Critical care medicine
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Critical care medicine · Mar 2002
Neutrophils and platelets accumulate in the heart, lungs, and kidneys after cardiopulmonary bypass in neonatal pigs.
Cardiac surgery with cardiopulmonary bypass elicits a systemic inflammatory response. An exaggerated response is associated with organ dysfunction and increased morbidity and mortality. ⋯ The cardiopulmonary bypass procedure without cardiac surgery elicits organ dysfunction in terms of impaired respiratory and hemodynamic function. Platelets and polymorphonuclear neutrophils were entrapped in the heart, lungs, and kidneys of cardiopulmonary bypass animals, indicating that cell accumulation may contribute to the developing organ dysfunction.
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Critical care medicine · Mar 2002
Effects of heparin and lisofylline on pulmonary function after smoke inhalation injury in an ovine model.
This study evaluates the effects of heparin alone and in combination with lisofylline, 1-(5-R-hydroxyhexyl)3,7-dimethylxanthine, on severe smoke injury. ⋯ Treatment with heparin alone did not attenuate pulmonary dysfunction after severe smoke injury. Combined treatment with nebulized heparin and systemic lisofylline had beneficial effects on pulmonary function in association with a decrease in blood flow to poorly ventilated areas and less lipid peroxidation.
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Critical care medicine · Mar 2002
Sedation modulates recognition of novel stimuli and adaptation to regular stimuli in critically ill adults.
Responsiveness of critically ill patients is affected by disease and by therapy. Subjective tests of responsiveness (e.g., modified Ramsay score) reflect global integrity of a response arc that includes transduction, perception, classification, and an overt response. The performance of individual components is usually not assessed. ⋯ Commonly administered sedative medications may alter the brain's biophysical state and thereby modulate specific aspects of the brain's information processing and adaptive functions. These functions can be interrogated even when the patient is seemingly unresponsive. If this observation is confirmed in subsequent prospective controlled randomized trials, electrophysiologic interrogation of the brain's information processing and adaptive capacities could serve as an adjunct to clinical assessment of responsiveness and management of sedative medications.
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Critical care medicine · Mar 2002
Complement activation alters myocellular sodium homeostasis during polymicrobial sepsis.
To determine whether complement activation alters sodium homeostasis in fast-twitch skeletal muscles during sepsis, and if protein kinase-C is involved in this process. ⋯ Polymicrobial sepsis alters sodium homeostasis in fast-twitch skeletal muscles, which is significantly attenuated by administration of soluble complement receptor 1. Protein kinase-C inhibition completely blocks changes in myocellular [Na+]i and [Na+]i/[K+]i ratios induced by sublytic zymosan-activated rat sera. Collectively, these results suggest that an inappropriate activation of complement is, at least in part, responsible for changes in skeletal muscle sodium homeostasis during sepsis, and activation of PKC is one of the intracellular signaling pathways by which complement activation alters myocellular sodium homeostasis.