Abstract
Death of patients from septic shock is usually associated to severe reduction of systemic vascular resistances and severe hypotension despite elevated cardiac output values. The mediator of vasodilatation, nitric oxide (NO), is synthesised by the inducible NO synthase. Excess NO synthesis during septic shock causes abnormal vasodilatation [1]. A possible therapeutic approach is represented by the pharmacological inhibition of the enzyme guanylate cyclase by methylene blue (MB), a long known and safe pharmacological approach for the treatment of nitrate intoxication and methemoglobinemia [2]. The aim of the present study is the evaluation of short term effects of methylene blue on hemodynamics and gas exchange in patients with septic shock.
Highlights
Brain swelling (BS) is a kind of response observed in 15%– 20% of severe head injury
Conclusions: (i) The oxygen free radical (OFR) and LA have some important effect in postischemic-anoxic encephalopathy. (ii) Mild hypothermia induced immediately with reperfusion after Cardiac arrest (CA) may improve cerebral outcome. (iii) The mechanism of this beneficial effect may be to reduce the generation of OFR and to mitigate the lipid peroxidation induced by OFR
We describe our experience with a new and novel method for insertion of a percutaneous tracheostomy minimising the inherent risks of bleeding, misplacement and pneumothorax which have been described with other techniques
Summary
Brain swelling (BS) is a kind of response observed in 15%– 20% of severe head injury. Mean arterial blood pressure in fair prognosis patients increased significantly compared with control values, while slight decreases occurred in leukocyte and platelet counts after 30 min of this treatment. Methods: After approval of the ethics committee and written informed consent, 12 patients (6 male and 6 female, mean age 59 ± 10 years) undergoing elective liver resection randomly received either 0.4 g/kg HBOC-201 (Biopure MA, group 1) or 3 ml/kg of hydroxyethylstarch 70,000/0.5 (B Braun, FRG, group 2) after autologous blood donation of 1 l. Subjects and methods: A prospective study evaluating the efficacy of increasing peri-operative oxygen delivery in high risk surgical patients, to greater than 600 ml/min/m2 with dopexamine hydrochloride, in routine clinical practice Results: Expressed as medians with 25%, 75% centiles.
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