Abstract
We have previously shown that the mixture of bicarbonate and calcium in the solutions for continuous renal replacement therapies (CRRT) leads to the formation of crystals and a decrease in the delivered dose of calcium. The aim of this study was to investigate the impact of bicarbonate/calcium and lactate/calcium solutions for CRRT on polymorphonuclear cell (PMN) viability and function. We tested four customized bicarbonate buffered solutions: the single bag (bicarbonate and calcium mixed 24 hours before testing), the double bag (mixed immediately before), and the filtered single bag and double bag solutions. We also tested one commercial lactate buffered solution. Blood from six volunteers was incubated with the test solution for 30 min followed by PMN isolation. Isolated PMNs were resuspended in 50% RPMI + 50% autologous serum and kept overnight. Viability, necrosis and apoptosis were analyzed by annexin V and PI staining. Phagocytosis was determined by the analysis of Staphylococcus aureus-PI stained PMN and ROS production by the mean fluorescence intensity of DCFH in these cells. There was no difference between the test solutions with respect to PMN viability and function. Lactate and bicarbonate had similar effects on PMN viability and function. More studies are mandatory to elucidate the impact of CRRT solutions on other inflammatory cells and pathways, particularly on the cytokines associated with systemic inflammatory response syndrome and sepsis.
Highlights
Cardiac surgery with cardiopulmonary bypass (CPB) is a recognized trigger of systemic inflammatory response, usually related to postoperative acute lung injury (ALI)
In 14 patients, bone marrow was harvested from iliac crest and Bone marrow-derived mononuclear cell (BM-MNC) were selected by Ficoll gradient
The objective was to evaluate the characteristics of Chest pain (CP) in patients with acute aortic dissection (AAD) admitted in a chest pain unit (CPU)
Summary
Cardiac surgery with cardiopulmonary bypass (CPB) is a recognized trigger of systemic inflammatory response, usually related to postoperative acute lung injury (ALI). Few studies exist analysing the handling of acute respiratory insufficiency with invasive mechanical ventilation (IMV) and its correlation with mortality among the elderly intensive care unit (IUC) patient population. In Brazil, most patients with TBI are managed in general ICUs. The results of the treatment of patients admitted to nonspecialized ICUs must be compared with those obtained in neurosurgical ICUs. An acute confusional state (ACS) has been a frequent finding in patients undergoing cardiac surgery (CS), which, according to the literature, has resulted in a greater number of complications and in an increase in hospitalization and length of stay in the intensive care unit (ICU). The mortality of elderly patients who are admitted to intensive care units (ICU) has been the aim of some recent studies. Drugs that modulate such phenotypic alterations may be useful in the control of these and other clinical situations
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