Proinflammatory
cytokines have been implicated in mediating
respiratory failure associated with major surgery. We investigated the effect of giving
glucocorticoids preoperatively for the prophylaxis of surgical stress and the association of
cytokine levels, such as
interleukin-6 (IL-6) and
interleukin-8 (IL-8), with oxygenation after
esophagectomy. We studied 17 patients who underwent subtotal
esophagectomy. Seven patients (
steroid group) were chosen at random to be given
methylprednisolone (10 mg/kg) and 10 patients (control group) to be given saline intravenously before operation. Plasma and bronchoalveolar lavage fluid (BALF)
IL-8 levels in the control group were significantly higher than those in the
steroid group. In both groups, plasma
IL-6 levels were significantly higher than those in BALF, but in contrast, BALF
IL-8 levels were significantly higher than plasma levels of
IL-8 postoperatively. The PaO(2)/FiO(2) ratio was significantly reduced in the control group. The PaO(2)/FiO(2) ratio of the control group had significantly lower values than that of the
steroid group. There was significant correlation between BALF
IL-8 levels and the PaO(2)/FiO(2) ratio postoperatively. We conclude that preoperative administration of
methylprednisolone may attenuate postoperative reduction of arterial oxygen saturation by suppressing the release of
cytokines.