Effects of Mild perioperative hypothermia on cellular immune responses

Unintentional perioperative hypothermia is a common complication of anesthesia and surgery associated with adverse effects on several systems, including impaired wound healing and more frequent wound infections. Mild hypothermia affects various immune functions. In the current study, the authors sou...

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Veröffentlicht in:Anesthesiology (Philadelphia) 1998-11, Vol.89 (5), p.1133-1140
Hauptverfasser: BEILIN, B, SHAVIT, Y, RAZUMOVSKY, J, WOLLOCH, Y, ZEIDEL, A, BESSLER, H
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container_issue 5
container_start_page 1133
container_title Anesthesiology (Philadelphia)
container_volume 89
creator BEILIN, B
SHAVIT, Y
RAZUMOVSKY, J
WOLLOCH, Y
ZEIDEL, A
BESSLER, H
description Unintentional perioperative hypothermia is a common complication of anesthesia and surgery associated with adverse effects on several systems, including impaired wound healing and more frequent wound infections. Mild hypothermia affects various immune functions. In the current study, the authors sought to determine whether immune alterations in the perioperative period might be induced, at least in part, by impaired thermoregulation during this period. Sixty patients undergoing abdominal surgery were randomly assigned to two thermal care groups: routine care or forced-air warming. The patients' anesthetic care was standardized. Venous blood samples were collected 90 min before induction of anesthesia and immediately, 24 h, and 48 h after surgery. White cells were separated and frozen. Peripheral blood mononuclear cells were used to test cytokine production (interleukins [IL] -1beta, -2, and -6; tumor necrosis factor-alpha [TNF-alpha]), mitogens-induced proliferation, and natural killer NK cell cytotoxicity. Plasma cortisol levels were also determined. Patients in the normothermia group maintained normal body core temperature, whereas temperature decreased by approximately 1 degree C in the hypothermia group. Mitogenic responses were suppressed in cells from patients in the hypothermia but not in the normothermia group 24 and 48 h after surgery. Proinflammatory cytokine (IL-1beta, IL-6, TNF-alpha) production increased in both groups, although the production of IL-1beta was significantly higher in the normothermia group 24 h after surgery. Production of IL-2 was suppressed in the hypothermia but not in the normothermia group at 24 h. Mild perioperative hypothermia suppressed mitogen-induced activation of lymphocytes and reduced the production of certain cytokines, IL-1beta and IL-2, and in this way may contribute to the immune alterations observed in the perioperative period.
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Mild hypothermia affects various immune functions. In the current study, the authors sought to determine whether immune alterations in the perioperative period might be induced, at least in part, by impaired thermoregulation during this period. Sixty patients undergoing abdominal surgery were randomly assigned to two thermal care groups: routine care or forced-air warming. The patients' anesthetic care was standardized. Venous blood samples were collected 90 min before induction of anesthesia and immediately, 24 h, and 48 h after surgery. White cells were separated and frozen. Peripheral blood mononuclear cells were used to test cytokine production (interleukins [IL] -1beta, -2, and -6; tumor necrosis factor-alpha [TNF-alpha]), mitogens-induced proliferation, and natural killer NK cell cytotoxicity. Plasma cortisol levels were also determined. 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Cell therapy and gene therapy</subject><subject>Antibody-Dependent Cell Cytotoxicity - physiology</subject><subject>Biological and medical sciences</subject><subject>Body Temperature - physiology</subject><subject>Cell Division - drug effects</subject><subject>Cell Division - physiology</subject><subject>Female</subject><subject>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Antibody-Dependent Cell Cytotoxicity - physiology</topic><topic>Biological and medical sciences</topic><topic>Body Temperature - physiology</topic><topic>Cell Division - drug effects</topic><topic>Cell Division - physiology</topic><topic>Female</topic><topic>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Hypothermia - immunology</topic><topic>Immunity, Cellular - physiology</topic><topic>Interleukin-1 - blood</topic><topic>Interleukin-2 - blood</topic><topic>Intraoperative Complications - immunology</topic><topic>Killer Cells, Natural - immunology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mitogens - pharmacology</topic><topic>Neutrophils - immunology</topic><topic>Neutrophils - physiology</topic><topic>Tumor Necrosis Factor-alpha - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BEILIN, B</creatorcontrib><creatorcontrib>SHAVIT, Y</creatorcontrib><creatorcontrib>RAZUMOVSKY, J</creatorcontrib><creatorcontrib>WOLLOCH, Y</creatorcontrib><creatorcontrib>ZEIDEL, A</creatorcontrib><creatorcontrib>BESSLER, H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anesthesiology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BEILIN, B</au><au>SHAVIT, Y</au><au>RAZUMOVSKY, J</au><au>WOLLOCH, Y</au><au>ZEIDEL, A</au><au>BESSLER, H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Mild perioperative hypothermia on cellular immune responses</atitle><jtitle>Anesthesiology (Philadelphia)</jtitle><addtitle>Anesthesiology</addtitle><date>1998-11-01</date><risdate>1998</risdate><volume>89</volume><issue>5</issue><spage>1133</spage><epage>1140</epage><pages>1133-1140</pages><issn>0003-3022</issn><eissn>1528-1175</eissn><coden>ANESAV</coden><abstract>Unintentional perioperative hypothermia is a common complication of anesthesia and surgery associated with adverse effects on several systems, including impaired wound healing and more frequent wound infections. Mild hypothermia affects various immune functions. In the current study, the authors sought to determine whether immune alterations in the perioperative period might be induced, at least in part, by impaired thermoregulation during this period. Sixty patients undergoing abdominal surgery were randomly assigned to two thermal care groups: routine care or forced-air warming. The patients' anesthetic care was standardized. Venous blood samples were collected 90 min before induction of anesthesia and immediately, 24 h, and 48 h after surgery. White cells were separated and frozen. Peripheral blood mononuclear cells were used to test cytokine production (interleukins [IL] -1beta, -2, and -6; tumor necrosis factor-alpha [TNF-alpha]), mitogens-induced proliferation, and natural killer NK cell cytotoxicity. Plasma cortisol levels were also determined. Patients in the normothermia group maintained normal body core temperature, whereas temperature decreased by approximately 1 degree C in the hypothermia group. Mitogenic responses were suppressed in cells from patients in the hypothermia but not in the normothermia group 24 and 48 h after surgery. Proinflammatory cytokine (IL-1beta, IL-6, TNF-alpha) production increased in both groups, although the production of IL-1beta was significantly higher in the normothermia group 24 h after surgery. Production of IL-2 was suppressed in the hypothermia but not in the normothermia group at 24 h. Mild perioperative hypothermia suppressed mitogen-induced activation of lymphocytes and reduced the production of certain cytokines, IL-1beta and IL-2, and in this way may contribute to the immune alterations observed in the perioperative period.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>9822001</pmid><doi>10.1097/00000542-199811000-00013</doi><tpages>8</tpages></addata></record>
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subjects Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Antibody-Dependent Cell Cytotoxicity - physiology
Biological and medical sciences
Body Temperature - physiology
Cell Division - drug effects
Cell Division - physiology
Female
General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation
Humans
Hydrocortisone - blood
Hypothermia - immunology
Immunity, Cellular - physiology
Interleukin-1 - blood
Interleukin-2 - blood
Intraoperative Complications - immunology
Killer Cells, Natural - immunology
Male
Medical sciences
Middle Aged
Mitogens - pharmacology
Neutrophils - immunology
Neutrophils - physiology
Tumor Necrosis Factor-alpha - metabolism
title Effects of Mild perioperative hypothermia on cellular immune responses
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