Abstract

Septic shock remains a major cause of multiple organ failure with a high mortality rate. A relationship between high-mobility group box-1 protein (HMGB-1) and septic shock was recently reported. On the other hand, treatment of direct hemoperfusion with polymyxin B-immobilized fiber column (PMX; Toray Industries Inc., Tokyo Japan) was developed in Japan in 1994 and has been used for treatment of septic shock of endotoxemia. Reduction of the serum endotoxin level by PMX has been recognized. Clinical effectiveness data of this column have also been reported, for example increasing the systolic blood pressure and improvement of the systemic vascular resistance index. Although a decrease of inflammatory cytokine after direct hemoperfusion with PMX has been reported, the detailed mechanism of PMX is not known.

Highlights

  • Tight blood glucose (BG) control has been shown to videos of the alveolar dynamics

  • 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

  • Taurocholic acid into the pancreatic duct. This allowed us to separate and to determine the specific role of pancreatic blood vs Introduction In the frame of protective lung ventilation, alveolar normal blood on the expression of injury evidenced during isolated biomechanics become more and more the focus of scientific lung reperfusion

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Summary

Introduction

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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