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At least 523 records · Page 29Linked to original sources
PubMed2000

Incidence of septic complications and multiple organ failure in severely injured patients is sex specific.

BACKGROUND: Sexual hormones are potent regulators of various immune functions. Although androgens are immunosuppressive, estrogens protect against septic challenges in animal models. This study correlates sexual dimorphism with the incidence of posttraumatic complications in severely injured patients. METHODS: From January of 1991 to February of 1996, 1,276 consecutive injured patients (Injury Severity Score [ISS] > or = 9 points) were studied. Males (n = 911) did not differ from females (n = 365) with regard to severity of injury (ISS) and injury pattern. RESULTS: The incidence of posttraumatic sepsis (30.7%) and multiple organ dysfunction syndrome (29.6%) was significantly increased in severely injured males with ISS > or = 25 points in comparison to the equivalent group of females (sepsis, 17.0%; multiple organ dysfunction syndrome, 16.0%). No difference was found in patients with ISS < 25 points. Moreover, plasma levels of procalcitonin and interleukin-6 were elevated (p < 0.05) in severely injured males compared with females. CONCLUSION: Sex influences posttraumatic morbidity in severely injured patients and supports the concept that females are immunologically better positioned toward a septic challenge.

Adult↗
PubMed2000

The role of tumor necrosis factor in the development of multiple organ failure in a murine model.

OBJECTIVE: To elucidate the role of tumor necrosis factor (TNF) in the development of multiple organ dysfunction syndrome (MODS) after zymosan-induced peritonitis in mice. DESIGN: Prospective controlled laboratory study on zymosan-induced generalized inflammation in mice. Over < or =28 days, a single intraperitoneal administration of zymosan induced a three-phase illness in C57BL mice, rendering them very ill with MODS-like symptoms from day 7 onward. Additionally, the same experiment was performed on C57BL/6 TNF-Rc-p55 knockout mice to elucidate the role of TNF and its receptor p55. SETTING: Animal research laboratory. SUBJECTS: Inbred C57BL mice and C57BL p55-/- mice received a single sterile intraperitoneal injection of zymosan suspended in paraffin oil (0.75 mg/g of body weight). MEASUREMENTS AND MAIN RESULTS: The animals were monitored for survival, condition, and body weight for < or =28 days. At 3, 7, 14, and 28 days after zymosan administration, bronchoalveolar lavage was performed and lungs and livers were extracted for isolation of RNA and histopathologic evaluation. Reverse-transcriptase-polymerase chain reaction was performed to quantify TNF-alpha messenger RNA (mRNA) in the respective organs. Both animal strains went through initial shock with a high mortality rate during the first 3 days. The C57BL mice developed MODS with typical symptoms and histopathologic results correlating with excessive TNF-alpha mRNA expression from day 7 onward. In contrast, no disease, histopathologic changes, nor TNF-alpha mRNA expression in liver or lung was found within the TNF-Rc-p55-/- mice. CONCLUSION: Organ-derived TNF-alpha plays a crucial role in the development of MODS in this murine model.

Animals↗
PubMedDate not supplied

[A present-day variant of intermitttent replacement renal therapy in patients with multiple organ failure after cardiovascular surgery].

The efficiency of "semi-prolonged" replacement renal therapy (RRT) was assessed in patients with multiple organ dysfunction (MOD) after cardiovascular surgery. The results of semiprolonged RRT are analyzed in 65 patients (36-69 years, mean age 52.4 +/- 15.7 years, body weight 57-105 kg, mean 79.4 +/- 21.6 kg) operated on at A. N. Bakulev Cardiovascular Surgery Center, Russian Academy of Medical Sciences. Bicarbonate hemodialysis (BHD) was carried out in 50 patients, on-line hemodiafiltration (HDF) in the rest patients. Interventions on the heart and vessels of different complexity were carried out. The results indicate that semiprolonged SRT in complex with intensive care measures notably reduced the mortality of patients with MOD and improved the survival rate in this category of patients. Semiprolonged RRT is an effective method, which can and should be used in critical patients. This method meets all the requirements to modern RRT and ensures adequate filtration of nitrous metabolism products, corrects water-electrolyte and acid base balance, allows infusion/transfusion therapy and parenteral nutrition, and has no negative impact on the hemodynamic values, which is particularly important after cardiovascular interventions.

Adult↗
PubMed1990

The multiple organ failure syndrome.

Technology that has made it possible to resuscitate the severely sick and injured from formerly lethal shock has exposed a new disease. A potential sequela of ruptured aneurysm, acute pancreatitis, septic shock, burns, surgical complications, and trauma, MOF syndrome is the leading cause of death in surgical ICUs. Aggressive monitoring and prompt therapy can save lives.

Combined Modality Therapy↗
PubMed1998

[Is modification of systemic inflammatory response syndrome and multiple organ failure by parenteral feeding possible?].

In this prospective, randomized, double-blind controlled clinical study, 29 patients after severe trauma (ISS about 40) were randomized to receive either IMPACT (Test) or an isonitrogenous isocaloric diet (Control). The primary study endopoints were the incidence of SIRS and MOF (definitions according to Bone, Goris and Sauaia). Test-fed patients developed significantly less SIRS between days 1 and 28 (8 vs 13.3, P < 0.05) and especially between days 8 and 14 (3 vs 6.2, P < 0.001). In the control group the Goris score was significantly worse (P < 0.05) on days 3, 4, 6, 7, 10, 11, 16, 17 and the Sauaia score on days 8, 9, 10, 11 (P < 0.05, P < 0.01). According to the results, an arginine, omega-3-fatty acids and nucleotide-enriched diet during early enteral feeding leads to reduction of SIRS and MOF scores after severe multiple injury.

Critical Care↗
PubMed1990

[Pharmacokinetics of drugs in single and multiple organ failure].

Organ failure modifies the pharmacokinetics of drugs and usually requires a decrease in their dosage. A decrease in cardiac output, in protein binding and extraction ratio, hepatic and renal insufficiency, a modification in acid-base balance are the main factors regulating pharmacokinetics of drugs used in anaesthesia and intensive therapy.

Anesthesia↗