Significance of central venous-to-arterial carbon dioxide difference for early goal-directed therapy in septic patients / 中南大学学报(医学版)

OBJECTIVE@#To determine whether central venous-to-arterial carbon dioxide tension difference (Pcv-aCO(2)) could still be used as a goal of fluid resuscitation in septic patients who already had ScvO2 greater than 70% after early resuscitation.@*METHODS@#A prospective observational study was performed on 56 septic patients admitted to the Intensive Care Unit (ICU) in a single University Hospital, who already had ScvO2 greater than 70% after early resuscitation. They were divided into two groups, based on whether the patients' initial Pcv-aCO2 was less than 6 mmHg (low gap group) or greater than or equal to 6 mmHg (high gap group). The following data were collected at 0, 12, and 24 hours (T(0), T(12), T(24)) after study inclusion: hemodynamic indices [mean blood pressure (MAP), heart rate (HR), cardiac output (CO), central venous pressure (CVP)], perfusion-related indexes [ScvO(2), Pcv-aCO2, serum lactate (Lac), Lac clearance rate], organ function- related indices [oxygenation index (PaO2/FiO(2)), serum creatinine (SCr), creatine kinase (CK-MB)], APACHE II score, SOFA score, and 24 hours amounts of fluid infusion.@*RESULTS@#Twenty patients (42.9%) with initial Pcv-aCO(2) ≥ 6 mmHg were included in the high gap group and another thirty-two patients were included in the low gap group. At T12 and T24, ScvO(2) and CO were significantly higher, and Lac and SCr were significantly lower in low gap patients than high gap patients (P 70% has achieved after early resuscitation, Pcv-aCO2 can still be used as a goal of fluid resuscitation in septic patients .

Mechanism of growth hormone inhibiting of alveolar type Ⅱ epithelial cells in rats / 中华急诊医学杂志

Objective To investigate the mechanism of growth hormone inhibiting IPS-induced apoptosis of alveolar type Ⅱ epithelial cells in rats. Method Isolated and purified AEC Ⅱ cells of SD rats were divided into 5 groups,8 duplicate wells in each group. Group I served as control group; group Ⅱ:LPS 10 ug/ml;group Ⅲ:LPS 10 ug/ml + GH 50 ng/ml;gronp IV :LPS 10 ug/ml + GH 100ng/ml; group V: LPS 10 ug/ml + GH 200 ng/ml. LPS was finally added into wells in group Ⅱ～V . After the cells were incubated for 24 hours, the apoptosis rate and necrosis rate of AEC Ⅱ cells stained with Annexin V/PI were detected by flow cytometry and Fas protein of AEC Ⅱ cells were measured by immunocytochemistry. Results (1) The apoptosis rate and necrosis rate of AECⅡ cells in group Ⅱ,Ⅲ, Ⅳ and V were significantly hitOer than those in group Ⅰ( qapoptosis rate Ⅰ, Ⅱ =12.26,qnecroeis Ⅰ,Ⅱ=18.34, qapoptosisⅠ.Ⅱ=9.63,qnecrosisⅠ,nⅡ=5.75,qapotosisⅠ,Ⅳ= 9.15,qnecrosisⅠ,Ⅳ= 5.39, qapotosisⅠ,Ⅴ = 10.87, qnecrosisⅠ,Ⅴ = 5.91, P 0.05), but lower in group Ⅲ,IV and V than those in group Ⅱ(qapoptosis Ⅱ,Ⅲ= 15.24, qpecrosisⅡ,Ⅲ=16.38, qapoptosisⅡ.Ⅳ = 15.95,qnecrosisⅡ.Ⅳ=16.95, qapoptosis rate Ⅱ,Ⅴ=14.57, qnecrosisⅡ.Ⅴ = 15.61,P<0.05). (2)The positive rate of Fas expression on AEC Ⅱ cells in group Ⅱ,Ⅲ, Ⅳ and V was obviously higher than that in group Ⅰ. ( q Ⅰ.Ⅱ=35.67, qⅠ ,Ⅲ=14.32, qⅠ,Ⅳ = 13.87, qⅠ.Ⅴ=26.16, P<0.05), but lower in gronpⅢ ,Ⅳ and Ⅴ than that in gronp Ⅱ(qⅡ,Ⅲ=12.54, qⅡ,Ⅳ = 13.02, qⅡ,Ⅴ =6.96, P<0.05). Conclusions GH can probably de-crease the apoptosis of AEC Ⅱ cells by inhibiting Fas expression.