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Effect of preoperative fever-range whole-body hyperthermia on immunological markers in patients undergoing colorectal cancer surgery.
Sulyok, I; Fleischmann, E; Stift, A; Roth, G; Lebherz-Eichinger, D; Kasper, D; Spittler, A; Kimberger, O.
Afiliação
  • Sulyok I; Division of General Anaesthesia and Intensive Care, Department of Anaesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria.
Br J Anaesth ; 109(5): 754-61, 2012 Nov.
Article em En | MEDLINE | ID: mdl-22855633
ABSTRACT

BACKGROUND:

Previous studies have demonstrated beneficial immunological effects of fever-range whole-body hyperthermia (FR-WBH) as an adjunct to non-surgical cancer therapy. We conducted a study of preoperative FR-WBH in patients undergoing colorectal cancer surgery to evaluate perioperative, hyperthermia-induced immunomodulation.

METHODS:

The trial was conducted as a subject-blinded, controlled, randomized study. Subjects in the FR-WBH group (n=9) were treated with FR-WBH before operation under propofol sedation; the target core temperature was 39 (0.5)°C with 1 h warming and 2 h plateau phase. Subjects in the control group (n=9) were treated with propofol sedation only. Blood samples were acquired before and after treatment, after operation, and 24, 48 h, and 5 days after the end of surgery. The following parameters were measured lipopolysaccharide (LPS)-induced tumour necrosis factor (TNF)-α, procalcitonin (PCT), interleukin (IL)-6/10, heat shock proteins (HSPs) 60, 70, and 90, human leucocyte antigen-DR (HLA-DR), and LPS-binding protein (LBP).

RESULTS:

HSPs were increased in the FR-WBH group after treatment [HSP60, 48 h postop 143 (41)% vs 89 (42)%, P=0.04; HSP90, postop 111 (33)% vs 64 (31)%, P=0.04; HSP70 P=0.40; FR-WBH vs control, P-values for area under the level/time curve]. TNF-α levels were elevated after surgery in the control group and remained near baseline in the FR-WBH group [24 h postop 73 (68)% vs 151 (72)%, P=0.04]. PCT increased in both groups 24 h after surgery; in the control group, this increase was significantly higher (P=0.02). There were no significant differences for IL, HLA-DR, or LBP.

CONCLUSIONS:

The immune system to react to surgical stress, as measured by a panel of laboratory indicators, might be improved by preoperative FR-WBH.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Pré-Operatórios / Neoplasias Colorretais / Cirurgia Colorretal / Imunomodulação / Hipertermia Induzida Tipo de estudo: Clinical_trials Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Anaesth Ano de publicação: 2012 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Pré-Operatórios / Neoplasias Colorretais / Cirurgia Colorretal / Imunomodulação / Hipertermia Induzida Tipo de estudo: Clinical_trials Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Anaesth Ano de publicação: 2012 Tipo de documento: Article