InfectionRoutine clinical markers of the magnitude of the systemic inflammatory response after elective operation: A systematic review
Section snippets
Methods
A literature search was performed with the keywords surgery, endocrine response, systemic inflammatory response, acute phase response, cortisol, IL-6, WCC, and CRP was made of the US National Library of Medicine (MEDLINE), the Excerpta Medica Database (ie, EMBASE), PubMed, and the Cochrane Database of Systemic Reviews (ie, CDSR) for articles that reported cortisol, IL-6, WCC, and CRP after operation. From this, titles of studies and abstracts were analyzed for relevance. Bibliographies of
Study selection process
The selection process is summarized in Fig. With the aforementioned search criteria, abstracts were identified, and the bibliographies of these articles were hand searched for additional articles. In total 296 abstracts were identified and full text obtained. Subsequent analysis of the full text of these articles resulted in 132 being excluded from analysis: 3 were unavailable in English language, 12 were review articles, 5 were animal studies, 14 articles involved emergency or trauma
Discussion
The present review shows that cortisol, IL-6, WCC, and CRP all peak after all types of elective operations, minor and major, laparoscopic and open. The peak responses after operation occur at approximately 0–4 hours for cortisol, 12–24 hours for IL-6, 24–48 hours for WCC, and 24–72 hours for CRP. Only IL-6 and CRP consistently were associated with the magnitude of operative injury. Therefore, IL-6 and CRP would appear to be useful markers for assessing the magnitude of the SIR after elective
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