Different Acute-Phase Response in Newborns and Infants Undergoing Surgery

Abstract

In a prospective clinical study, we investigated the inflammatory response in 88 neonatal subjects (43 boys and 45 girls) who underwent major abdominal surgery owing to congenital malformation involving the gastrointestinal tract and compared it with the response in 20 infants (8 boys, 12 girls; mean age, 4 mo) who underwent elective surgery for resolution of an existing temporary stoma. In both groups, plasma levels of endotoxin, IL-6, and C-reactive protein as well as leukocyte counts were determined during and after surgery. Endotoxin was measured by the Limulus amebocyte test, IL-6 by ELISA, and C-reactive protein by nephelometry. Statistical analyses were performed using the Wilcoxon signed-rank test. A significant increase in circulating endotoxin and a leukocyte shift was observed in the infant group only. Postoperatively, IL-6 levels peaked between 2 and 6 h and C-reactive protein after 24 h in the infant group. In contrast, no significant increase in the levels of endotoxin, IL-6, and C-reactive protein in plasma were observed during and after surgery in the neonatal subjects, except those with gastroschisis. Newborns with gastroschisis developed an inflammatory response after surgery that was less pronounced than the response of infants older than 4 mo. The finding that endotoxemia in newborns does not follow surgical trauma is most likely because of the absence of bacterial colonization of the gastrointestinal tract.

Melatonin reduces oxidative stress in surgical neonates

“…16 Recently, the postoperative values of IL-6 in neonates undergoing major surgery have been studied showing no significant change in their values compared with infants. 18 NOx are end products of NO metabolism, and enhanced formation of NO has been described in different pathologic conditions such as asphyxia, sepsis, or inflammation. 19 NOx also have been studied as marker of oxidative stress.…”

Perbedaan Kadar IL-6 dan C-Reactive Protein pada Anak Pascabedah Perut dengan Bedah Saraf

“…Pada bayi di atas usia 4 bulan, respon yang mirip pasien dewasa baru terlihat. 8 Pada hari ke-5 pascabedah, kadar IL-6 kedua kelompok menurun. Median kadar IL-6 hari ke-5 pascabedah bedah saraf turun menjadi 14, sedangkan pada jenis bedah perut median turun menjadi 22 pg/mL.…”

Inflammatory response in a rat model of gastroschisis is associated with an increase of NF-kappaB

“…Moreover, shorter bowel loops accompany smaller livers. The implications of the hepatic inflammatory process activated in gastroschisis may stimulate new studies of the prognosis and treatment of fetal gastroschisis, as well as studies of responses to the fetal insulin receptors in the presence of in utero inflammatory processes and growth retardation in gastroschisis (27,28).…”