Critical care : the official journal of the Critical Care Forum
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This review discusses the possible involvement of a variety of genetic polymorphisms on the course of meningococcal disease. It has been shown that several common genetic polymorphisms can either influence the susceptibility to meningococcal disease or can account for a higher mortality rate in patients. Gene polymorphisms concerning antibody receptors, lipopolysaccharide (LPS) binding receptors or proteins, innate complement proteins as well as cytokines and hemostatic proteins are described. The study of genetic polymorphisms might provide important insights in the pathogenesis of meningococcal disease and could make it possible to identify individuals who are at risk of either contracting or dying from meningococcal disease.
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Comparative Study
Use of a rapid arterial blood gas analyzer to estimate blood hemoglobin concentration among critically ill adults.
To evaluate whether measurement of the hemoglobin (Hb) concentration with a blood gas analyzer approximates that determined by a conventional coulter counter in critically ill adults. ⋯ An arterial blood gas analyzer may provide a valid alternative method to the traditional coulter counter for the rapid assessment of Hb concentration among critically ill adults. Since issues related to its safety, quality control, data entry and cost savings have yet to be addressed, however, use of such point of care testing should be viewed as a supplement to conventional laboratory testing.
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Rotating antibiotics in the intensive care unit may result in less infections caused by resistant organisms and in even less mortality. The selection of super-resistant organisms associated with the rotation strategy cannot be excluded, however, and many practical issues will have to be addressed before antibiotic rotation can be routinely recommended.
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Comparative Study
Effects of intravenous furosemide on mucociliary transport and rheological properties of patients under mechanical ventilation.
The use of intravenous (IV) furosemide is common practice in patients under mechanical ventilation (MV), but its effects on respiratory mucus are largely unknown. Furosemide can affect respiratory mucus either directly through inhibition of the NaK(Cl)2 co-transporter on the basolateral surface of airway epithelium or indirectly through increased diuresis and dehydration. We investigated the physical properties and transportability of respiratory mucus obtained from 26 patients under MV distributed in two groups, furosemide (n = 12) and control (n = 14). ⋯ In contrast, no significant changes were observed in the control group. The remaining parameters did not change significantly in either group. Our results support the hypothesis that IV furosemide might acutely impair MCT in patients under MV.