Journal of critical care
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Journal of critical care · Aug 2012
Absolute eosinophils count as a marker of mortality in patients with severe sepsis and septic shock in an intensive care unit.
Eosinophils in the circulating blood undergo apoptosis during sepsis syndromes induced by the action of certain cytokines. ⋯ Eosinophils counts were lower in patients who died of sepsis than in those who survived, but its clinical usefulness seems limited. Their role as an indicator of clinical stability seems to be important.
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Journal of critical care · Aug 2012
Comparative StudySerum neutrophil gelatinase-associated lipocalin in ballistic injuries: a comparison between blast injuries and gunshot wounds.
Neutrophil gelatinase-associated lipocalin (NGAL) is part of a functionally diverse family of proteins that generally bind small, hydrophobic ligands. Neutrophil gelatinase-associated lipocalin is expressed in a number of human tissues including gastrointestinal, respiratory, and urinary tracts and tends to rise in response to inflammation. For this reason, we hypothesized that levels of NGAL might be expressed at higher levels after blast injury compared with other ballistic injury. ⋯ Neutrophil gelatinase-associated lipocalin is not a specific marker of blast injury but is predictive of both renal failure and poor outcome.
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Journal of critical care · Aug 2012
Multicenter StudyEvolution of neutrophil apoptosis in septic shock survivors and nonsurvivors.
The aims were to analyze the temporal evolution of neutrophil apoptosis, to determine the differences in neutrophil apoptosis among 28-day survivors and nonsurvivors, and to evaluate the use of neutrophil apoptosis as a predictor of mortality in patients with septic shock. ⋯ During the first 12 days of septic shock development, the level of neutrophil apoptosis decreases and does not recover normal values. No differences were observed between surviving and nonsurviving patients.
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Journal of critical care · Aug 2012
Prevalence and characteristics of nonlactate and lactate expressors in septic shock.
The study's objective was to determine the proportion and patient characteristics of patients in vasopressor-dependent septic shock who presented without lactatemia. ⋯ Almost one-half of patients with vasopressor-dependent septic shock did not express lactate on presentation, although a high mortality rate remains in this population. We found a significant association between lactate expressors and liver disease and between lactate expressors and positive blood cultures. The use of lactatemia as the sole indicator of need for additional intravenous fluid or an end point of resuscitation in septic shock may be inadequate.