Minerva anestesiologica
-
Minerva anestesiologica · Sep 2009
Randomized Controlled TrialExpression of monocyte human leukocyte antigen-DR in relation with sepsis severity and plasma mediators.
After an initial septic hit, the immune response to a new antigen changes as time progresses, with an unpredictable efficiency. The aim of this study was to characterize the monocyte functional phenotype by HLA-DR expression in septic patients at the onset of sepsis and during recovery in relation to organ failure and plasma mediators. ⋯ At the onset of sepsis, an initial low mHLA-DR was not related to any prior IS drug regimen, the severity of the sepsis or the outcome. The duration of mHLA-DR downregulation could be related to plasma factors in SOF, while other mechanisms may be implicated in MOF evolution.
-
The application of transesophageal echocardiography (TEE) in the perioperative setting has been expanding over the past decades. TEE has become increasingly important in the management of critically ill patients both in the operating room and in the intensive care unit (ICU). TEE is a semi-invasive imaging technique that provides a rapid, real-time, bedside assessment of cardiac function and morphology. ⋯ Hemodynamic parameters, such as volumes and pressures, can be obtained via TEE assessment of cardiac performance and may be helpful for diagnosis and treatment. Intraoperative TEE is actually considered an important diagnostic tool in patients scheduled for cardiac surgery as well as in high-risk patients undergoing non-cardiac surgery. All types of hemodynamic impairment can be quickly assessed via TEE, and the management of the echo data can define both the cause and the diagnosis.
-
Minerva anestesiologica · Sep 2009
Editorial CommentInfection versus innate immunity in septic shock.