RT Journal Article
SR Electronic
T1 The effect of positive end-expiratory pressure on inflammatory cytokines during laparoscopic cholecystectomy
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 1358
OP 1362
DO 10.15537/smj.2015.11.12442
VO 36
IS 11
A1 Yılmazlar, Firdevs
A1 Karabayırlı, Safinaz
A1 Gözdemir, Muhammet
A1 Usta, Burhanettin
A1 Peker, Murat
A1 Namuslu, Mehmet
A1 Erdamar, Hüsamettin
YR 2015
UL http://smj.org.sa/content/36/11/1358.abstract
AB Objectives: To investigate effects of the positive end-expiratory pressure (PEEP) application of 10 cm H2O on the plasma levels of cytokines during laparoscopic cholecystectomy.Methods: A prospective study was conducted on 40 patients who presented to the Department of General Surgery, Medical Faculty, Turgut Özal University, Ankara, Turkey scheduled for laparoscopic cholecystectomy operation during a 10 month period from September 2012 to June 2013. Forty patients scheduled for laparoscopic cholecystectomy operation were randomly divided into 2 groups; ventilation through zero end-expiratory pressure (ZEEP) (0 cm H2O PEEP) (n=20), and PEEP (10 cm H2O PEEP) (n=20). All patients were ventilated with 8 ml/kg TV. Levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL 10, and transforming growth factor (TGF)-β1 were measured in the pre- and post-operatively collected samples.Results: Blood samples of 30 patients’ were analyzed for plasma cytokine levels, and 10 were excluded from the study due to hemolysis. Post-operative plasma IL-6 levels were observed to be significantly higher than the pre-operative patients (p=0.035). Post-operative plasma TGF-β1 levels in the PEEP group was found significantly higher compared with the pre-operative group levels (p=0.033). However, there were no significant differences in the pre- and post-operative plasma cytokine levels between the 2 groups.Conclusion: The application of PEEP of 10 cm H2O, which has known beneficial effect on respiratory mechanics, does not have any effect on systemic inflammatory response undergoing pneumoperitoneum during laparoscopic cholecystectomy surgery.