Patterns of cytokine evolution (tumor necrosis factor-alpha and interleukin-6) after septic shock, hemorrhagic shock, and severe trauma.

Objective: To compare the patterns of evolution of two proinflammatory cytokines (tumor necrosis factor [TNF]-alpha and interleukin-6 [IL-6]) in two major clinical entities associated with systemic inflammatory response: septic shock and multiple trauma (with and without hemorrhagic shock).

Design: Prospective study of two cohorts of patients.

Setting: Critical care unit and Emergency Center of a university hospital.

Antimicrobial prophylaxis in surgery: general concepts and clinical guidelines. French Study Group on Antimicrobial Prophylaxis in Surgery, French Society of Anesthesia and Intensive Care.

Bacteria are found in 90% of surgical incisions, regardless of surgical technique or environment. Initially, the number of pathogens is low, but proliferation is facilitated by favorable local conditions and weakened host defense mechanisms. The principles of presurgical administration of antibiotics are well defined, but a few controversies persist.