Abstract
S100B is a protein synthesized in astroglial and Schwann cells in the central nervous system (CNS). Only very low concentrations of this protein are normally present in serum, whereas high levels of S100B have been found in the blood of patients suffering from a variety of CNS disorders, including tumors, cerebrovascular insults or traumatic brain injury (BI). Data on S100B in patients with brain-death are sparse. To clarify this issue, 48 brain-dead (BD) patients (34 men, 14 women) with a mean (± SD) age of 48 ± 21 years (range 14–85 years) were studied. Brain-death was due to trauma (n = 35), spontaneous intracerebral hemorrhage (n = 11), intracerebral thrombosis (n = 1) and intracerebral aneurysm (n = 1). For comparison, 36 patients (32 men, 4 women), with severe traumatic BI who did not develop brain-death, having a mean age of 33 ± 15 years (range 17–70 years) were also studied. All patients were intubated and mechanically ventilated. In BD patients, blood samples for S100B determination were obtained after clinical diagnosis of brain-death. In BI patients, blood samples were collected upon admission in the hospital and every 24 hours thereafter, for a maximum of seven consecutive days; in these patients peak and average values of S100B were used for analysis. Protein S100B levels in BD patients (median 7.68 μg/l, interquartile range 4.06–14.10 μg/l) were significantly higher compared to the peak (median 1.30 μg/l, interquartile range 0.60–1.90 μg/l, P < 0.001, Mann–Whitney U test) or to the average (median 0.60 μg/l, interquartile range 0.36–0.97 μg/l, P < 0.001, Mann–Whitney U test) values of S100B in BI patients. In conclusion, serum concentrations of protein S100B are high in brain-death victims. Further prospective studies are required to determine the predictive value of S100B levels in the early diagnosis of brain-death.
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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