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Local vs. systemic immune and haemostatic response to hip arthroplasty

Published online by Cambridge University Press:  16 August 2006

M. Kristiansson ,
M. Soop ,
K. G. Sundqvist ,
A. Soop ,
A. M. Suontaka  and
M. Blombäck
M. Kristiansson
Affiliation:
Department of Anaesthesiology and Intensive Care, Karolinska Institute, Huddinge University Hospital, Sweden
M. Soop
Affiliation:
Department of Anaesthesiology and Intensive Care, Karolinska Institute, Huddinge University Hospital, Sweden
K. G. Sundqvist
Affiliation:
Department of Clinical Immunology, Karolinska Institute, Huddinge University Hospital, Sweden Department of Clinical Immunology, University Hospital of Umeå, Sweden
A. Soop
Affiliation:
Department of Anaesthesiology and Intensive Care, Karolinska Institute, Huddinge University Hospital, Sweden
A. M. Suontaka
Affiliation:
Department of Clinical Chemistry and Blood Coagulation, Karolinska Institute, Karolinska University Hospital
M. Blombäck
Affiliation:
Department of Clinical Chemistry and Blood Coagulation, Karolinska Institute, Karolinska University Hospital
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Abstract

Local and systemic immune and haemostatic responses were studied in 10 patients, aged 57–78 years, undergoing elective hip arthroplasty. Cytokines, soluble cytokine receptors, interleukin-1 receptor antagonist, soluble adhesion molecules, antithrombin, fibrin, soluble and fibrin d-dimer were analysed in wound drainage blood and in blood taken from the systemic circulation for up to 24 h post-operatively. Wound drainage blood concentrations of cytokines, interleukin-1 receptor antagonist and soluble cytokine receptors were increased compared with those in the systemic circulation except for the soluble interleukin-6 receptor. In wound drainage blood, soluble tumour necrosis factor receptors (P<0.05), interleukin-1 receptor antagonist (P<0.05) and interleukin-6 (P<0.05–<0.01) increased during the study period. In blood from the systemic circulation interleukin-6 increased (P<0.05) while the soluble interleukin-6 receptor decreased (P<0.05) compared with pre-operative values. Concentrations of soluble adhesion molecules did not change. Wound drainage blood showed marked hypercoagulation. After hip arthroplasty pro-inflammatory cytokines and their inhibitors were mainly confined to the local trauma site. A predominance for inhibitors was noted.

Keywords

haemostatic responselocalsystemiccytokinesfibrinolysiship arthroplasty
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 15 , Issue 3 , May 1998 , pp. 260 - 270
Copyright
1998 European Society of Anaesthesiology

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