Articles: sepsis.
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Clinical Trial Controlled Clinical Trial
Interleukin-1, -6 and tumor necrosis factor-alpha release is down-regulated in whole blood from septic patients.
Proinflammatory cytokines are important mediators during endotoxemia. In experimental models, injection of lipopolysaccharide (LPS) activates macrophages leading to excessive secretion of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta and IL-6; infusion of high dose of these mediators results in organ failure and death. Natural infection may be different, because it persists over days or even weeks, with repeated endotoxin challenge to macrophages. ⋯ These results indicate that different mechanisms down-regulate proinflammatory cytokine release in the whole blood of septic patients. Although excessive secretion is known to be deleterious, low concentrations of these cytokines are involved in regulating essential cellular and humoral immune functions. Thus, the reduced capacity to express and release adequate amounts of proinflammatory cytokines after exposure to endotoxin, as observed in whole-blood PBMCs from septic patients, may contribute to the development of immunodeficiency.
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Critical care medicine · Jan 1996
Nitric oxide synthase inhibition during experimental sepsis improves renal excretory function in the presence of chronically increased atrial natriuretic peptide.
To test whether renal excretory function decreases after nitric oxide synthase inhibition during experimental hyperdynamic sepsis. ⋯ In this ovine model of experimental hyperdynamic sepsis, renal excretory function decreases in the presence of chronically increased concentrations of atrial natriuretic peptide. Administration of the nitric oxide synthase inhibitor, N omega-nitro-L-arginine methyl ester, reverses the vasodilatory state, thereby improving fluid balance and glomerular filtration.
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While hyperoxia is commonly used for treating carbon monoxide poisoning, chronic nonhealing ulcers, acute traumatic and chronically ischemic wounds, and refractory osteomyelitis, its efficacy is unproven in numerous clinical situations, including treatment during severe sepsis. ⋯ Tissue pO2 may be an important regulator of gut barrier function. Hyperoxia treatment appears to play a major role in preserving gut barrier function.