Relative adrenal insufficiency in patients with severe acute pancreatitis

K Heyndrickx,D Rijkckaert,D Baert,P Thibo,F Colardyn,J De Waele,P Van Biervliet,E Hoste

doi:10.1186/cc5561

Abstract

Objective Inadequate cortisol levels and adrenal dysfunction may play a role in the pathophysiology of severe acute pancreatitis. This study aimed to analyse the incidence of relative adrenal insufficiency (RAI) in these patients, to identify factors associated with RAI and to describe how adrenal responsiveness affects outcome.

Highlights

To clarify the relation between ATP and prostaglandinE2 (PGE2) in the immunologic system, we investigated the acute and chronic effects of PGE2 on activation of purinergic signaling in monocytes by measuring the ATP-induced elevation of intracellularCa2+ ([Ca]i) in fura-2-loaded THP-1 monocytes
IFNγ plays a critical role in host defense by promoting Th1 phenotype and bacterial clearance
Low IFNγ levels are were washed, loaded with fura-2-AM, and transferred into a quartz associated with the Th2 phenotype consistent with critical illness cuvette and placed in the thermostat-regulated sample chamber of anergy [2]

Summary

Introduction

To clarify the relation between ATP and prostaglandinE2 (PGE2) in the immunologic system, we investigated the acute and chronic effects of PGE2 on activation of purinergic signaling in monocytes by measuring the ATP-induced elevation of intracellularCa2+ ([Ca]i) in fura-2-loaded THP-1 monocytes. Several experimental studies suggest that thrombolysis therapy acts directly on thrombi or emboli and enhances microcirculatory reperfusion In this retrospective study we investigated the extent of blood coagulation and fibrin formation via the plasma D-dimer level, an indicator of endogenous fibrinolytic activity, in patients who underwent inhospital and out-of-hospital cardiac arrest from nontraumatic causes. Methods MEDLINE, EMBASE, CINAHL, and the Cochrane Library were searched, and studies were included if they reported on ICU patients > 16 years old who were evaluated for CINMA clinically and electrophysiologically, and they contained sufficient data to quantitatively measure the association between CINMA and clinically relevant exposures and/or outcomes. Our aim was to evaluate the role of the cardiac markers NT-proBNP, Troponin T (TnT) and myoglobin as predictors of inhospital and 6-month all-cause mortality in patients admitted to a general adult ICU with severe sepsis/septic shock. Aging is associated with decreased cardiopulmonary and renal reserve as well as the development of progressive organ failure

Objectives

Methods

Results

Discussion

Conclusion