Critical care : the official journal of the Critical Care Forum
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Editorial
Sequential C-reactive protein measurements in patients with serious infections: does it help?
C-reactive protein (CRP) is a marker of inflammation traditionally used as a complementary tool to support the clinical diagnosis and as a marker of severity of disease. CRP is an acute-phase protein synthesized by the liver after stimulus by cytokines and its serum levels increase markedly within hours after the onset of infection, inflammation or tissue injury. Dynamic serial measurement of CRP has been widely used to help therapeutic decision-making. Decreasing plasma concentrations of this biomarker have been used as an indicator for resolution of infection or sepsis.
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Editorial Comment Letter
Free haemoglobin in 'old' transfused blood - baddy or bystander?
In the previous issue of Critical Care, Vermeulen Windsant and colleagues demonstrate that transfusion of packed red cells is associated with a transient increase in plasma free haemoglobin and scavenging of nitric oxide in vitro. They also demonstrate that older units of blood have more free haemoglobin in their supernatants. Whether the administration of older stored blood results in adverse clinical outcomes is a topical clinical question. The present study proposes a mechanism for transfusion-related harm but also has implications for patients who have other sources of free haemoglobin in their circulation.