Preoperative Oral Application of Immunoglobulin-Enriched Colostrum Milk and Mediator Response During Abdominal Surgery
2002; Lippincott Williams & Wilkins; Volume: 17; Issue: 1 Linguagem: Inglês
10.1097/00024382-200201000-00002
ISSN1540-0514
AutoresEdwin B lke, Peter Jehle, F. Hausmann, Armin D ubler, H Wiedeck, Gerald Steinbach, Martin Störck, Klaus Orth,
Tópico(s)Pediatric Pain Management Techniques
ResumoOur objective was to evaluate the influence of pre-operative oral application of an immunoglobulin-enriched milk preparation on endotoxin translocation and mediator release during and after abdominal surgery. Forty patients who had been treated by partial (n = 4) or total gastrectomy (n = 8) or pancreatic resection (n = 28) were enrolled in a placebo-controlled pilot study. Pre-operatively, patients were randomly treated for 3 days by oral application of a bovine milk preparation (lactobin 56g/day, n = 20) or placebo (n = 20). In both groups, endotoxin translocation and mediator release was studied pre- and intraoperatively by measuring endotoxin, endotoxin-neutralizing capacity (ENC), interleukin 6, C-reactive protein, transferrin, alpha-2-macroglobulin, albumin, apoliprotein-A1/-B, IgG, IgA, and IgM. The clinical course was followed up by daily evaluation of the Apache-II-score. Clinical data were comparable in both groups. The lactobin group showed significantly lower levels of endotoxin and ENC compared to the placebo group. Acute phase response, endotoxin-binding proteins, and clinical outcome did not differ between both groups. We conclude that prophylactic oral application of lactobin reduces perioperative endotoxemia and prevents reduction of ENC, suggesting a stabilization of gut barrier during abdominal surgery.
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