caa a22 4500 445885432 CHVBK 20180317145558.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s00011-010-0267-4 doi (NATIONALLICENCE)springer-10.1007/s00011-010-0267-4 Temporal trends of circulating nitric oxide and pro-inflammatory cytokine responses ex vivo in intra-abdominal sepsis: results from a cohort study [Elektronische Daten] [Miriam Ojeda Ojeda, Hilev Larrondo Muguercia, Abel Magdariaga Figuerola, Alfredo Sánchez Valdivia, Ingrid Rodríguez Alonso, Carmen Valenzuela Silva, Elizeth García Iglesias, Emma Domínguez Alonso, Wim Buurman, Manuel Araña Rosaínz] Objective and design: To evaluate the association of pro-inflammatory mediators with organ dysfunction and adverse outcome in intra-abdominal sepsis patients. Subjects: Twenty-one patients admitted to the Intensive Care Unit (ICU) were prospectively included in the study. Only patients with surgical diagnosis of intra-abdominal sepsis were enrolled. Results: Tumor necrosis factor-α (TNFα) and interleukin (IL)-6 produced ex vivo were significantly lower in non-survivors on admission (p=0.021) and day 2 (p=0.013), respectively. Nitric oxide (NOx) levels were significantly higher in non-survivors from the onset of sepsis and until day 4 after diagnosis (p<0.05). Circulating lymphocyte counts were lower in non-survivors after admission over time, but there was no association with impaired cytokine production in this group of patients during the entire follow-up. All non-survivors developed nosocomial pneumonia concomitantly with multiple organ dysfunction and septic shock. There was a significant correlation between nitric oxide (NOx) concentrations and the sequential organ failure assessment (SOFA) score at day 2 (r=0.598, p=0.009), and ICU stay (r=0.605, p=0.006). Continuously high NOx levels correlated with organ failure. The pro-inflammatory mediators TNFα, IL-6 and NOx, and also the Simplified Acute Physiology Score II (SAPS-II), discriminate survivors from non-survivors. According to logistic regression models, although these parameters are independently associated with the outcome, they do not improve the predictive power of the SAPS-II score for mortality risk. Conclusions: Disturbances in inflammatory responses and increase in NOx generation seem to characterize early intra-abdominal sepsis, in which immune suppression is associated with an increased susceptibility to nosocomial infections. Sequential NOx determinations could be a useful approach for improving the management of patients with intra-abdominal sepsis. Springer Basel AG, 2010 Sepsis nationallicence Peritonitis nationallicence Intensive care nationallicence Cytokines nationallicence Markers nationallicence Ojeda Ojeda Miriam Division of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut Larrondo Muguercia Hilev Critical Care Unit, Hospital "Hermanos Ameijeiras”, Havana, Cuba aut Magdariaga Figuerola Abel Division of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut Sánchez Valdivia Alfredo Critical Care Unit, Hospital "Hermanos Ameijeiras”, Havana, Cuba aut Rodríguez Alonso Ingrid Division of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut Valenzuela Silva Carmen Division of Clinical Trials, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut García Iglesias Elizeth Division of Clinical Trials, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut Domínguez Alonso Emma Department of Immunology, National Institute of Endocrinology, 10400, Havana, Cuba aut Buurman Wim Department of General Surgery, University of Maastricht, Maastricht, The Netherlands aut Araña Rosaínz Manuel Division of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut Inflammation Research SP Birkhäuser Verlag Basel 60/3(2011-03-01), 289-297 1023-3830 60:3<289 2011 60 11 https://doi.org/10.1007/s00011-010-0267-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00011-010-0267-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ojeda Ojeda Miriam Division of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut NATIONALLICENCE 700 1- Larrondo Muguercia Hilev Critical Care Unit, Hospital "Hermanos Ameijeiras”, Havana, Cuba aut NATIONALLICENCE 700 1- Magdariaga Figuerola Abel Division of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut NATIONALLICENCE 700 1- Sánchez Valdivia Alfredo Critical Care Unit, Hospital "Hermanos Ameijeiras”, Havana, Cuba aut NATIONALLICENCE 700 1- Rodríguez Alonso Ingrid Division of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut NATIONALLICENCE 700 1- Valenzuela Silva Carmen Division of Clinical Trials, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut NATIONALLICENCE 700 1- García Iglesias Elizeth Division of Clinical Trials, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut NATIONALLICENCE 700 1- Domínguez Alonso Emma Department of Immunology, National Institute of Endocrinology, 10400, Havana, Cuba aut NATIONALLICENCE 700 1- Buurman Wim Department of General Surgery, University of Maastricht, Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Araña Rosaínz Manuel Division of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Havana, Cuba aut NATIONALLICENCE 773 0- Inflammation Research SP Birkhäuser Verlag Basel 60/3(2011-03-01), 289-297 1023-3830 60:3<289 2011 60 11 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer