Ulus Travma Acil Cerrahi Derg. 2008; 14(1): 14-20

The therapeutic effect of normobaric oxygen in experimental peritonitis and the efficiency of rectal fever, WBC, CRP and procalcitonin in monitoring response of the therapy

Tayfun Yücel¹, Doðan Gönüllü², Salih Güçlü³, Mustafa Þit², Rýza Adaleti⁴, Seza Tetikkurt⁵, Ali Özcan⁶, Ferda Nihat Köksoy^2
1Department Of Health Care And Research Center, Sakarya University,
²Department Of 1. General Surgery, Taksim Traninig And Research Hospital, Istanbul
³Department Of General Surgery, Silifke State Hospital, Mersin
⁴Department Of Microbiology Laboratory, Haydarpaþa Training And Research Hospital, Istanbul
⁵Department Of Patology, Taksim Traninig And Research Hospital, Istanbul
⁶Ahenk Medical Diagnosis and Research Laboratory, Istanbul

BACKGROUND: It was investigated the effect of using normobaric oxygen (NO) in addition to antibiotherapy in experimental peritonitis and the changes of rectal fever (RF), WBC, CRP and procalcitonin levels were evaluated. METHODS: After the preliminary research of the normal values, rats were infected by E. coli intraperitoneally. Four groups were assigned into “no therapy”, “given NO”, “given antibiotic”, “given antibiotic + NO” groups.
RESULTS: The decline of RF and WBC levels on 3rd and 5th days was recorded in antibiotic + NO group versus the other groups. It was observed that group 4 was superior to the others. The positivity of periton cultures and the inflammation in the muscle were found to be less in antibiotic + NO group. No correlation was found between pathological and microbiological recovery and blood CRP level in all groups. But a significant decrease in blood procalcitonin level was determined in group 4 compared to the other groups. On day 3, procalcitonin and CRP levels increased with increasing WBC levels. On day 5, procalcitonin levels also decreased in groups with decreased WBC levels, but no significant correlation was found between CRP and WBC levels. CONCLUSION: It was concluded that using of NO in addition to antibiotherapy could increase the success rate of experimental intraabdominal sepsis therapy and blood procalcitonin and WBC levels could be more beneficial than CRP levels in monitoring of the severity of the sepsis.

Keywords: CRP, experimental peritonitis; leukocyte; normobaric oxygen; rectal fever; procalcitonin; rat, Wistar-albino.

---

Normobarik oksijenin deneysel peritonitin tedavisindeki yeri ve tedavinin izlenmesinde rektal ateþ, lökosit, CRP ve prokalsitoninin etkinliði

Tayfun Yücel¹, Doðan Gönüllü², Salih Güçlü³, Mustafa Þit², Rýza Adaleti⁴, Seza Tetikkurt⁵, Ali Özcan⁶, Ferda Nihat Köksoy^2
1Sakarya Üniversitesi Saðlýk Bilimleri Uygulama Ve Araþtýrma Merkezi, Sakarya
²Taksim Eðitim Ve Araþtýrma Hastanesi 1.genel Cerrahi Kliniði, Ýstanbul
³Silifke Devlet Hastanesi, Genel Cerrahi Servisi, Mersin
⁴Haydarpaþa Numune Eðitim Ve Araþtýrma Hastanesi Mikrobiyoloji Laboratuarý, Ýstanbul
⁵Taksim Eðitim Ve Araþtýrma Hastanesi Patoloji Kliniði, Istanbul
⁶Ahenk Týbbi Taný Ve Araþtýrma Laboratuarý, Istanbul

AMAÇ: Deneysel peritonitte, antibiyotik kullanýmýna normobarik oksijen (O2) eklenmesinin, tedavideki yeri ve bu tedaviye cevabýn izlenmesinde, ateþ, lökosit, C-reaktif protein (CRP) ve prokalsitoninin etkinliðinin araþtýrýlmasý amaçlandý.
GEREÇ-YÖNTEM: Normal deðerleri saptayan ön çalýþmayý takiben gerçekleþtirilen E. coli peritoniti deneyinde, “tedavisiz”, “normobarik O2 tedavisi”, “antibiyotik tedavisi”, “antibiyotik ve normobarik O2 tedavisi” olmak üzere dört grup oluþturuldu.
BULGULAR: Üçüncü ve dördüncü gün rektal ateþin ve kan lökosit deðerinin düþmesi açýsýndan grup 4’ün diðer gruplara üstünlük saðladýðý gözlendi. Grup 4’de periton kültürü pozitifliði anlamlý derecede az bulunurken, patolojik incelemede kas inflamasyonu derecesi en düþük düzeyde bulundu. Kan CRP düzeyi tüm gruplarda anlamlý korelasyonlar gösteremedi. Kan prokalsitonin düzeyinde ise grup 4’de diðer gruplara göre anlamlý azalma saptandý. Üçüncü gün kan lökosit düzeyi arttýkça prokalsitonin ve CRP düzeyi arttý, beþinci gün ise kan lökosit düzeyi düþen gruplarda prokalsitonin düzeyi de düþerken, CRP deðeri ile anlamlý baðlantý kurulamadý. SONUÇ: Deneysel olarak karýniçi sepsis tedavisinde, normobarik O2 tedavisinin antibiyotik tedavisi ile birlikte kullanýlmasýnýn, tedavinin baþarýsýný artýrabileceði ve sepsis þiddetinin takibinde, kan lökosit ile prokalsitonin düzeyinin CRP’ye göre daha deðerli olabileceði kanýsýna varýldý.

Anahtar Kelimeler: CRP, deneysel peritonit; lökosit; normobarik oksijen; prokalsitonin; rektal ateþ; sýçan, Wistar-albino.

---

CITE