ABSTRACT
Objective: Fluid therapy may affect inflammatory response to surgery. We investigated the effect of volumereplacement with hydroxyethyl starch (HES) or Ringer's Lactate (RL) on cytokines and matrix metalloproteinases (MMPs) postoperative levels.
Methods: Forty-seven patients undergoing moderate or major abdominal surgery under general anaesthesia were allocated to receive intraoperatively and 24 hours postoperatively either only RL (RL-group, n = 25) or HES 130/0.4 combined with RL (HES-group, n = 22) for volume replacement. Blood samples were collected before anaesthesia induction, at the end of operation and 24 hours postoperatively and Cytokines (IL-6, IL-8) and MMPs (MMP-9, MMP-13) were measured.
Results: Demographics, operations and haemodynamics were similar in two groups. RL-group received in total 3983 + 888 ml of RL and HES-group 1068 + 242 ml of HES 130/0.4 plus 2033 + 672 ml of RL, per patient respectively. In all operations, 24 hours postoperatively, IL-8 serum levels were significantly lower in HES-group (14.6 ± 6.9 pg/ml vs 23.2+13.9 pg/ml, p<0.05). In major operations, apart from IL-8, MMP-9 was also affected ([HES-group: 128.3 + 11.8 ng/ml] vs [RL-group: 131.8 + 7.1 ng/ml]; p < 0.05).
Conclusion: HES volume replacement compared to RL presented a lower increase of IL-8 after abdominal surgery. This protective effect was more intensive in major surgeries since both IL-8 and MMP-9 were affected.
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