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| Einfluss der intraoperativen Blutglukosekonzentrationen auf die postoperative Infektionsrate sowie die Monozytenfunktion bei Risikopatienten Hagner, Sandra |
| 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 |
| Author(s) | Hagner, Sandra
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. |
| Documents |
Dataobject from FUDISS_thesis_000000014345
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| FU Department | Department of Medicine - Charité - University Medicine Berlin |
| Year of publication | 2010 |
| Document type | Doctoral thesis |
| Media type/Format | Text |
| Language | German |
| Terms of use/Rights | Nutzungsbedingungen |
| Date of defense | 2010-01-29 |
| Created at | 2009-11-26 : 09:27:11 |
| Last changed | 2010-02-19 : 11:32:08 |
| Static URL | http://www.diss.fu-berlin.de/diss/receive/FUDISS_thesis_000000014345 |
| NBN | urn:nbn:de:kobv:188-fudissthesis000000014345-2 |
| Statistics | |
| E-mail address | sandra.hagner@charite.de |
