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PubMed · 9758732

Glucocorticoid attenuates a decrease of antithrombin III following major surgery.

T Matsutani·M Onda·K Sasajima·M Miyashita
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Abstract

BACKGROUND: Major surgery, such as esophagectomy, activates inflammatory responses and the coagulation system, and this activation is characterized by release of inflammatory cytokines and a decrease in antithrombin-III (AT-III), respectively. Preoperative glucocorticoid administration has been reported to suppress circulatory cytokine levels after major surgery. PATIENTS AND METHODS: A total of 28 patients underwent esophagectomy for esophageal carcinoma; 14 of them were given 10 mg/kg of methylprednisolone intravenously upon induction of anesthesia and 14 served as controls. Circulating levels of tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6), polymorphonuclear (PMN) elastase, thrombin-antithrombin III complex (TAT), AT-III, and albumin were measured before and immediately after the operation and on postoperative days (PODs) 1, 3, 5, and 7. RESULTS: TNF-alpha, IL-6, and TAT levels significantly increased after esophagectomy in both groups. AT-III and albumin decreased to their minimum levels on POD 1 and POD 3, respectively. Methylprednisolone treatment effectively inhibited the increases in TNF-alpha and IL-6 and the decreases in AT-III and albumin, but did not inhibit the increases in PMN-elastase and TAT levels. There were significant correlations between AT-III, IL-6, and albumin levels. CONCLUSIONS: These results suggest that methylprednisolone pretreatment attenuates the decrease in AT-III by reducing IL-6 production postoperatively.

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AgedAntithrombin IIICarcinomaCytokinesEsophageal NeoplasmsEsophagectomyFemaleGlucocorticoidsHumansInflammation MediatorsLeukocyte ElastaseMaleMethylprednisoloneMiddle AgedOsmolar ConcentrationPostoperative PeriodTime FactorsJournal Article

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T Matsutani, M Onda, K Sasajima, M Miyashita. 1998. Glucocorticoid attenuates a decrease of antithrombin III following major surgery.. https://doi.org/10.1006/jsre.1998.5404

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