Wpływ przedoperacyjnej indukcji metylprednizolonem na uogólnioną reakcję zapalną po resekcji miąższu płuca z powodu raka
Objectives: Mayor surgery is associated with realizing pro-inflammatory mediators. Post-surgical changes in cytokines and acute phase mediators leads to phagocyte and endothelial cell activation, it may resulted circulatory instability and organ dysfunction. We hypothesize that the methyloprednizolone is capable to reduce systemic inflammatory response in lung cancer patients undergoing pulmonary resection.
Influence of metyloprednizolone on acute phase response were analyzed in 60 lung cancer patients undergoing lung resection.
Patients were prospectively randomized to group 1 (n-30) – 15 mg/kg metyloprednizone were given 24 hours pre-operatively and during the operations, or group 2 (n-30) control.
Blood sample was taken 24 hours pre-operatively and at 24 and 72 hours post-operatively for analysis of C-reactive protein (CRP), interleukin 6 (IL-6), tumors necrosis factor (TNF-α).
Number of leucocytes and lymphocytes were counting 24 hours pre-and post-operatively. Complications in both groups were analyzed.
Result: Serum levels of CRP, IL-6 and TNF-α were increased after surgery in both groups. Serum levels of CRP (one and three days) and IL-6 (one day) were significantly lower after surgery in steroids group1. There were not differences between groups in TNF-α levels after surgery.
Frequency of complications like air leakage, hemorrhage and atrial fibrillation statistically were in same level in both groups Conclusions: Methyloprednizolone given the day before and during operations was reduced acute phase response after thoracic surgery. Methyloprednizolone induction did not reduce complications after surgery.
Adres: dr. hab med. Eugeniusz Jadczuk
Katedra i Klinika Chirurgii Klatki Piersiowej AMG
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