Abstract
Genetic factors may predispose to increased risk for sepsis in critically ill patients. Mannose-binding lectin (MBL) is an important factor in innate immune defence. Accordingly, we investigated whether MBL gene polymorphisms causing low levels of functional MBL in the the blood are associated with the development and progression of sepsis in adult intensive care patients. In 272 patients with systemic inflammatory response syndrome followed prospectively, different MBL genotypes were compared with respect to microbiology, sepsis development, and survival. The presence of MBL variant alleles was highly significantly associated with development of sepsis, severe sepsis and septic shock in a gene dose-dependent fashion. An increased risk of death was observed in variant allele carriers. These data show that a genetic factor such as MBL insufficiency plays an important role in the susceptibility of critically ill patients for development and progression of sepsis, and confer a substantial risk for fatal outcome.
Highlights
In contrast to conventional surgical tracheostomy, percutaneous dilational tracheostomy (PDT) in different variants is spreading rapidly in intensive care units today
Summary Our study demonstrated that LS is a good alternative to restore cardiac contractile function when combined with NE
The use of AVP may lead to further deteriorate sepsis-related myocardial dysfunction even when combined with a positive inotropic agent
Summary
In contrast to conventional surgical tracheostomy, percutaneous dilational tracheostomy (PDT) in different variants is spreading rapidly in intensive care units today. The objectives of the current study were (1) to assess the prognostic significance of plasma concentrations of NSE for early prediction of outcome in patients at risk for anoxic encephalopathy after cardiopulmonary resuscitation (CPR), and (2) to compare the prognostic information provided by NSE measurements with that provided by conventional risk indicators (clinical neurological examination and computerised tomography [CT] scan of the brain). Independent pulmonary ventilation was introduced in the 1930s and allows the utilization of different ventilatory strategies for each lung to improve gas exchange, respiratory mechanics or both in patients with heterogeneous lung diseases It is not clear whether the lower inflection point (LIP) on the inspiratory limb or the point of maximum curvature (PMC) on the deflation limb of the pressure–volume (PV) curve should be used for the positive end-expiratory pressure (PEEP) setting in acute lung injury (ALI). The long-term outcome, health-related quality of life (HRQL), and ICU and hospital costs of medical ICU patients were assessed
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