ISSN:0952-7907    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Systemic inflammatory reactions may cause multiple organ failure, which is associated with a high mortality. Ischaemia of the bowel mucosa is known to be associated with multiple organ failure, and in particular may cause pulmonary damage. A decreased barrier function of the gut, either as a consequence of ischaemia or atrophy, results in translocation of bacteria and endotoxin into the portal or systemic circulation. There is no doubt that bacterial translocation and systemic endotoxaemia occurs in haemorrhagic and septic shock and in thermal injury. It is not clear to what extent these phenomena contribute to injury of remote organs. Xanthine oxidase-mediated induction of oxygen radical species within the ischaemic bowel may directly activate complement and neutrophils, subsequently causing pulmonary damage.

ISSN:0952-7907    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The route of choice for the provision of nutrition in a critically ill patient is now enteral. The realization that the majority of such patients can be fed using the gastrointestinal tract without significant risk, notwithstanding the presence of critical illness or recent abdominal surgery, has led to a cultural change in attitudes concerning nutritional support in the intensive care unit. Also, the more widely perceived hazards of total parenteral nutrition, combined with the effects of depriving the gastrointestinal tract of a lumenal source of nutrition have, at the same time, contributed to the reappraisal of the role of total parenteral nutrition as a form of metabolic support.

ISSN:0952-7907    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Sepsis and septic shock represent the systemic inflammatory response to the presence of infection with a variety of micro-organisms. The complex pathophysiology of this inflammatory response has been brought into clearer perspective during recent years, in part, related to the ability to interrupt the inflammatory cascade with the use of specific blockers or inhibitors of the individual potential mediators. Work in experimental animals, healthy human volunteers, and septic patients, has provided insight into the events that trigger and sustain the inflammatory response. Many questions persist and further work is required to fully unravel the complex interrelationships between the various components of this inflammatory cascade.

ISSN:0952-7907    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The past 5 years have seen a concerted effort to develop new methods to treat severe sepsis. Both immunological agents and conventional pharmaceuticals have been identified which, in animal models, seem to be protective. This year the results of the first phase III trials of these drugs have been reported. None were unequivocally successful, but in several cases there was clear evidence of efficacy, at least in subgroups of patients. Follow-up trials have already begun in an effort to define more clearly how these types of drugs should be used, when, and in whom.

ISSN:0952-7907    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Adult respiratory distress syndrome is the result of direct or indirect lung injury via mediator action in the microcirculatory bed, with symptoms and signs similar to those of inflammatory reactions. This review evaluates possible inducers of these events. Toxic actions of substances such as lipopolysaccharides, derived for example from gut translocation, are indirect; they are mediated primarily via phagocytes and endothelial cell-derived products, for example cytokines like interleukin-8. Furthermore, the relationship between leucocyte activation, tumour necrosis factor, and complement activation is discussed together with the reaction of endothelial cells and the vascular damage caused by pro-oxidant events. Finally, most recent reports on surfactant impairment by inflammatory processes and therapeutic surfactant replacement are reviewed.

ISSN:0952-7907    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Nitric oxide (NO) is an important endothelium-dependent relaxing factor. When inhaled as a gas at low levels, NO selectively dilates the pulmonary circulation. Significant systemic vasodilation does not occur as NO is inactivated by rapidly binding to hemoglobin. In an injured lung with pulmonary hypertension, inhaled NO produces local vasodilation of wellventilated lung units and may 'steal' blood flow away from unventilated regions. This reduces intrapulmonary shunting and may improve systemic arterial oxygenation. Potentially, inhaled NO may be a valuable therapy in a wide variety of patients with acute lung injury and/or pulmonary hypertension.

ISSN:0952-7907    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Critical illness is accompanied by a loss of body protein which can result in loss of immunocompetence, poor wound healing, muscle weakness and even mortality. Growth hormone administration increases protein synthesis and induces production of increased levels of insulin-like growth factor-l, thereby also decreasing protein breakdown. Growth hormone administration to postoperative patients and to patients with burns and sepsis has shown that an anabolic state can be achieved. Preservation of muscle mass has also been documented. In paediatric burns patients, administration of growth hormone decreased length of stay in hospital.

ISSN:0952-7907    

出版商:OVID    

年代:1994

数据来源: OVID