Key result
Negative pressure therapy in severe abdominal sepsis is linked to distinct IL10 clearance patterns.
Why the study?
Open abdomen technique with negative pressure therapy is widely used in severe abdominal sepsis, but cytokine clearance in serum and peritoneal fluid during this therapy needed evaluation.
Does negative pressure therapy affect cytokine clearance in serum and peritoneal fluid in patients with severe abdominal sepsis?
Observational (n=6)
Does negative pressure therapy affect cytokine clearance in serum and peritoneal fluid in patients with severe abdominal sepsis?
Cytokines display distinct patterns of clearance or persistence in peritoneal fluid and serum over the first 48 hours of negative pressure therapy for severe abdominal sepsis.
Answers are grounded in this paper and cite their sources.
Does not support practice change in abdominal sepsis; leaves open peritoneal cytokine dynamics under negative pressure therapy.
Objectives Open abdomen technique with negative pressure therapy (NPT) is widely used in patients with severe abdominal sepsis. The aim of this study was to evaluate cytokine clearance in serum and peritoneal fluid during NPT. Methods This prospective pilot study included six patients with severe abdominal sepsis requiring discontinuity resection and NPT for 48 h followed by planned reoperation. Cytokines (IL6, IL8, IL10, TNFalpha, and IL1beta) were measured in the serum and peritoneal fluid during index operation, on postoperative days 0, 1, and 2. Results Concentrations of cytokines in peritoneal fluid were higher than in serum. IL10 showed a clearance both in serum (to 16.6%, p=0.019) and peritoneal fluid (to 40.9%, p=0.014). IL6 cleared only in serum (to 24.7%, p=0.001) with persistently high levels in peritoneal fluid. IL8 remained high in both serum and peritoneal fluid. TNFalpha and IL1beta were both low in serum with wide range of high peritoneal concentrations. Only TNFalpha in peritoneal fluid showed significant differences between patients with ischemia vs. perforation (p=0.006). Conclusions The present pilot study suggests that cytokines display distinct patterns of clearance or persistence in the peritoneal fluid and serum over the first 48 h of treatment in severe abdominal sepsis with NPT.
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Faes et al. (2020) conducted an observational in severe abdominal sepsis (n=6). Open abdomen technique with negative pressure therapy (NPT) was evaluated on Cytokine clearance in serum and peritoneal fluid. Negative pressure therapy in severe abdominal sepsis demonstrated distinct cytokine clearance patterns over 48 hours, with IL10 clearing in both serum and peritoneal fluid.
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