Journal of critical care
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Journal of critical care · Dec 1995
Multicenter Study Comparative Study Clinical TrialThe influence of clinical study design on cost-effectiveness projections for the treatment of gram-negative sepsis with human anti-endotoxin antibody.
This study was performed to compare the effect of entry criteria, patient population, and study design on outcome and projected cost-effectiveness of human anti-endotoxin antibody (HA-1A). ⋯ Extrapolating cost-effectiveness from RCT-derived analyses to open-label usage may yield widely inaccurate projections because of only small differences in patient population and the drug administration protocol.
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The effective treatment of sepsis and septic shock has remained elusive despite intense research efforts. The tools of molecular biology have been applied to the problem of sepsis in an attempt to design more rational, directed therapy. Cellular interactions with invading microorganisms begin a series of stimulation events within the cell. ⋯ The measurement of cytokines is critically important to our understanding of their role in health and disease. Cytokines may be measured by either immunologic methods or biological assays. Molecular biology has made important contributions to our understanding of sepsis by precisely identifying some of the mediators and providing reagents for therapeutic use.
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Journal of critical care · Dec 1995
Local and systemic effects of endotoxin in contracting skeletal muscle.
This study was performed to determine the direct effect of endotoxin on force generation, O2 consumption and vascular resistance in contracting skeletal muscle. ⋯ Endotoxin must affect muscle force production by acting through intermediates such as cytokines, and the effect is not apparent in the first 60 minutes.
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Although pyruvate supplementation enhances endurance in humans and increases cardiac output in dogs, its effects on cardiac and peripheral vascular function are not known. Thus, we assessed the cardiovascular effects of pyruvate infusion. ⋯ We conclude that pyruvate infusion in normal dogs induces venodilation but does not alter either cardiac contractility or arterial tone.