ISSN:0090-3493    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

ObjectiveTo determine the effects of intra-abdominal sepsis on polymorphonuclear leukocyte tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) receptor expression.DesignProspective, randomized comparison between patients undergoing elective colon surgery vs. patients with intra-abdominal sepsis.SettingTertiary-care center with all patients with intra-abdominal sepsis in a surgical ICU environment.PatientsGroup 1 (n = 7) represents control patients who underwent elective colon surgery without intra-abdominal sepsis. Group 2 (n = 10) represents patients with intra-abdominal sepsis.Measurements and Main ResultsPolymorphonuclear leukocyte TNF-α and IL-1β receptor expression ± stimulation of the oxidative burst was measured using125I TNF-α and125I IL-1β. Superoxide anion production and candicidal activity were measured in the presence of TNF-α and IL-1β. Group 2 patients expressed fewer TNF-α and IL-1β receptors on their cell surface, and stimulation of oxidative burst reduced TNF-α and IL-1β receptor expression in group 2 more than in group 1. Diminished TNF-α and IL-1β binding reduced superoxide anion production by group 2 polymorphonuclear leukocytes. Decreased TNF-α binding but not IL-1β, reduced polymorphonuclear leukocyte candicidal activity by group 2 polymorphonuclear leukocytes.Conclusionsa) Intra-abdominal sepsis reduces polymorphonuclear leukocyte TNF-α and IL-1β receptor expression. b)Expression of these surface receptors is altered by stimulation of the polymorphonuclear leukocyte oxidative burst. c) Diminished TNF-α and IL-1β receptor expression is associated with functional impairments in polymorphonuclear leukocyte activity. (Crit Care Med 1992; 20:11)

ISSN:0090-3493    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

ObjectiveTo compare the effects of furosemide administered by intermittent iv infusion vs. continuous iv infusion on urine output, hemodynamic variables, and serum electrolyte concentrations.DesignProspective, randomized trial.SettingPediatric ICU.PatientsPostoperative pediatric cardiac patients.InterventionsPatients were assigned to either the continuous iv infusion or the intermittent infusion groups. The intermittent group received 1 mg/kg iv of furosemide every 4 hrs to be increased by 0.25 mg/kg iv every 4 hrs to a maximum of 1.5 mg/kg iv if the urine output was <1 mg/kg·hr. The continuous infusion group received an initial furosemide dose of 0.1 mg/kg iv (minimum 1 mg) followed by an iv infusion rate of 0.1 mg/kg·hr of furosemide to be doubled every 2 hrs to a maximum of 0.4 mg/kg·hr if the urine output was <1 mL/kg·hr.Measurements and Main ResultsDemographic variables, fluids, electrolyte and inotropic requirements were the same in both groups. A significantly (p= .045) lower daily dose of furosemide (4.90 ± 1.78 vs. 6.23 ± 0.62 mg/kg·day) in the continuous iv infusion group produced the same 24-hr urine volume as that of the intermittent group. There was more variability in urine output in the intermittent group as well as more urinary losses of sodium (0.29 ± 0.15 vs. 0.20 ± 0.06 mmol/kg·day,p= .0007) and chloride (0.40 ± 0.20 vs. 0.30 ± 0.12 mmol/kg·day,p= .045).ConclusionFurosemide administered by continuous iv infusion is advantageous in the post-operative pediatric patient because of a more controlled and predictable urine output with less drug requirement and less urinary loss in sodium and chloride. (Crit Care Med 1992; 20:17)

ISSN:0090-3493    

出版商:OVID    

年代:1992

数据来源: OVID