal 24 hours postoperatively. No significant changes in IL-1β levels (mean range, 70 to 110 pg/mL) were seen in these patients. TNF levels were undetectable (<20 pg/mL) throughout the study. Cortisol levels were increased in all patients during operation. Serum C-reactive protein levels were first detected 24 hours postoperatively and continued to increase 48 hours postoperatively. Hemodynamically, heart rate increased during the first 3 hours of operation and correlated with increase in IL-6 levels. Blood pressure and temperature changes did not correlate with cytokine levels. This study identifies IL-6 as the earliest detectable cytokine response associated with major surgery in infants. It also suggests that IL-6 can be unregulated, independently of other cytokines, in response to surgical stress.
AB - Cytokines are immunoregulatory molecules that are important mediators of the host response to stress and infection. Infants and children undergoing major surgery are particularly at risk of developing sepsis and have altered metabolic responses to surgical stress compared to adults. We have investigated the temporal sequence of cytokine responses in six infants (mean age, 11 ± 7.5 months) undergoing pull-through operation for Hirschsprung's disease and correlated them with hemodynamic and biochemical parameters. Tumor necrosis factor (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) were measured by ELISA preoperatively, intraoperatively (hourly), and 24 and 48 hours postoperatively. IL-6 levels increased significantly in all cases within 2 hours of commencement of the operation (P < .01) and were maximal 24 hours postoperatively. No significant changes in IL-1β levels (mean range, 70 to 110 pg/mL) were seen in these patients. TNF levels were undetectable (<20 pg/mL) throughout the study. Cortisol levels were increased in all patients during operation. Serum C-reactive protein levels were first detected 24 hours postoperatively and continued to increase 48 hours postoperatively. Hemodynamically, heart rate increased during the first 3 hours of operation and correlated with increase in IL-6 levels. Blood pressure and temperature changes did not correlate with cytokine levels. This study identifies IL-6 as the earliest detectable cytokine response associated with major surgery in infants. It also suggests that IL-6 can be unregulated, independently of other cytokines, in response to surgical stress.
KW - Cytokines
KW - surgical stress, infants
UR - http://www.scopus.com/inward/record.url?scp=0026645869&partnerID=8YFLogxK
U2 - 10.1016/0022-3468(92)90553-J
DO - 10.1016/0022-3468(92)90553-J
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C2 - 1403530
AN - SCOPUS:0026645869
SN - 0022-3468
VL - 27
SP - 1033
EP - 1037
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 8
ER -