Critical care medicine
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Critical care medicine · Apr 2007
Early modifiable factors associated with fatal outcome in patients with severe traumatic brain injury: a case control study.
Survival of patients with severe traumatic brain injury may be improved by minimizing secondary brain injury. We aimed to identify potentially modifiable contributors to secondary brain injury that may persist and adversely affect patient outcome. ⋯ In patients with severe traumatic brain injury, lower blood pressure in the first 4 hrs after admission was associated with mortality and may have increased the rate of secondary brain injury. Outcomes of patients with severe traumatic brain injury may potentially be improved by early targeting of the higher mean arterial pressure observed in survivors (mean arterial pressure 80 mm Hg), which may facilitate improved cerebral perfusion. Slower initiation of intracranial pressure monitoring and of intensive care unit admission may also have adversely affected outcomes, whereas persistent hypothermia was associated with nonsurvival.
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Critical care medicine · Apr 2007
Selective alpha7-nicotinic acetylcholine receptor agonist GTS-21 improves survival in murine endotoxemia and severe sepsis.
Tumor necrosis factor and high mobility group box 1 are critical cytokine mediators of inflammation. The efferent vagus nerve inhibits cytokine release through alpha7-nicotinic acetylcholine receptor-mediated cholinergic signaling. Here we studied whether GTS-21, a selective alpha7-nicotinic acetylcholine receptor agonist, inhibits proinflammatory cytokines in vitro and in vivo and improves survival in murine endotoxemia and severe sepsis. ⋯ These findings are of interest for the development of alpha7-nicotinic acetylcholine receptor agonists as a new class of anti-inflammatory therapeutics.