Limits of peritoneal cytokine measurements during abdominal lavage treatment for intraabdominal sepsis

Background: Monitoring of peritoneal cytokine concentrations of tumor necro sis factor (TNF)-alpha was recommended for early detection of severe postop erative complications. In the present study the clinical application of cyt okine monitoring was examined in the treatment course of severe peritonitis . Methods: Nineteen patients with secondary peritonitis were followed up duri ng 75 abdominal lavages. Serum and peritoneal interleukin (IL)-6, IL-8, and IL-10 and TNF-alpha were measured before the surgical intervention, after 1 hour, 3 hours, 6 hours, and 24 hours. Additionally, cardiorespiratory par ameters, osmolarity, C-reactive protein, and total leucocyte count were rec orded. Results: Serum and peritoneal cytokine concentrations did not correlate to each other as well as to the observed cardiorespiratory parameters. Periton eal cytokine concentrations were 10- to 1000-fold higher to serum concentra tions and showed an intermittent wash out. There were no differences in det ermined cytokine concentrations between survivors and nonsurvivors Conclusions: Once elevated, peritoneal cytokine measurements offer no new d iagnostic or prognostic tool in abdominal lavage peritonitis treatment. (C) 2001 Excerpta Medica, Inc. All rights reserved.