[Evaluation of neutrophil activation using elastase releasing capacity in vitro during perioperative period of...

Neutrophil activation is considered to play a major role in organ dysfunction after severe trauma. Major surgery like esophagectomy also induces various host responses including neutrophil activation and it may be responsible for postoperative complications. We measured neutrophil elastase releasing capacity in 14 patients undergoing esophagectomy to evaluate perioperative changes of neutrophil activation. Elastase releasing capacity was estimated by the fMLP-induced elastase release from separated neutrophils in vitro and expressed as % increase of released elastase activity induced by 0.2 microM fMLP. Elastase releasing capacity was significantly increased from 28.6 +/- 17.7% after induction of anesthesia to 63.7 +/- 38.8% at 72 hours after induction, and decreased to 57.6 +/- 15.4% at 72 hours after induction. Elastase alpha 1-antitripsin inhibitor complex showed no significant increase during perioperative period. Interleukin-6 showed a peak level 24 hours after induction and interleukin-8 was increased significantly 12 hours after induction and maintained the elevated level until 72 hours postoperatively. We concluded that the neutrophil activity was increased during the perioperative period of esophagectomy and the priming of neutrophil took place during extensive surgical intervention.