INFLAMMATORY RESPONSE AFTER ABDOMINAL-TRAUMA, INFECTION, OR INTESTINAL-OBSTRUCTION MEASURED BY OXYGEN RADICAL PRODUCTION IN PERITONEAL-FLUID

BACKGROUND: Reactive oxygen intermediates (ROI) have been implicated i n many pathophysiological processes of inflammatory tissue damage and tissue repair. In the present study we compared the production of ROI in three different types of tissue damage in surgical patients. METHOD S: Peritoneal fluid specimens were harvested during the initial operat ion and postoperatively from 25 surgical patients with abdominal traum a, intraabdominal infection, and intestinal obstruction. The optical d ensity at 412 nm, representing the peroxidation of hemoglobin, was mea sured to assess intraperitoneal ROI production. Patients were categori zed into 3 groups: (A) infected patients with good outcome, (B) patien ts after trauma or obstruction with good outcome, and (C) patients wit h poor outcome due to persistent or secondary infection and multiple o rgan failure, Analysis of variance (ANOVA) and paired t test were used for statistical analysis. RESULTS: Overall, the ROI production decrea sed significantly at days 2 and 3 compared with day 0 and 1 (P = 0.001 3). No initial differences of intraoperative ROI concentrations were f ound among the three groups; however, patients with a poor outcome sho wed increased ROI values after 4 to 5 days (P = 0.038) when compared w ith the good outcome group. CONCLUSIONS: We have demonstrated that int raperitoneal ROI production (1) can be measured in patients with intra abdominal tissue damage, (2) is not different between patients with in traabdominal infections, abdominal trauma, or intestinal obstruction, and (3) correlates with the clinical picture and the presence of an in flammatory intraabdominal focus or tissue damage. (C) 1997 by Excerpta Medica, Inc.