Journal of critical care
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Journal of critical care · Dec 2011
Suppression of high-mobility group box-1 and receptor for advanced glycation end-product axis by polymyxin B-immobilized fiber hemoperfusion in septic shock patients.
Endotoxin plays a role in organ failure in septic shock patients. High-mobility group box 1 (HMGB1) and receptor for advanced glycation end-products (RAGE) axis is also involved in septic shock. We investigated here the effects of endotoxin removal by polymyxin B-immobilized polystyrene fiber (PMX-F) treatment on circulating levels of HMGB1, soluble RAGE (sRAGE), and interleukin-6 (IL-6) in septic shock patients. ⋯ Our present study suggests that PMX-F treatment could block the HMGB1-RAGE axis in patients with septic shock via removal of endotoxin-induced inflammatory reactions.
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Journal of critical care · Dec 2011
Elevated plasma matrix metalloproteinases and their tissue inhibitors in patients with severe sepsis.
Matrix metalloproteinases (MMPs) are essential for tissue remodeling. Our objectives were to determine (1) the concentrations of MMPs and their tissue inhibitors (TIMPs) in plasma obtained from patients with severe sepsis, (2) to correlate changes in MMP and TIMP levels with disease severity, and (3) to investigate recombinant activated protein C (rAPC) actions on plasma MMP2, 9 activities from severe sepsis patients. ⋯ Most plasma MMPs and TIMPS were elevated in patients with severe sepsis, but only a limited subset of MMPs (7, 9) negatively correlated with disease severity. Recombinant activated protein C does not appear to directly alter MMP2, 9 activities.
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Journal of critical care · Dec 2011
Plasma gelsolin levels and 1-year mortality after first-ever ischemic stroke.
Plasma gelsolin depletion has been associated with poor outcome of critically ill patients. We sought to investigate change in plasma gelsolin level after ischemic stroke and to evaluate its relation with disease outcome. ⋯ Plasma gelsolin level is a useful, complementary tool to predict mortality after ischemic stroke.
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Journal of critical care · Dec 2011
Interaction between fluid balance and disease severity on patient outcome in the critically ill.
There is evidence in literature regarding the benefits of immediate aggressive fluid resuscitation together with conservative fluid management approach after initial stabilization. This retrospective study assesses the relationship between fluid balance during intensive care unit (ICU) stay and outcomes among general critically ill patients. In addition, we also aim to see the effect of fluid gain among patients with different disease severity. ⋯ Early adequate fluid resuscitation together with conservative late fluid management may provide better patient outcomes. The effect of fluid management strategy on patient outcome may depend on the underlying disease severity.
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Journal of critical care · Dec 2011
Renal replacement therapy in prolonged mechanical ventilation patients with renal failure in Taiwan.
Renal failure requiring renal replacement therapy (RRT) is associated with a high mortality rate in intensive care unit (ICU) patients. Little information is available on the outcomes of patients having prolonged mechanical ventilation (PMV) in addition to RRT. The purpose of this study was to investigate the impact of RRT in PMV patients. ⋯ The present study demonstrates that the need for RRT had a negative impact on weaning and mortality in PMV patients compared with patients without RRT. Patients who had RRT initiated at the RCC had a significantly lower weaning rate compared with ESRD patients.