beta2-Adrenoceptor blockade partially restores ex vivo TNF production following hemorrhagic shock.

The aim of the study was to assess the mechanisms through which leukocyte deactivation occurs upon hemorrhagic shock. In particular, the influence of beta-adrenergic tone was evaluated. BALB/c mice were hemorrhaged and resuscitated 60 min after hemorrhage.

The influence of tidal volume on the dynamic variables of fluid responsiveness in critically ill patients.

Respiratory-related variabilities in stroke volume and arterial pulse pressure (Delta%Pp) are proposed to predict fluid responsiveness. We investigated the influence of tidal volume (Vt) and adrenergic tone on these variables in mechanically ventilated patients. Cyclic changes in aortic velocity-time integrals (Delta%VTI(Ao), echocardiography) and Delta%Pp (catheter) were measured simultaneously before and after intravascular volume expansion, and Vt was randomly varied below and above its basal value.

Hydrocortisone increases the sensitivity to alpha1-adrenoceptor stimulation in humans following hemorrhagic shock.

Objective: To assess the pressor response to phenylephrine infusion before and after hydrocortisone in severe trauma patients and to correlate this response with their adrenal reserve.

Design: Prospective clinical study.

Setting: Surgical intensive care unit in a university teaching hospital.

Influence of resuscitation volume on blood cells TNF production in a murine model of haemorrhage.

The influence of haemorrhage and resuscitation on Tumour Necrosis Factor (TNF) production by whole blood cultures under endotoxin (Escherichia coli LPS) stimulation was investigated in male BALB/c mice. Haemorrhagic shock was induced by removing 0.026 +/- 0.

Early embolization and vasopressor administration for management of life-threatening hemorrhage from pelvic fracture.

Background: In this retrospective study, we reviewed our protocol for management of hemodynamically unstable patients with pelvic injury.

Methods: We managed the patients with the same predetermined plan including controlled hemodynamic resuscitation with early use of vasopressors and pelvic angiography as a first-line treatment.

Results: Of 311 patients with pelvic fracture, 32 hemodynamically unstable patients (10.

Incidence and significance of cardiac troponin I release in severe trauma patients.

Background: The incidence and significance of troponin I release and its mechanism are unknown in severe trauma patients. The characteristics of this release were prospectively studied in such patients and correlated with presence of shock, existence of myocardial contusion, and outcome.

Methods: During a 24-month period, serial electrocardiogram recordings and troponin I measurements were performed in all trauma patients admitted at a surgical intensive care unit.

Effect of isoproterenol on the cardiac troponin I degradation and release during early TNFalpha-induced ventricular dysfunction in isolated rabbit heart.

We studied the consequences of an early phase of TNFalpha-induced LV dysfunction and of its treatment by isoproterenol on an isolated rabbit heart preparation. Two dosages of TNFalpha (2 and 4 microg) were infused, followed by isoproterenol (ISO), infused by increasing concentrations from 10 to 10 M. Left ventricular developed pressure (DP) was recorded.

Effect of bupivacaine on the isolated rabbit heart: developmental aspect on ventricular conduction and contractility.

Background: Newborns and infants seem to be at greater risk of bupivacaine cardiotoxicity than adults do. Few experiments have studied the effects of local anesthetics on myocardium associated with developmental changes, and their conclusions are conflicting. The authors compared the effects of bupivacaine on an isolated heart preparation in newborn and adult rabbits.

Toll-like receptor-mediated tumor necrosis factor and interleukin-10 production differ during systemic inflammation.

Major trauma is associated with a decreased capacity of patients' leukocytes to produce proinflammatory cytokines on in vitro stimulation. We studied leukocytes from 48 patients with trauma and showed that this hyporeactivity was restricted to gram-negative bacteria, Escherichia coli endotoxin, and unmethylated bacterial DNA, whereas Leptospira interrogans endotoxin-induced tumor necrosis factor production was similar to that observed with healthy donors. As well, tumor necrosis factor and interleukin-6 production in response to gram-positive bacteria was not altered.

Cortisol response to corticotropin stimulation in trauma patients: influence of hemorrhagic shock.

Background: An abnormal adrenocortical function and a vasopressor dependency have been demonstrated during septic shock. Because trauma and hemorrhage are the leading causes of noninfectious inflammatory syndromes, the goal of this study was to assess the adrenal reserve of trauma patients and its relation with clinical course.

Methods: Cortisol response to an intravenous corticotropin bolus was obtained in 34 young trauma patients (Injury Severity Score =29.

Dobutamine and gastric-to-arterial carbon dioxide gap in severe sepsis without shock.

Objectives: To evaluate the effect of an early dobutamine infusion on gastrointestinal perfusion in patients with severe sepsis.

Design: Prospective, randomized, controlled, multicenter clinical study.

Setting: Six medical and/or surgical intensive care units (ICU) of teaching hospitals.