Abstract
Additional biomarkers in severe sepsis are needed to tackle the challenges of determining prognosis and optimizing selection of high-risk patients for application of therapy. The use of serum cholesterol as a prognostic indicator of infection and multiple organ dysfunction syndrome, and as a biologic marker for resolution of systemic inflammation is less well defined. Proposed explanations for the development of hypocholesterolemia include downregulation of hepatic synthesis, dilutional effects with resuscitation, loss of apoproteins in burns after blister formation, and metabolic utilization. A number of inflammatory cells and mediators involved in the inflammatory response have been assessed for their role as potential markers of the presence and severity of the inflammatory response and organ failure. Serum levels of C-reactive protein (CRP), an acute-phase protein synthesized by the liver following stimulus by various cytokines including tumor necrosis factor and IL-6, markedly increase within hours after infection or inflammation.
Highlights
Tight blood glucose (BG) control has been shown to videos of the alveolar dynamics
Computer-advised insulin infusion in postoperative cardiac surgery patients: a randomized prospective controlled multicenter trial quality the alveoli are observed at an open chest wall under a glass plate representing an artificial situation. To circumvent this restriction we developed a method of intravital endoscopy and tested it on an animal rat model
1Royal Brompton Hospital, London, UK; 2Medical University Graz, observation from mechanical deformation due to the tip of the Austria; 3Charles University Hospital, Prague, Czech Republic; endoscope we developed a flushing catheter that continuously
Summary
Tight blood glucose (BG) control has been shown to videos of the alveolar dynamics. The thorax remains intact.decrease morbidity and mortality in critically ill patients [1] but is Results Figure 1 shows a tissue area after lavage of 0.8 mm difficult to achieve using standard insulin infusion protocols. Results Patient characteristics (mean ± SD): age 57.4 ± 15.4 years, 28 female, 52 male, APACHE II score 28.2 ± 6.6; number of organ failures 4.0 ± 1.12; preceding ICU period 8.5 ± 9.3 days; continuous sedation with midazolam 31.2 ± 34.2 mg/hour, fentanyl 0.12 ± 0.08 mg/hour, propofol 45.6 ± 105.2 mg/hour; sedation assessment according to RS 5.65 ± 0.63, CPS 5.15 ± 1.67, CKS 0.65 ± 0.69, CS 9.34 ± 2.13 und LSS 1.78 ± 1.69, RASS –4.50 ± 1.27, FiO2 0.52 ± 0.17, PEEP 8.2 ± 2.4 cmH2O, ventilatory frequency 20.5 ± 4.8/min, pressure control 16.8 ± 4.4 cmH2O, tidal volume 540 ± 115 ml, TVV 2525.6 ± 11,366 ml (minimum 1.52; maximum 91,586). We hypothesized that S100β levels correlate with this tumor’s preoperative characteristics and with perioperative neurological injury despite its supratentorial location and non-neural origin
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