Articles: sepsis.
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Critical care medicine · Nov 1996
Comparative StudyEndothelial cell activity varies in patients at risk for the adult respiratory distress syndrome.
The endothelial cell produces many bioactive compounds that are presumed to play important roles in the pathogenesis of the adult respiratory distress syndrome (ARDS). We postulated that individuals with sepsis and trauma-two at-risk diagnoses for the development of ARDS--might demonstrate differences in the degree of endothelial cell activity. ⋯ These findings suggest that differences in endothelial cell activity exist between sepsis and trauma patients who are at risk for the development of ARDS.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1996
[Sepsis score in surgical intensive care medicine].
In a prospective study (400 patients, intensive care stay > 18 h) the following data were documented daily: Clinical sepsis, a modified sepsis score, Apache II-score, number of organ failure, Elastase-concentrations and injury severity score (ISS > or = 20 = polytrauma). On admission day a prognostic assessment for early diagnosis of septic complications during intensive care could be demonstrated by a combination of the modified sepsis score and the number of organ failures and the presence of polytrauma. All other parameters did not have any predictive value.
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Comparative Study
Procalcitonin in patients with and without immunosuppression and sepsis.
High serum levels of procalcitonin (PCT) are observed in patients with sepsis or severe infection. In a prospective study of 122 hospitalised adult medical patients with sepsis, serum PCT was determined on admission and for 9 days thereafter. Patients with no alteration in their immune system showed high PCT values up to day 5, decreasing to normal levels by day 9. ⋯ PCT concentrations fell to base line levels on days 6 to 9 of the sepsis episode in both groups. The observed difference was not significantly related to the kind of causative microorganism or a culture negative sepsis. Leukopenia seemed to go together with lower PCT values after day 2 of the episode, but this could not be proven statistically.
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Anesthesia and analgesia · Nov 1996
Nitric oxide synthase inhibition restores vasopressor effects of norepinephrine in ovine hyperdynamic sepsis.
To investigate the hypothesis that nitric oxide synthase (NOS) inhibition restores the vasopressor response to norepinephrine (NE) in ovine hyperdynamic sepsis, eight sheep were chronically instrumented. In the non-septic portion of the study, NE was titrated to achieve an increase in mean arterial pressure (MAP) by 15 mm Hg ("small dose"). Small-dose NE was repeated 1 h after administration of the NOS inhibitor NG-nitro-L-arginine methyl ester (L-NAME; bolus 5 mg/kg, followed by 1 mg.kg-1.h-1). ⋯ To increase MAP by 15 mm Hg, the NE dose had to be increased to 0.34 +/- 0.06 microgram.kg-1.min-1 (large dose). During L-NAME infusion, NE administration increased MAP by 16 +/- 2 mm Hg and 28 +/- 4 mm Hg (small and large dose, respectively). Thus, L-NAME restored the vasopressor response to NE in sepsis, and increased the vasopressor response to NE in a similar fashion in healthy and septic sheep.
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To study hemodynamic effects of growth hormone (GH) and its main mediator, insulin-like growth factor-1, in a model of critical illness. ⋯ GH promoted metabolic acidosis in traumatized sepsis and impaired compensation of a subsequent hemorrhage.