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Titolo:
Endothelin in septic patients: Effects on cardiovascular and renal function and its relationship to proinflammatory cytokines
Autore:
Tschaikowsky, K; Sagner, S; Lehnert, N; Kaul, M; Ritter, J;
Indirizzi:
Univ Erlangen Nurnberg, Dept Anesthesiol, D-91054 Erlangen, Germany Univ Erlangen Nurnberg Erlangen Germany D-91054 -91054 Erlangen, Germany Knoll AG, Ludwigshafen, Germany Knoll AG Ludwigshafen GermanyKnoll AG, Ludwigshafen, Germany
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 6, volume: 28, anno: 2000,
pagine: 1854 - 1860
SICI:
0090-3493(200006)28:6<1854:EISPEO>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
PORCINE ENDOTOXIN-SHOCK; BIG-ENDOTHELIN; PLASMA-LEVELS; RECEPTOR ANTAGONIST; NECROSIS-FACTOR; CRITICALLY ILL; SEPSIS; FAILURE; DYSFUNCTION; CLEARANCE;
Keywords:
creatinine clearance; endothelin; interleukin-6; interleukin-8; multiple organ dysfunction; multiple trauma; pulmonary vascular resistance; sepsis; tumor necrosis factor-alpha;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Tschaikowsky, K Univ Erlangen Nurnberg, Dept Anesthesiol, Krankenhausstr 12, D-91054 Erlangen, Germany Univ Erlangen Nurnberg Krankenhausstr 12 Erlangen Germany D-91054
Citazione:
K. Tschaikowsky et al., "Endothelin in septic patients: Effects on cardiovascular and renal function and its relationship to proinflammatory cytokines", CRIT CARE M, 28(6), 2000, pp. 1854-1860

Abstract

Objective: To determine the time course of big-endothelin (big-ET) and itsrelationship to proinflammatory cytokines and organ function in sepsis. Design: Prospective analysis in patients meeting criteria of severe sepsisas part of a multicenter study (RAMSES) with an anti-tumor necrosis factormonoclonal antibody F(ab')(2) fragment (afelimomab). Setting: University hospital intensive care unit. Patients: A total of 23 nontrauma patients with severe sepsis or septic shock and ten multiple trauma patients. Septic patients were randomized for additional experimental treatment when initial interleukin (IL)-6 serum level was above 1000 pg/mL. Interventions: Randomized patients received 1.0 mg/kg afelimomab or placebo three times daily over 3 days in addition to standard treatment. In each patient, serial blood samples for plasma big-ET and cytokine determination as well as clinical data were collected over 28 days. Measurements and Main Results: Significantly increased concentrations of circulating big-ET were found in patients with severe sepsis as compared with healthy subjects. In septic papatients, and were more elevated in randomized than in nonrandomized patients. At study entry (day 0), big-ET reached a peak concentration and significantly correlated with IL-6 (r(2) =.43) andIL-8 (r(2) =.44) in patients with severe sepsis. Moreover, big-ET levels in septic patients, pooled over all observation days, correlated positively with pressure-adjusted heart rate, central venous pressure, pulmonary artery pressure, and pulmonary Vascular resistance and correlated inversely withcreatinine clearance (r(2) = .54, .54, .59, .40, and .51, respectively, p = .0001). In all randomized septic patients, pressure-adjusted heart rate decreased from day 0 to day 2 in parallel with big-ET; however, a significant decrease in big-ET (day 0 to day 2) was only found in patients additionally treated with afelimomab. Conclusions: In patients with severe sepsis, big-ET plasma levels are markedly increased, even above those of multiple trauma patients, in close relationship to IL-6 and IL-8, and with significant correlation to renal function and pulmonary vascular tone.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 22:55:58