European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes
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The aim of this study was to characterize the changes in the quantitative expression of beta 2-integrins and L-selectin detected by means of fluorochrome-conjugated monoclonal antibodies and flow cytometry on leukocytes in the systemic circulation after a major musculoskeletal trauma, i.e. hip replacement surgery, and to relate these changes to parameters of the acute-phase response [plasma acute-phase reactants (C-reactive protein, CRP, and interleukin-6, IL-6) and parameters of coagulation activation (thrombin-antithrombin III complexes, TAT)]. Eight patients with either primary or secondary osteoarthritis of the hip received uncemented total hip prostheses. LFA-1 (CD11a/CD18) was upregulated on granulocytes during the operation. ⋯ The rise in CRP was inversely correlated with the maximal increase in expression of MAC-1 on monocytes. In conclusion, the changes in leukocyte adhesion molecules during and after surgery indicate changes in critical leukocyte functions. The lack of correlation between quantitative up- and downregulation of leukocyte beta 2-integrins and parameters of the acute phase response suggests that these processes are regulated through independent pathways or that functional up- and downregulation of adhesion molecules, shedding, leukocyte-endothelial adhesion and mobilization of new unactivated cells may result in a net estimate of leukocyte activation not suspected to be positively correlated to acute-phase reactants.
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Bacteria transfer to the blood from the peritoneum is thought to be augmented when the diaphragmatic stomata are activated by an increased intra-abdominal pressure. Therefore, it may be expected that the increase in intra-abdominal pressure during laparoscopic surgery can augment the absorption of bacteria from the peritoneum to the blood. The present study examines the effect of pneumoperitoneum on bacteremia in experimental Escherichia coli peritonitis in rabbits. ⋯ In all groups, the growth value (GV) was measured in the 3rd- and 6th-hour blood cultures using the Bactec NR 730 system. There was no difference in the 3rd- and 6th-hour GVs (p > 0.05) among the three groups. In conclusion, pneumoperitoneum with 15 mm Hg CO2 in experimental E. coli peritonitis did not increase the bacteremia when compared with the control and laparotomy groups.