RESUMO
To determine whether treatment with recombinant human tissue factor pathway inhibitor (TFPI), an inhibitor of the extrinsic coagulation pathway, can improve survival in a clinically relevant model of gram-negative sepsis, rabbits were given an intraperitoneal inoculation of a suspension containing hemoglobin (40 microg/mL), porcine mucin (150 microg/mL), and viable Escherichia coli O18:K1 (1.0 +/- 0.5 x 10(5) cfu/kg). Treatment with gentamicin (5 mg/kg every 12 h for five doses) was instituted 4 h after induction of peritonitis. At the same time point, rabbits were randomized to receive a 24-h infusion of vehicle or one of three different doses of TFPI. Treatment groups, 7-day survival rates, and significance versus control were as follows: control, 1 of 20; TFPI(LOW DOSE) (0.1 mg/kg, then 1 microg/kg/min), 3 of 12 (P = .14); TFPI(MID DOSE), (0.5 mg/kg, then 5 microg/kg/min), 7 of 12 (P = .002); TFPI(HIGH DOSE) (10 mg/kg, then 10 microg/kg/min), 4 of 13 (P = .04). Thus, delayed treatment with TFPI improves survival in septic rabbits.
Assuntos
Anticoagulantes/administração & dosagem , Infecções por Escherichia coli/tratamento farmacológico , Lipoproteínas/administração & dosagem , Peritonite/tratamento farmacológico , Choque Séptico/tratamento farmacológico , Animais , Antibacterianos/uso terapêutico , Coagulação Sanguínea/efeitos dos fármacos , Pressão Sanguínea , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Infecções por Escherichia coli/mortalidade , Gentamicinas/uso terapêutico , Humanos , Oxigênio/sangue , Peritonite/mortalidade , Coelhos , Proteínas Recombinantes/uso terapêutico , Choque Séptico/mortalidade , TromboplastinaAssuntos
Aneurisma Aórtico/cirurgia , Dissecção Aórtica/cirurgia , Pressão Sanguínea , Circulação Cerebrovascular , Monitorização Intraoperatória , Idoso , Tronco Braquiocefálico/fisiopatologia , Transtornos Cerebrovasculares/prevenção & controle , Artéria Femoral/fisiopatologia , Humanos , Complicações Intraoperatórias/prevenção & controle , Masculino , Artéria Radial/fisiopatologia , Fluxo Sanguíneo RegionalRESUMO
I.m. temperature probes were used in humans during and after hypothermic cardiopulmonary bypass (CPB). After rewarming to apparent normothermia of the body core, we found that the temperature of the vastus lateralis muscle remained well below the nasopharyngeal temperature at the time of weaning from bypass. This reduced muscle temperature represents a considerable deficit in total body heat which may account for a large proportion of the afterdrop in temperature which occurs in the postoperative period. There was no morbidity associated with the use of the i.m. probes which could be incorporated into standard clinical practice.
Assuntos
Temperatura Corporal , Ponte Cardiopulmonar , Monitorização Intraoperatória/métodos , Músculo Esquelético/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hipotermia Induzida , Masculino , Pessoa de Meia-Idade , Nasofaringe/fisiopatologia , ReaquecimentoRESUMO
We report a case where misleading readings form a pulse oximeter were compared with the results obtained from a continuous multiparameter blood gas sensor (Paratrend 7 - Biomedical Sensors UK). The continuous mode of recording was useful in determining the right clinical course for the patient and serves to show how pulse oximetry may demonstrate misleading results in low flow states.
