ABSTRACT
Background: Erythropoietin [EPO] is known as a regulating hormone for the production of red blood cells, called erythropoiesis. Some studies have shown that EPO exerts some non-hematopoietic protective effects on ischemia-reperfusion injuries in myocytes. Using echocardiography, we evaluated the effect of EPO infusion on reducing ischemia-reperfusion injuries and improvement of the cardiac function shortly after coronary artery bypass graft surgery [CABG]
Methods: Forty-three patients were recruited in this study and randomly divided into two groups: the EPO group, receiving standard medication and CABG surgery plus EPO [700 IU/ kg], and the control group, receiving standard medication and CABG surgery plus normal saline [10 cc] as placebo. The cardiac function was assessed through echocardiography before as well as at 4 and 30 days after CABG
Results: Echocardiography indicated that the ejection fraction had no differences between the EPO and control groups at 4 days [47.05 +/- 6.29 vs. 45.90 +/- 4.97; P=0.334] and 30 days after surgery [47.27 +/- 28 vs. 46.62 +/- 5.7; P=0.69]. There were no differences between the EPO and control groups in the wall motion score index at 4 [P=0.83] and 30 days after surgery [P=0.902]. In the EPO group, there was a reduction in left ventricular end-systolic and end-diastolic diameters [LVESD and LVEDD, respectively], as compared to the control group
Conclusion: Our results indicated that perioperative exogenous EPO infusion could not improve the ventricular function and wall motion index in the immediate post-CABG weeks. Nevertheless, a reduction in LVEDD and LVESD at 4 days and 30 days after CABG in the EPO group, by comparison with the control group, suggested that EPO correlated with a reduction in the remodeling of myocytes and reperfusion injuries early after CABG
ABSTRACT
Fungi are considered as a life threatening in immunocompromised patients and respiratory tract is the main involvement location. Critically ill patients who are admitted to intensive care units [ICU] may also be susceptible to these infections, because of their conditions. Fungal colonization in respiratory tract maybe consider as a probable source for infection. Therefore, in the present study we evaluatedfungal flora of respiratory tract in patients admitted to ICU. Bronchoalveolar lavage samples were collected by bronchoscope from 45 patients with underlying predisposing conditions for invasive fungal infection twice a week. Samples were homogenated by pancreatin for performance of direct microscopic examination and cultured on Sabouraud's dextrose agar. The grown fungi on culture media were identified by standard mycological procedures. The main underlying predisposing conditions were COPD [22.2%], hematologic malignancy [20.3%] and prolonged stay in the ICU [16.9%]. The mean length of ICU stay was 19.6 days. Overall, 80 samples had positive result in direct examination [76.2%] and culture [71.2%], respectively. The most frequent isolated fungi were Candida [64.7%], Aspergillus [19.3%] and Penicillium [7.9%]. Among Candida and Aspergillus species, C. albicans and A. flavus were most common. In 48.4% of patients, similar fungal species were isolated in both sampling times. The results of our study showed that the ICU patients were susceptible to fungal resistant colonization especially Candida and Aspergillus as two life threatening fungal agents. So we emphasize the control procedures to reduce the fungal infection possibility among ICU patients