Journal of Biomedical Advancement Scientific Research

Abstract

Introduction: In trauma, lactic acidosis has been associated with a robust inflammatory response and poorer outcomes. However, its effect on peritoneal fluid cytokine production following trauma has not been eluci dated. The aim of this study was to investigate how lactic acidosis is associated with cytokine production in peritoneal fluid of trauma patients after damage control laparotomy (DCL).

Methods: Peritoneal fluid was collected from adult patients undergoing DCL at a Level 1 Trauma Center for blunt or penetrating trauma. Peritoneal fluid cytokine levels were measured using a 10-analyte multiplex assay. Patients were separated by admission serum lactate level: low (≤ 2.5 mmol/L), medium (>2.5 mmol/L and ≤4 mmol/L) and high (>4 mmol/L) based on previous literature. Univariate and multivariate analyses were used to compare the groups.

Results: Of the 61 samples studied from 35 patients, no significant differences in baseline demographics were observed amongst groups. IL-4 significantly differed based on admission lactate and was lowest in the medium group (p=0.005). Multivariable analysis however revealed no significant differences in IL-4 levels amongst groups. Levels of other cytokines studied were not significantly different (p>0.05). No significant differences in general or postoperative complications were seen with differing lactate levels. There were no significant differences in mortality amongst groups (p>0.05).

Conclusion: Lactic acidosis in trauma patients is associated with altered peritoneal fluid cytokine levels, specifically IL-4, an anti-inflammatory cytokine that counteracts the pro-inflammatory cascade. Further in vestigation into the role of lactate as an inflammatory modulator in trauma may provide insight into the local inflammatory response to trauma.