Document Detail


Beneficial effects of theophylline infusions in surgical patients with intra-abdominal hypertension.
MedLine Citation:
PMID:  21638083     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intra-abdominal hypertension (IAH) can cause high mortality. Recently, we found that IAH was associated with increased serum levels of adenosine and interleukin 10. Our present "hypothesis-generated study" was based on the above mentioned results.
MATERIALS AND METHODS: In this uncontrolled clinical trial, a total of 78 patients with IAH were enrolled representing a 13-20 mmHg range of intra-abdominal pressure (IAP). Patients requiring surgical abdominal decompression were excluded. Patients were treated with the following protocols: standard supportive therapy (ST, n = 38) or ST plus infusion with the adenosine receptor antagonist theophylline (T, n = 40). Over the 5-day measurement period, IAP was monitored continuously and serum adenosine concentration and other clinical and laboratory measurements were monitored daily. Mortality was followed for the first 30 days following the diagnosis of IAH.
RESULTS: Mortality of ST patients was 55%, which is compatible to other studies. Serum adenosine concentration was found to be directly proportional to IAP. Of the 40 patients receiving T treatment, survival was 100%. An increased survival related to theophylline infusion correlated with improving serum concentrations of IL-10, urea, and creatinine, as well as 24-h urine output, fluid balance, mean arterial pressure, and O(2)Sat.
CONCLUSIONS: Adenosine receptor antagonism with T following IAH diagnosis resulted in markedly reduced mortality in patients with moderated IAH (<20 mmHg). Theophylline-associated mortality reduction may be related to improved renal perfusion and improved MAP, presumably caused by adenosine receptor blockade. Because this study was not a randomized controlled study, these compelling observations require further multicentric clinical confirmation.
Authors:
Zsolt Bodnár; Zoltán Szentkereszty; Zoltán Hajdu; Gilbert A Boissonneault; Sándor Sipka
Related Documents :
2296063 - Altered pulmonary surfactant in uncomplicated and septicemia-complicated courses of acu...
9466283 - Bronchoalveolar lavage cell composition in allogeneic bone marrow transplant patients w...
9764053 - Histological patterns of atherosclerotic plaques in unstable angina patients vary accor...
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-06-03
Journal Detail:
Title:  Langenbeck's archives of surgery / Deutsche Gesellschaft für Chirurgie     Volume:  396     ISSN:  1435-2451     ISO Abbreviation:  Langenbecks Arch Surg     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-16     Completed Date:  2011-12-29     Revised Date:  2012-02-06    
Medline Journal Info:
Nlm Unique ID:  9808285     Medline TA:  Langenbecks Arch Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  793-800     Citation Subset:  IM    
Affiliation:
Department of Surgery, Hospital de Torrevieja, Torrevieja, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
APACHE
Abdomen*
Adenosine / blood
Biological Markers / blood
Compartment Syndromes / drug therapy*,  mortality,  physiopathology
Cytokines / blood
Decompression, Surgical
Female
Humans
Infusions, Intravenous
Male
Middle Aged
Postoperative Complications / drug therapy*,  mortality,  physiopathology
Purinergic P1 Receptor Antagonists / therapeutic use*
Theophylline / administration & dosage,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cytokines; 0/Purinergic P1 Receptor Antagonists; 58-55-9/Theophylline; 58-61-7/Adenosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The role of PERK and GCN2 in basal and hydrogen peroxide-regulated translation from the hepatitis C ...
Next Document:  RGD-conjugated human ferritin nanoparticles for imaging vascular inflammation and angiogenesis in ex...