Critical care medicine
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Critical care medicine · Aug 2006
Tumor necrosis factor-alpha and interleukin-10 gene expression in peripheral blood mononuclear cells after cardiac surgery.
Cytokine response after cardiac surgery may be genetically influenced. A study was carried out to investigate the relation between cytokine gene expression in peripheral blood mononuclear cells, genotype, and clinical events after cardiac surgery. ⋯ There is a predominant anti-inflammatory cytokine response after uneventful cardiac surgery. IL-10 may have a protective role after cardiac surgery.
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Critical care medicine · Aug 2006
Effect of recombinant activated protein C and low-dose heparin on neutrophil-endothelial cell interactions in septic shock.
To examine the effects of recombinant activated protein C (rhAPC) and low-dose heparin on neutrophil-platelet-endothelial cell interactions in septic shock. ⋯ These data suggest that the in vitro addition of rhAPC decreases sepsis-induced interactions between isolated platelets, neutrophils, and endothelial cells. Low-dose heparin attenuates the benefits observed with rhAPC. The changes in neutrophil-endothelial cell interactions demonstrated with rhAPC may play a role in preserving microvascular patency in patients with septic shock.
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Critical care medicine · Aug 2006
Multicenter StudyDynamic versus static respiratory mechanics in acute lung injury and acute respiratory distress syndrome.
It is not clear whether the mechanical properties of the respiratory system assessed under the dynamic condition of mechanical ventilation are equivalent to those assessed under static conditions. We hypothesized that the analyses of dynamic and static respiratory mechanics provide different information in acute respiratory failure. ⋯ Exploiting dynamic respiratory mechanics during incremental PEEP, both compliance and recruitment can be assessed simultaneously. Based on these findings, application of dynamic respiratory mechanics as a diagnostic tool in ventilated patients should be more appropriate than using static pressure-volume curves.
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Critical care medicine · Aug 2006
Accuracy of weight and height estimation in an intensive care unit: Implications for clinical practice and research.
Numerous calculations routinely used in the intensive care require the knowledge of patients' weight and height, although these measurements are not always made. Estimates by doctors or nurses are often substituted. This study sought to ascertain the accuracy of estimates of weight and height of patients made by intensive care unit (ICU) staff. ⋯ Individual estimates of weight and height are frequently inaccurate. These errors of estimation could compromise application of effective therapies, as well as contribute to a reduction in design sensitivity of clinical trials.