Fluid Of Children Research Articles

Broad range detection of viral and bacterial pathogens in bronchoalveolar lavage fluid of children to identify the cause of lower respiratory tract infections

BackgroundKnowledge on the etiology of LRTIs is essential for improvement of the clinical diagnosis and accurate treatment. Molecular detection methods were applied to identify a broad range of bacterial and viral pathogens in a large set of bronchial alveolar lavage (BAL) fluid samples. The patterns of detected pathogens were correlated to the clinical symptoms.MethodsBAL fluid samples and clinical data were collected from 573 hospitalized children between 1 month and 14 years of age with LRTIs, enrolled from January to December 2018. Pathogens were detected using standardized clinical diagnostics, with a sensitive, high-throughput GeXP-based multiplex PCR and with multiplex qPCR. Data were analyzed to describe the correlation between the severity of respiratory tract disease and the pathogens identified.ResultsThe pathogen detection rate with GeXP-based PCR and multiplex qPCR was significantly higher than by clinical routine diagnostics (76.09% VS 36.13%,χ2 = 8.191, P = 0.004). The most frequently detected pathogens in the BAL fluid were human adenovirus (HADV)(21.82%), Mycoplasma pneumoniae (20.24%), human rhinovirus (13.96%), Streptococcus pneumoniae (8.90%) and Haemophilus influenzae (8.90%). In 16.4% of the cases co-detection with two or three different pathogens was found. Viral detection rates declined with age, while atypical pathogen detection rates increased with age. Oxygen supply in the HADV and Influenza H1N1 infected patients was more frequent (49.43%) than in patients infected with other pathogens.ConclusionBroad range detection of viral and bacterial pathogens using molecular methods is a promising and implementable approach to improve clinical diagnosis and accurate treatment of LRTI in children.

Does ondansetron reduce the need for hospitalization or IV fluids in children with AGE?

Evidence-Based Practice: August 2021 - Volume 24 - Issue 8 - p 9-10 doi: 10.1097/EBP.0000000000001205

Effect of Oral 12% Carbohydrate Containing Clear Fluid in Children on Post-anaesthesia Recovery Profile- A Randomised Clinical Trial

Effect of Oral 12% Carbohydrate Containing Clear Fluid in Children on Post-anaesthesia Recovery Profile- A Randomised Clinical Trial

PECULIARITIES OF FREE RADICAL OXIDATION AND ANTIOXIDANT PROTECTION PARAMETERS OF THE ORAL FLUID IN CHILDREN WITH CHRONIC CATARRHAL GINGIVITIS WITH UNDERLYING DIABETES MELLITUS

The aim: Objective of the research was to study peculiarities of free radical oxidation and antioxidant protection parameters of the oral fluid in children with chronic catarrhal gingivitis with underlying diabetes mellitus. Materials and methods: Oral fluid was examined in 105 children aged 12 including somatically healthy ones with intact periodontium and chronic catarrhal gingivitis, suffering from diabetes mellitus up to 5 years and more than 5 years with chronic catarrhal gingivitis. The parameters of lipid peroxide oxidation (level of diene conjugates, Malone dialdehyde) and antioxidant protection (activity of SOD and catalase, POM, whole protein; ceruloplasmin; НS-groups) of the oral fluid were determined. Results: The results obtained are indicative of available probable difference in the examined parameters among children depending on their general state of health and periodontal tissue condition. The best parameters were found among somatically healthy children with intact periodontium. They deteriorated in children with chronic catarrhal gingivitis available irrespective of their general state of health. They reached the most critical level in children with diabetes mellitus lasting longer than 5 years. Conclusions: The course of chronic catarrhal gingivitis in children, both somatically healthy and those suffering from diabetes mellitus, is associated with increased parameters of lipid peroxide oxidation and decreased enzymatic activity of the antioxidant protection system of the oral fluid. The most considerable changes are found in patients suffering from diabetes mellitus lasting more than 5 years.

Genetic characteristics of antimicrobial resistance mechanisms in Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii isolated from blood and cerebrospinal fluid of children

Objective. To assess antimicrobial susceptibility, presence of resistance genes and determine the phenotypic groups of K. pneumoniae, P. aeruginosa and A. baumannii isolated from blood and cerebrospinal fluid of children with nosocomial infections in intensive care units from 2014 to 2020. Materials and Methods. Minimum inhibitory concentrations of antibiotics were determined using the serial broth microdilution method. The identification of genes encoding the production of carbapenemases was carried out using hybridization fluorescence detection. Results. A total of 63 isolates of K. рneumoniae, 23 isolates of P. aeruginosa and 14 isolates of A. baumannii were tested in this study. K. pneumoniae was detected in 10.3%. P. aeruginosa was isolated at a frequency of 3.5%. A. baumannii accounted for 2.3%. The proportion of carbapenemresistant K. pneumoniae strains to meropenem and imipenem was 33% and 37%, respectively, of all isolates. Resistance to colistin and polymyxin in K. pneumoniae isolates was 33% and 24%, respectively. The production of carbapenemases OXA-48 was detected in 25 (89%) isolates. The presence of NDM, VIM, KPC carbapenemases was not detected. Among P. aeruginosa, 65% were resistant to meropenem, and 74% to imipenem. The highest activity against P. aeruginosa in vitro was exhibited by polymyxins. There were no strains that were insensitive to colistin. The detection rate of metallo-β-lactamases (MBL) in P. aeruginosa strains was 48%. Only VIM-type MBLs were identified. No other types of MBL have been found. A. baumannii was non-susceptible to meropenem in 64% and to imipenem in 71%. The highest in vitro activity against A. baumannii was shown by polymyxin. Rate of colistin resistance was 29%. The OXA-40 and OXA-23 genes were detected in 5 and 3 isolates, respectively. Conclusions. There were high resistance rates to most antimicrobials among K. pneumoniae, P. aeruginosa и A. baumannii isolated from blood and cerebrospinal fluid in children with nosocomial infections. The increase in carbapenem resistance rates was also observed. Carbapenem resistance was due to OXA48 carbapenemases in K. pneumoniae, VIM-type MBLs in P. aeruginosa, and OXA-40 and OXA-23 carbapenemases in A. baumannii.

Behavioral and brain dynamics of executive control in relation to children's fluid intelligence

According to the dual mechanism of cognitive control theory, executive processes can be proactive when there is effort to monitor the context and control is implemented from before an imperative event occur, or reactive if control processes only take place after the appearance of the imperative event. During childhood, the coordination of both types of control protractedly evolve from more reactive towards a more proactive.In adults, a relationship between increased use of proactive control and fluid intelligence has been observed. In the current study, we examined whether the dynamics of executive control vary in children who differ in fluid intelligence. We employed the AX–CPT paradigm together with ERP registration to examine behavioral and brain dynamics of proactive and reactive control, including processes of anticipation, conflict monitoring and inhibition. Children with higher fluid intelligence showed better behavioral indices of proactive control, together with increased brain preparation to response cues and increased subsequent inhibition costs when the response was finally not required. This suggests that fluid intelligence in childhood is related to the capacity to implement a more proactive strategy even when executive control is not yet fully developed.

EVALUATION OF THE EFFECTIVENESS OF TREATMENT OF CHRONIC CATARRHAL GINGIVITIS IN CHILDREN WITH DIABETES MELLITUS IN LONG-TERM OBSERVATIONS

EVALUATION OF THE EFFECTIVENESS OF TREATMENT OF CHRONIC CATARRHAL GINGIVITIS IN CHILDREN WITH DIABETES MELLITUS IN LONG-TERM OBSERVATIONS

Dyadic Effects of Fluid Mindset on Psychological Growth in Immigrant Mothers and Their Children: Indirect Effect of Resilience.

Immigration research has recently investigated positive adaptation outcomes such as psychological growth. This study tested actor and partner effects between fluid mindset and psychological growth, mediated by resilience, in 200 migrant mother-child dyads from Mainland China to Hong Kong. Mothers' fluid mindset had significant actor and partner effects on their own and their children's psychological growth, whereas children's fluid mindset showed an actor effect. For mothers and children, fluid mindset had significant actor indirect effects on psychological growth via resilience. Mothers' fluid mindset had a significant partner indirect effect on children's psychological growth via children's resilience. The findings have implications for enhancing immigrants' psychological growth by strengthening fluid mindset and considering mothers and children as the intervention unit in resilience programs.

Functioning of glutation system of children's oral fluid under the development of odontogenic inflammatory process

A special place among antioxidants is occupied by thiols, the functioning of which is mostly ensured by the glutathione system. Glutathione as the main intracellular thiol plays an important role in metabolic and physiological processes: protein synthesis and breakdown, activation and inactivation of enzymes, synthesis of deoxyribose metabolites, stabilization of the cell membrane and more.The aim of the study. To study the peculiarities of the state of the glutathione system of oral fluid in children with the development of odontogenic inflammatory process in the tissues of the maxillofacial area.Material and methods. Examination of 98 children aged 7-15 years, somatically healthy and with concomitant pathology of the thyroid gland, who had an acute odontogenic inflammatory process. The level of reduced glutathione, the activity of the enzymes glutathione reductase, glutathione transferase, glutathioperoxidase and the content of HS groups were determined in the children's oral fluid. Statistical processing of the obtained data was performed by standard methods of variation statistics.Results. It was found that the functioning of the glutathione system of oral fluid in children with the development of odontogenic inflammatory process is unbalanced and insufficient: a decrease in the activity of glutathione reductase by 49.02% (p <0.05), glutathione transferase - by 69.27% (p <0.05), increase in the level of glutathioperoxidase activity by 73.29% (p <0.05), which leads to a decrease in the level of reduced glutathione by 4.76 times (p <0.05).Conclusion. 1. The dynamics of changes in the components of the glutathione system is characterized by a decrease in the activity of GR and G-ST, which causes insufficient functioning of the detoxification and antioxidant parts of the glutathione system. 2. Activation of GP indicates the preservation of certain protective mechanisms, which, however, do not compensate for the negative effects of inflammatory products. Therefore, the condition of the antiperoxide component of the glutathione system can be described as unbalanced and insufficient.

Ultrasound assessment of gastric emptying time after intake of clear fluids in children scheduled for general anesthesia-A prospective observational study.

While many clinics have changed their local regimen toward a more liberal policy regarding clear fluid fasting for general anesthesia, there is a lack of studies evaluating gastric emptying time in a clinical setting. Based on this and before implementation of a more liberal preoperative clear fluid fasting policy for children, we studied gastric emptying time of clear fluids in children and hypothesized that the mean gastric emptying time would be 1hour. Between March and December 2019, children scheduled for general anesthesia at our University Children's Hospital were enrolled in this prospective observational study. After overnight fasting, gastric emptying was examined by sonographic measurements of the gastric antral area before and 5, 15, 30, 45, and 60minutes after intake of water or fruit juice. Twenty-six children were enrolled in this study, and 24 aged 11 (range 4-17) years were included for statistical analysis. The median ingested fluid volume was 4.7 (range 1.8-11.8)mLkg-1 . The gastric antral area of the children initially increased and subsequently decreased after intake of clear fluids and correlated significantly with fasting time (r=-0.55, P<.0001). After 1hour, the gastric antral area had returned to the baseline level in 20 children but not in four children with a fluid intake >5mLkg-1 . There was no difference in the gastric antral area between water and fruit juice. Using a linear regression model, the calculated mean gastric emptying time of clear fluids was 52minutes. This study showed that the gastric emptying time of children after intake up to 5mLkg-1 clear fluids was <1hour in a clinical setting. These results support the more liberal fasting regimen favoring a 1-hour fasting time and suggest 5mLkg-1 as an upper limit for clear fluids (eg, water, sugared water or tea or diluted fruit juice) from 2hours to 1hour before induction of anesthesia in children.

314 Prevalence of Asymptomatic Intraperitoneal Fluid in Children on Focused Assessment With Sonography in Trauma Ultrasound

314 Prevalence of Asymptomatic Intraperitoneal Fluid in Children on Focused Assessment With Sonography in Trauma Ultrasound

Gambaran Balance Cairan Pada Anak Diare Setelah Diberikan Pemenuhan Kebutuhan Cairan di Rumah Sakit Kaliwates Jember

Diarrhea is a global event in various countries, including in many developing countries. Management of diarrhea is to use fluid rehydration. Other diarrhea management can be used with supplements, using Oral Rehydration Salt (ORS), using medication from the doctor, and drinking lots of water to replace lost fluids. This study aims to determine how to describe the fluid balance in children with diarrhea after being given the fulfillment of fluid needs in the hospital. The research was conducted at Kaliwates Hospital in Jember, with the research time used by researchers was one month. The sample of this study was thirty-two children of diarrhea patients with mild, moderate, severe dehydration. Data collection was carried out for three days while the child is hospitalized. The result of this study was obtained from total sampling. It was obtained that the fluid balance in diarrhea children did not all turn into balance. There was excess fluid, and they still experienced dehydration. From the research data, it was found that most of the experience of extra fluid status. The study concludes that after rehydration, children have an increasing fluid status. Fulfillment of fluids in children with diarrhea aims to reduce the risk of decreased fluid and maintain body fluids when they lose fluid through liquid feces. Fluid balance makes people's body became immune to the disease.

Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices.

Background: Hyponatraemia is associated with increased morbidity, increased mortality and is frequently hospital-acquired due to inappropriate administration of hypotonic fluids. Despite several attempts to minimise the risk, knowledge is lacking as to whether inappropriate prescribing practice continues to be a concern. Methods: A cross-sectional survey was performed in Danish emergency department physicians in spring 2019. Prescribing practices were assessed by means of four clinical scenarios commonly encountered in the emergency department. Thirteen multiple-choice questions were used to measure knowledge. Results: 201 physicians responded corresponding to 55.4% of the total population of physicians working at emergency departments in Denmark. About a quarter reported that they would use hypotonic fluids in patients with increased intracranial pressure and 29.4% would use hypotonic maintenance fluids in children, both of which are against guideline recommendations. Also, 29.4% selected the correct fluid, a 3% hypertonic saline solution, for a patient with hyponatraemia and severe neurological symptoms, which is a medical emergency. Most physicians were unaware of the impact of hypotonic fluids on plasma sodium in acutely ill patients. Conclusion: Inappropriate prescribing practices and limited knowledge of a large number of physicians calls for further interventions to minimise the risk of hospital-acquired hyponatraemia.

The predictive value of the Pleth Variability Index on fluid responsiveness in spontaneously breathing anaesthetized children-A prospective observational study.

BackgroundIn children, the preoperative hydration status is an important part of the overall clinical assessment. The assumed preoperative fluid deficit is often routinely replaced during induction without knowing the child's actual fluid status.AimWe investigated the predictive value of the Pleth Variability Index as a measure of fluid responsiveness in spontaneously breathing anesthetized children.MethodsPleth Variability Index, stroke volume and Cardiac Index, measured by electrovelocimetry, mean blood pressure, and heart rate were recorded during anesthesia induction in 50 pediatric patients <6 years. Baseline values were compared to values recorded after administration of 10 mL/kg of Ringer's lactate and during two passive leg raising tests (before and after fluid administration). Fluid responsiveness was defined as an increase of ≥10% in stroke volume.ResultsOnly in fluid responsive patients, Pleth Variability Index values were higher before fluid administration than thereafter (21.4 ± 5.9% vs 15.0 ± 9.4%, 95% CI of difference 1.1 to 11.8%, P = .02). Pleth Variability Index values at baseline were higher in fluid responders (21.4 ± 5.9%) than in fluid nonresponders (15.3 ± 7.7%), 95% CI of difference 1.6 to 10.6%, P = .009. The area under the receiver operating curve indicating fluid responsiveness was 0.781 (95% CI 0.623 to 0.896, P = .0002), with the highest sensitivity (82%) and specificity (70%) at a Pleth Variability Index of >15% (Positive predictive value 2.71 (95% CI: 1.4 to 5.2)). Only in fluid responders, the Pleth Variability Index decreased during passive leg raising, while stroke volume increased.ConclusionsThe Pleth Variability Index may be of additional value to predict fluid responsiveness in spontaneously breathing anesthetized children. A significant overlap in baseline Pleth Variability Index values between fluid responsive and nonfluid responsive patients does not allow a reliable recommendation as to a cut off value.

Major and minor lymphocytes subpopulations in peripheral blood and cerebrospinal fluid of children with meningitis

Introduction. The analysis of current publications indicates at our insufficient understanding of subpopulation composition of lymphocytes in peripheral blood and cerebrospinal fluid (CSF) during pediatric neuroinfectious diseases. It has been found that the main lymphocyte populations are divided into many small (minor) subpopulations.The purpose of this research was to assess percentage of major and minor blood and CSF lymphocyte subsets in children with aseptic viral meningitis (AM) or bacterial purulent meningitis (BM).Materials and methods. Phenotyping of blood and CSF lymphocytes of children aged from 4 months to 17 years diagnosed with AM (n = 86) and BM (n = 39) was carried out by using flow cytometry. As a comparison group, we analyzed peripheral blood and CSF samples collected from children with acute respiratory viral infections (ARVIs) associated with syndrome of meningism (n = 27). There was evaluated percentage of the major cell subpopulations (CD3+ T-lymphocytes, T-helpers — CD3+CD4+ Th, cytotoxic T-lymphocytes — CD3+CD8+ CTL, natural killer cells — CD3-CD16+CD56+ NK, B-cells — CD3-CD19+), as well as minor lymphocyte subsets (double positive (DP) (CD3+CD4+CD8+), double negative (DN) (CD3+CD4-CD8-) T-cells, NKT (CD3+CD16+CD56+), CD3-CD8+ NK, CD3+CD8dim and CD3+CD8 8bright).Results. It was found that the acute period of BM and AM vs. the comparison group (ARVI) was characterized by significant differences in the blood and CSF composition of major and minor lymphocyte subsets. In particular, blood T-cells, Th, CTL, NK, NKT, DN, CD3-CD8+ NK, CD3+CD8bright and CD3+CD8dim dominated in parallel with significantly lowered B-cell frequency in AM vs. BM. In the CSF of children with AM, T-cells and Th prevailed, whereas count of B-cells and CD3-CD8+ NK was lower compared to those in BM. In addition, further differences were revealed in CSF and blood cell subset composition depending on nosological entity, while maintaining differences in some major and minor lymphocyte subpopulations lacked in the comparison group. Calculating the CSF/blood ratio for the major and minor lymphocyte subsets uncovered the prevalence for the majority of cell subpopulations (the coefficients ranged from 1.2 to 16.4) in the CSF of the comparison group (ARVI), except B-cells, NK and CD3-CD8+ NK (coefficients ranged from 0.07 to 0.31). AM and BM were featured with various changes in the CSF/blood ratio found for most of the studied subpopulations in the acute period as well as the recovery phase highlighted with characteristic traits for each nosological form.Conclusion. The data obtained indicate about finding specific features in the activation of systemic and intrathecal immune response during viral and bacterial meningitis in children, which may be used as an additional differential diagnostic criterion.

P13 Optimising paediatric intravenous fluid management plans: a quality improvement project

IntroductionIntravenous (IV) maintenance fluids are often prescribed post-surgery when enteral routes are contraindicated. Serious consequences have been documented when poor fluid management has occurred, as highlighted in the National Patient Safety Alert (NPSA) 22; reducing the risk of hyponatraemia; when administering IV fluids to children.1 In response to this, the National Institute for Health and Care Excellence (NICE) published their guidance in December 2015 regarding IV fluids in children.2 Based on NICE recommendations, a pan hospital fluid guidance was produced. Within the NICE and hospital’s own guideline it states that there should be a daily fluid management plan documented. It has been well recognised that this daily fluid management plan was not routinely been completed; hence showing non-adherence to our hospital policy and NICE recommendations.AimsPrimary aim was to improve the documentation of the daily fluid management plan; aimed at the medical staff and the secondary aim was to improve the monitoring requirements of IV fluids and documentation of these; largely aimed at the nursing staff.MethodsA simple sticker was designed and attached to continuous sheets for medical notes which had a checklist of monitoring requirements and a section for fluid balance. Additionally, 2 posters were produced; one aimed at medical staff for documenting a fluid management plan and one aimed at the nursing staff with the monitoring requirements. These posters were displayed on the paediatric surgical ward.ResultsA total of 22 patients who were prescribed IV fluids were identified for a baseline measurement, an equal number of patients were compared after the intervention. Neonates and children receiving total parenteral nutrition were excluded from the data collection. There were 41% of daily fluid management plans completed pre intervention and post intervention there were 56% completed; showing a 15% increase in completion. As regards the monitoring indications; there were increases for nursing fluid balance completed from 19% to 46%, blood glucose taken and recorded from 64% to 83% and the daily weight documented from 10% to 49%.ConclusionsThis short QI project shows that implementation of an intervention did improve outcomes across all indications investigated. The results are not as dramatic as first hoped, but this is largely due to the short time scale of 4 weeks to introduce our change and it coincided with the change-over month of junior medical staff. With further education and champions within the medical and nursing teams; further improvement is very much possible, with the main aim in reducing risk and improving patient safety.ReferencesNational Patient Safety Alert: Reducing the risk of hyponatraemia when administering intravenous infusions to neonates 2007. Available at https://www.sps.nhs.uk/articles/npsa-alert-reducing-the-risk-of-hyponatraemia-when-administering-intraveneous-infusions-to-neonates/ [Accessed 12th June 2019]NICE guidance: Intravenous fluid therapy in children and young people in hospital. Available at https://www.nice.org.uk/guidance/ng29 [Accessed 12th June 2019]

EVALUATION OF THE MINERALIZING POTENTIAL OF ORAL FLUID IN CHILDREN WITH DOWN SYNDROME DEPENDING ON THE LEVEL OF THE CARIOGENIC PROCESS

Early diagnosis of dental caries in children is difficult. This fact is applied to children with Down syndrome. In order to identify predictors of dental diseases, a crystallographic method is widely used for studying oral fluid. The aim of the work is to evaluate the mineralizing potential of oral fluid in children with Down syndrome before and after the course of preventive measures. Material and methods. We examined oral fluid in children with Down syndrome. Children and adolescents at the age of 8 months to 17 years (n=21) were divided into groups depending on the age and the level of caries intensity. The results were compared with the data of 55 children without chromosomal pathology. Results. The group of children with Down syndrome (MG), during the initial examination includes type II – 11 people (53 %) and type III – 7 people (33 %) microcrystallization of saliva, which generally corresponds to the situation in the group of children without chromosomal pathology (CG), where type II included 62 % (34 people) and type III – 22 % (12 people). The average value of the mineralizing potential of saliva in the main group was 2.78±0.22, and in the control group – 2.89±0.17. Conclusions. After preventive measures during the re-examination of children with Down syndrome, there was a tendency to an increase in the level of parameters of the mineralizing potential of saliva while maintaining this level after 6 months.

Proteomic Analysis of Cerebrospinal Fluid in Children with Acute Enterovirus-Associated Meningoencephalitis Identifies Dysregulated Host Processes and Potential Biomarkers.

Enteroviruses (EVs) are major causes of viral meningoencephalitis in children. To better understand the pathogenesis and identify potential biomarkers, cerebrospinal fluid proteome in children (n = 52) suffering from EV meningoencephalitis was compared to that in EV-negative control subjects (n = 53) using the BoxCar acquisition technique. Among 1697 proteins identified, 1193 with robust assay readouts were used for quantitative analyses. Differential expression analyses identified 154 upregulated and 227 downregulated proteins in the EV-positive group. Functional analyses showed that the upregulated proteins are mainly related to activities of lymphocytes and cytokines, inflammation, and responses to stress and viral invasion, while the downregulated proteins are mainly related to neuronal integrity and activity as well as neurogenesis. According to receiver operating characteristic analysis results, Rho-GDP-dissociation inhibitor 2 exhibited the highest sensitivity (96.2%) and specificity (100%) for discriminating EV-positive from EV-negative patients. The chemokine CXCL10 was most upregulated (>300-fold) with also high sensitivity (92.3%) and specificity (94.3%) for indicating EV positivity. Thus, this study uncovered perturbations of multiple host processes due to EV meningoencephalitis, especially the general trend of enhanced immune responses but impaired neuronal functions. The identified dysregulated proteins may also prompt biomarker development.

Intraoperative Peritoneal Interleukin-6 Concentration Changes in Relation to the High-Mobility Group Protein B1 and Heat Shock Protein 70 Levels in Children Undergoing Cholecystectomy.

The aim was the evaluation of IL-6 concentration in peritoneal lavage fluid of children which underwent cholecystectomy to ascertain if there is a difference in early inflammatory response depending on the type of surgical approach (open vs. laparoscopy). The analysis of high-mobility group protein B1 (HMGB1) and heat shock protein 70 (HSP70) was performed to find out if the source of IL-6 was related to tissue damage. IL-6 concentration in peritoneal lavage fluid samples, obtained at the beginning and at the end of the laparoscopic (N = 23) and open cholecystectomy (N = 14), was tested with a routinely used electrochemiluminescence assay. The concentrations of HMGB1 and HSP70 were analyzed with the use of an ELISA method. Statistical analysis was performed using the STATISTICA PL release 12.5 Program. The differences were assessed using the Mann-Whitney U test and Wilcoxon matched pairs test. Correlations were studied by using the Spearman correlation test. Our results demonstrated significant peritoneal lavage fluid IL-6 concentration growth measured at the end of the cholecystectomy as compared to the beginning, regardless of the type of the procedure. IL-6 growth during open cholecystectomy was greater compared to laparoscopic cholecystectomy (62.51-fold vs. 3.19-fold). IL-6 concentration did not correlate with HMGB1 and HSP70, which indicate that the significant growth of this cytokine was not related to mechanical tissue damage due to surgical procedure. A clinical significance of the study could be related to the fact that the evaluation of IL-6 concentration in peritoneal lavage fluid may be useful to assess an early local inflammatory response.

0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trial

0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trial