PREDICTIVE VALUE OF INTERLEUKIN-6 (IL-6), INTERLEUKIN-8 (IL-8) AND GASTRIC INTRAMUCOSAL PH (PH-I) IN MAJOR ABDOMINAL-SURGERY

Objective: To study plasma concentrations of interleukin 6 (IL-6) and interleukin 8 (IL-8) in patients with splanchnic hypoxia, as documente d by gastric intramucosal measurements (pH-i), during major abdominal surgery and the relationship between IL-6 and IL-8 concentrations and postoperative complications as well as clinical outcome. Design: A pro spective study. Patients: Twelve patients scheduled for major abdomina l surgery with no evidence of coexisting infectious disease. Results: Six out of seven samples from patients with postoperative complication s showed intraoperative pH-i levels lower than 7.32 and IL-6 levels hi gher than 300 pg/ml. Seven out of nine samples from patients without c omplications showed pH-i levels higher than 7.32 and IL-6 levels lower than 300 pg/ml. The difference in the pattern of distribution was sta tistically significant (p < 0.01). Only two out of seven samples of pa tients with postoperative complications showed intraoperative pH-i lev els lower than 7.32 and IL-8 levels higher than 60 pg/ml. It was not p ossible to identify a clear distribution pattern of data points for IL -6 and IL-8 during the postoperative period. Conclusions: Intraoperati ve splanchnic ischemia, as documented by gastric intramucosal pH-i, is directly correlated to the increase of IL-6 plasma levels and to the incidence of postoperative complications, while IL-8 levels showed no correlation with surgical complications.