Abstract
Sepsis results from a generalized inflammatory and pro-coagulant response to an infectious agent. Adhesion molecules and cytokines are of utmost importance for the development of early symptoms as well as the late sequela of endotoxemia. Heparin is widely known as an antithrombotic agent. But beyond its well-understood anticoagulant activity heparin is able to influence immunologic responses. In addition, in vitro experiments and animal studies have shown that heparin inhibits P-selectin and L-selectin mediated adhesion. Intravenous infusion of LPS into human volunteers provides a standardized model to study activation of inflammatory, pro-coagulant and adhesive cascades in humans. It was recently demonstrated that heparin blunts endotoxin-induced coagulation activation in a human LPS-model. As pro-coagulant and inflammatory processes are intricately linked in sepsis, we used this LPS-model to elucidate whether clinically applied doses of unfractionated (UFH) or low-molecular weight heparin (LMWH) are able to affect early inflammatory responses in low grade human endotoxemia.
Highlights
Intra-abdominal pressure (IAP) is an important parameter and prognostic indicator of the patient’s underlying physiologic status [1]
Smaller aerosol particles resulted in greater drug delivery in vitro when using the modified Aeroneb Pro during controlled mechanical ventilation (CMV)
We retrospectively reviewed 107 procedures performed on 48 patients in the period between March 2000 and November 2001
Summary
Intra-abdominal pressure (IAP) is an important parameter and prognostic indicator of the patient’s underlying physiologic status [1]. The aim of this study was to assess the respiratory effects of sufentanil and remifentanil in postsurgical critically ill patients during spontaneous ventilation since the drugs show pharmacokinetic and pharmacodynamic properties which make them attractive for intensive care use. Preliminary evidence suggests that hU-II levels during cardiac surgery are increased in patients with myocardial dysfunction [2] It is not known, if hU-II plasma concentrations are related to pulmonary capillary wedge pressure (PCWP) as an estimate of left ventricular filling pressure. AAF in cardiac surgery postoperative period has been implicated as a complication that leads to longer ICU and hospital stay and to augmented costs It has not been associated with increased mortality rates. We aimed to investigate the effects of use of preoperative and early postoperative standard and immunonutrient products on immune system and acute inflammatory response in the patients undergoing gastrointestinal malignancy surgery.
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