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|Einfluss der intraoperativen Blutglukosekonzentrationen auf die postoperative Infektionsrate sowie die Monozytenfunktion bei Risikopatienten|
|Main title||Einfluss der intraoperativen Blutglukosekonzentrationen auf die postoperative Infektionsrate sowie die Monozytenfunktion bei Risikopatienten|
|Title variations||Influence of intraoperative blood glucose on monocyte function and postoperative infection rate in high risk patients|
Place of birth: Heilbronn
|1. Referee||Prof. Dr. med. C. Spies|
|Further Referee(s)||Priv.-Doz. Dr. med. Chr. Hofstetter, Priv.-Doz. Dr. med. Pappert|
|Classification (DDC)||610 Medical sciences; Medicine|
|Summary||The function of monocytes is known as relevant factor for postoperative infection. Besides a diminished expression of HLA-DR a decreased ex-vivo-secretion of TNF-α and IL-10 indicate a monocytal deactivation. Aim of the study was to investigate whether intraoperative blood glucose levels ≥ 140 mg/dl alter the expression of HLA-DR and the function of monocytes.
Material and methods: This study is a prospective observation study with post-ad-hoc design, approved by the local ethic committee. 152 patients classified as ASA 3 and ASA 4 were consecutively included after written consent. Group allocation was carried out upon median intraoperative blood glucose levels at 140 mg/dL according to Gale et al.. Preoperative, postoperative and on the first postoperative day as well HLA-DR-expression as the ex-vivo-secretion in LPS-stimulated monocytes of TNF-α and IL-10 were measured. Infection rates were retrospectively detected regarding CDC criteria. Statistical analysis was performed using Brunner Analysis and Mann-Whitney U-Test.
Results No significant difference could be detected regarding HLA-DR-expression of monocytes among the two groups, as well within the subgroup analysis with and without infection. Likewise no significant difference regarding ex-vivo-secretion of TNF-α and IL-10 could be shown. However a significantly higher infection rate was detected within the hyperglycaemia group. Whereas 14 of 53 (26.4%) of the patients within the hyperglycaemia group suffered from postoperative infection, only 11 of 99 (11.1%) patients within the normoglycaemia group suffered from postoperative infection (p<0.05).
Conclusion Postoperative infections are associated with elevated intraoperative blood glucose levels. Monocyte function does not appear to be causative.
Dataobject from FUDISS_thesis_000000014345
|FU Department||Department of Medicine - Charité - University Medicine Berlin|
|Year of publication||2010|
|Document type||Doctoral thesis|
|Date of defense||2010-01-29|
|Created at||2009-11-26 : 09:27:11|
|Last changed||2010-02-19 : 11:32:08|