Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Oct 2001
Review[Sepsis--continual pathogenetic, diagnostic and therapeutic problem].
Sepsis is defined as systemic inflammatory response syndrome (SIRS) caused by infection. Massive activation of humoral and cellular mechanisms of host defense is present and can lead to a multiple organ dysfunction syndrome. Sepsis is good example, that inflammation binds with considerable energetic and metabolic effort of organism i.e. demand for oxygen, protein and microelements. ⋯ Precious advice in selection of antibiotic were given. Advantage penicillins and karbapenems over cephalosporins result from binding to PBP 2 or 1, considerably smaller release of free endotoxin and smaller induction Jarish-Heixhaimer's reaction. The side effect stimulates inflammation and deepens SIRS by release toxins and increase of TNF-alpha.
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Pol. Merkur. Lekarski · Oct 2001
[Results of coronary artery bypass grafting in patients with impaired left ventricular systolic function].
The purpose of this study was to examine the early and late results of CABG in patients with left ventricular ejection fraction (LVEF) lower than 40%. This study comprised 128 patients (114 male and 14 female) at age from 41 to 75 years (mean 58.3 +/- 7.9). Before operation 115 patients (89.8%) were in CCS class III or IV. ⋯ Patients with LVEF < 40% are at higher operative risk because of often postoperative low output syndrome. Low output syndrome can by successfully treated with IABP. CABG significantly improves circulatory sufficiency in patients with LVEF < 40%.