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Postoperative changes in resting energy expenditure and interleukin 6 level in infants
M O Jones1, A Pierro, I A Hashim
1Department of Child Health, University of Liverpool, UK.
Insights
Resting energy expenditure (REE) increased post-surgery in infants, peaking early. Interleukin-6 (IL-6), a stress marker, also rose, correlating with operative severity and potentially modulating the infant stress response.
Area of Science:
- Pediatric surgery
- Metabolic response to stress
- Inflammatory markers in infants
Background:
- Postoperative recovery in infants is complex.
- Understanding metabolic and inflammatory changes is crucial for infant care.
- Interleukin-6 (IL-6) is a key inflammatory cytokine.
Purpose of the Study:
- To investigate the relationship between resting energy expenditure (REE) and interleukin-6 (IL-6) levels after surgery in infants.
- To assess the correlation between IL-6 levels and operative severity.
- To explore the role of IL-6 in the infant stress response.
Main Methods:
- Studied 16 infants undergoing uncomplicated surgery.
- Measured plasma IL-6 levels at multiple time points post-surgery.
- Assessed REE using indirect calorimetry and urinary nitrogen excretion.
- Recorded operative stress scores.
Main Results:
- IL-6 levels significantly increased post-surgery, peaking at 12 hours.
- A linear correlation was found between IL-6 increase and operative severity score.
- REE significantly increased post-operation, peaking at 2-4 hours, preceding IL-6 changes.
- REE returned to baseline by 12 hours.
Conclusions:
- IL-6 serves as a marker for the infant surgical stress response.
- Changes in REE occur earlier than IL-6 elevation post-surgery.
- IL-6 may influence the modulation of the infant stress response following surgery.
Abstract:
The relationship was determined between resting energy expenditure (REE) and interleukin (IL)6 level following surgery in infants. Sixteen infants of mean(s.e.m.) weight 3.2(0.2) kg undergoing uncomplicated surgery were studied. The operative stress score was recorded and plasma IL-6 levels were measured before and 4, 8, 12 and 24 h after surgery. Respiratory gas exchange was measured by indirect calorimetry before and at 2, 4, 6, 8, 10, 12, 24 and 48 h. Urinary nitrogen excretion was measured and calculated. IL-6 levels increased significantly after surgery (P = 0.006) and were maximal at 12 h. There was a linear correlation between the increase in IL-6 level and operative severity score (r = 0.61, P = 0.012). REE increased significantly after operation (P < 0.001), peaking at 2-4 h, and returned to baseline levels by 12 h. The changes in REE preceded those in IL-6. IL-6 is a marker of the stress response in infants and may play a role in the subsequent modulation of this response.