Abstract
Purpose: The purpose of the study was to analyze the pro-inflammatory cytokines (TNF, IL-1, IL-6 and HNP) profile in the peritoneal fluid in preterm infants with intestinal perforation due to Necrotizing enterocolitis (NEC) or Spontaneous Intestinal Perforation (SIP) treated with percutaneous peritoneal drainage. Methods: 6 infants with intestinal perforation due to NEC or SIP treated with peritoneal drainage were analyzed prospectively. Samples of peritoneal fluid were drawn for 36 hours after drain placement. Concentrations of cytokines: TNF, IL-1, IL-6 and Human Neutrophil Peptide (HNP-1) were determined using enzyme like immunoassay technique. Results: The peritoneal fluid concentrations of TNF were 0-11,963 pg/mL (mean 960±2.249 pg/mL), IL-1 were 0-10,390 pg/mL (mean 968±2.219 pg/mL), IL-6 were 0.3-1.660 ng/mL (mean 184±335 ng/mL), HNP were 0.04-18.36 μg/mL (mean 3.18±4.32 μg/mL). Peritoneal fluid TNF level>1.000 pg/mL, IL-1>500-1.000 pg/mL and IL-6>200-500 ng/mL were associated with fatal outcome. Conclusions: In analyzed material the pattern of pro-inflammatory cytokines concentrations in peritoneal fluid after intestinal perforation in preterm infants was not identified. The highest peritoneal fluid TNF, IL-1 and IL-6 concentrations were related to fatal outcome in the most premature infants with unspecified extent of intestinal necrosis.
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