Metabolism of Albumin after Continuous Venovenous Hemofiltration in Patients with Systemic Inflammatory Response Syndrome

Background. The systemic inflammatory response syndrome (SIRS) is characterized by a hypercatabolic state induced by inflammatory mediators. Continuous venovenous hemofiltration (CVVH) stabilizes the internal environment but also aggravates loss of amino acids. The effect of CVVH on protein dynamics is largely unknown. We adopted the stable isotopic tracer technology to investigate how CVVH changed serum albumin metabolism.Methods. Twenty SIRS patients were randomized into low- (2000 mL/h) and high- (4000 mL/h) volume CVVH groups according to the rate of replacement fluid. Eight patients with abdominal infection matched for age, sex, and laboratory index served as controls. Consecutive arterial blood samples were drawn during a primed-constant infusion of two stable isotopes to determine the albumin fractional synthesis rate (FSR) and fractional breakdown rate (FBR).Results. Before treatment, there was no significant difference of FSR and FBR among 3 groups. After CVVH, the albumin FSR in high- and low-volume groups was 7.75 ± 1.08% and 7.30 ± 0.89%, respectively, both higher than in the control (5.83 ± 0.94%). There was no significant difference in albumin FBR after treatment.Conclusions. Protein dynamic indicators could reflect protein synthesis and breakdown state directly and effectively. CVVH increased albumin synthesis, while the breakdown rate remained at a high level independently of the CVVH rate.

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Anti-inflammatory response of IL-4, IL-10 and TGF-β in patients with systemic inflammatory response syndrome

Mediators of Inflammation ◽

10.1080/09629350020002912 ◽

2000 ◽

Vol 9 (3-4) ◽

pp. 193-195 ◽

Cited By ~ 23

Author(s):

Donato Torre ◽

Roberto Tambini ◽

Silvana Aristodemo ◽

Giovanna Gavazzeni ◽

Antonio Goglio ◽

...

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Transforming Growth Factor Beta ◽

Transforming Growth Factor ◽

Serum Levels ◽

Interleukin 10 ◽

Systemic Inflammatory Response ◽

Interleukin 4 ◽

Significant Difference ◽

Anti Inflammatory

The systemic inflammatory response syndrome (SIRS) is an inflammatory process seen in association with a large number of clinical infective and noninfective conditions.The aim of this study was to investigate the role of anti-inflammatory cytokines such as interleukin–4 (IL–4), interleukin–10 (IL–10), and transforming growth factor-beta (TGF-beta). Serum levels of IL–4, IL–10 and TGF-β were determined in 45 patients with SIRS: 38 patients had SIRS of infectious origin, whereas seven patients had non-infectious SIRS. Twenty healthy subjects were used as controls.Serum levels of IL–4, IL–10 and TGFg were determined by an immunoenzyme assay. A significant increase of IL–4 was observed in these patients at the time of diagnosis and 5 days later. In contrast, serum levels of IL–10 were not increased at the time of diagnosis, but a slight decrease was noted after 5 days. Serum levels of TGF-β were not increased at time of diagnosis, and a slight increase was observed after 5 days. Serum levels of IL–4 were significantly higher in patients with infectious SIRS at the time of diagnosis, whereas no significant difference between infectious and non-infectious SIRS was noted for serum levels of IL–10 and TGF-β at the time of diagnosis and 5 days later.During SIRS, serum levels of IL–4 were significantly increased with a significant correlation between IL–4 and mortality, and only levels of IL–4 were significantly increased in the SIRS caused by infectious stimuli.

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The effect of the duration between urine culture and semirigid ureteroscopic on the rate of systemic inflammatory response syndrome postoperatively

10.22541/au.161282090.06660085/v1 ◽

2021 ◽

Author(s):

Fatih Akkaş ◽

Emre Sam ◽

Ahmet Cinislioglu ◽

İbrahim Karabulut ◽

Fatih Kursat Yilmazel ◽

...

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Urine Culture ◽

Systemic Inflammatory Response ◽

Binary Logistic Regression Analysis ◽

Ureteroscopic Lithotripsy ◽

Entire Study ◽

Significant Difference ◽

The Impact ◽

Bladder Urine

Purpose: The aim of this study is to analyze the preoperative and intraoperative factors that might induce systemic inflammatory response syndrome after semirigid ureteroscopic lithotripsy (SULL) , and to evaluate the impact of duration between preoperative bladder urine culture (PBUC) and surgery on postoperative systemic inflammatory response syndrome (SIRS). Methods: A retrospective review was conducted including patients who underwent SULL in our center between January 2011 and June 2020. Prior to surgery, PBUC were obtained from all patients and postoperatively patients were observed for signs of SIRS. Univariable and multivariable binary logistic regression analysis were implemented to demonstrate the factors that predict SIRS postoperatively. Results: The entire study included a cohort of 572 patients. The rate of SIRS following SULL was 1.7%. Predictive factors for SIRS were listed as stone volume, surgical time, and history of recurrent urinary tract infection. No significant difference was detected in terms of the duration between PBUC and SULL when comparing the SIRS group with the other group. Conclusion: The duration between PBUC and SULL is not an efficacious factor for SIRS. It may be useful to conduct prospective studies to enlighten this issues as endourologists deal with this duration dilemma often in daily practice. Keywords: Semirigid ureteroscopic lithotripsy, Systemic inflammatory response syndrome, Preoperative bladder urine culture

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The value of procalcitonin in systemic inflammatory response syndrome after open-heart surgery for CHD

Cardiology in the Young ◽

10.1017/s1047951119001847 ◽

2019 ◽

Vol 29 (11) ◽

pp. 1335-1339

Author(s):

Kuntum Basitha ◽

Rubiana Sukardi ◽

Ratna Farida Soenarto ◽

Suprayitno Wardoyo

Keyword(s):

Platelet Count ◽

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Heart Surgery ◽

Open Heart Surgery ◽

Systemic Inflammatory Response ◽

Open Heart ◽

Time Duration ◽

Procalcitonin Level ◽

Significant Difference

AbstractBakground:Systemic inflammatory response syndrome, which is marked by fever, is a possible complication after open-heart surgery for CHD. The inflammatory response following the use of cardiopulmonary bypass shows similar clinical signs with sepsis. Therefore serial measurements of procalcitonin, an early infection marker, can be helpful to differentiate between sepsis and systemic inflammatory response syndrome.Objectives:To evaluate serial levels of procalcitonin in children who underwent open-heart surgery for cyanotic and acyanotic CHD, and identify factors associated with elevated level of procalcitonin.Methods:Children and infants who had open-heart surgery and showed fever within 6 hours after surgery were recruited. Procalcitonin levels were serially measured along with leukocyte and platelet count. Other data were also recorded, including diagnosis, age, body weight, axillary temperature, aortic clamp time, bypass time, duration of mechanical ventilation, risk adjustment for congenital heart surgery score-1, and length of stay in Cardiac ICU. The patients were categorised into cyanotic and acyanotic CHD groups.Results:High mean of procalcitonin level suggested the presence of bacterial infection. Cyanotic CHD group had significantly higher mean of procalcitonin level compared to acyanotic CHD group in the first two measurements. Both groups had no leukocytosis, though platelet count results were significantly different between the two groups. There was no significant difference of procalcitonin level observed in culture results and adverse outcomes.Conclusion:Serial procalcitonin measurement can be helpful to determine the cause of fever. Meanwhile other conventional markers such as leukocyte and platelet should be assessed thoroughly.

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Effect of tetrastarch (hydroxyethyl starch 130/0.4) on plasma creatinine concentration in cats: a retrospective analysis (2010–2015)

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x16676160 ◽

2016 ◽

Vol 19 (10) ◽

pp. 1073-1079 ◽

Cited By ~ 3

Author(s):

Ivayla D Yozova ◽

Judith Howard ◽

Katja N Adamik

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Hydroxyethyl Starch ◽

Reference Interval ◽

Systemic Inflammatory Response ◽

Plasma Creatinine ◽

Laboratory Evaluation ◽

Creatinine Concentration ◽

Maximum Change ◽

Significant Difference

Objectives The objective was to determine survival and changes in creatinine concentrations after administration of 6% tetrastarch (hydroxyethyl starch [HES] 130/0.4) vs crystalloids in critically ill cats. Methods The medical records were reviewed for cats admitted to the intensive care unit with at least two plasma creatinine measurements and initial concentrations not exceeding the upper reference interval. Cats were excluded if they had received HES prior to admission or if they had received fluid therapy for <24 h between initial and subsequent measurements. Changes in creatinine concentrations were evaluated as the percentage change from initial values to the maximum subsequent measurements. Cats receiving only crystalloids were assigned to the crystalloid group; cats receiving only HES or HES and crystalloids were assigned to the HES group. Results Ninety-three cats were included in the study (62 in the crystalloid group, 31 in the HES group). The total median cumulative HES dose was 94 ml/kg (range 26–422 ml/kg) and 24 ml/kg/day (range 16–42 ml/kg/day). No difference was detected between the groups for age, sex, body weight or mortality. The HES group had a significantly longer length of hospitalisation ( P = 0.012), lower albumin concentrations ( P <0.001), higher Acute Patient Physiologic and Laboratory Evaluation scores ( P = 0.037) and higher incidence of systemic inflammatory response syndrome ( P = 0.009) and sepsis ( P = 0.013). There was no significant difference in initial, maximum or maximum change in creatinine concentrations between the groups. Moreover, there was no significant difference in maximum change in creatinine concentrations in the subgroups of cats with systemic inflammatory response syndrome or sepsis. Conclusions and relevance In this population of cats, the administration of HES did not result in a significantly greater increase in creatinine from values measured on admission or higher mortality compared with administration of crystalloids. Further prospective studies are needed to assess both safety and efficacy of HES in cats before recommendations can be made.

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The effect of urinary and arterial blood pH on the progression of acute kidney injury in critically ill patients with systemic inflammatory response syndrome or sepsis and oliguria

Australian Critical Care ◽

10.1016/j.aucc.2015.06.001 ◽

2016 ◽

Vol 29 (1) ◽

pp. 41-45 ◽

Cited By ~ 1

Author(s):

Wendy J. Dunn ◽

Tomoko Shimizu ◽

Nick Santamaria ◽

Rhonda J. Underwood ◽

Tanya L. Woods

Keyword(s):

Acute Kidney Injury ◽

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Critically Ill ◽

Critically Ill Patients ◽

Kidney Injury ◽

Systemic Inflammatory Response ◽

Arterial Blood ◽

Blood Ph

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The Effect of the Duration between Preoperative Bladder Urine Culture and Semirigid Ureteroscopic Lithotripsy on the Rate of Systemic Inflammatory Response Syndrome Postoperatively

Urology Open Access Open Journal ◽

10.33169/uro.uoaoj-2-118 ◽

2021 ◽

Vol 2 (2) ◽

pp. 65-69

Author(s):

Fatih Akkas

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Urine Culture ◽

Systemic Inflammatory Response ◽

Binary Logistic Regression Analysis ◽

Ureteroscopic Lithotripsy ◽

Entire Study ◽

Significant Difference ◽

The Impact ◽

Bladder Urine

Purpose The aim of this study is to analyze the preoperative and intraoperative factors that might induce systemic inflammatory response syndrome (SIRS) after semirigid ureteroscopic lithotripsy (SUL), and to evaluate the impact of duration between preoperative bladder urine culture (PBUC) and surgery on postoperative systemic inflammatory response syndrome (SIRS). Methods A retrospective review was conducted including patients who underwent SUL in our center between June 2015 and June 2020. Prior to surgery, PBUC were obtained from all patients and postoperatively patients were observed for signs of SIRS. Univariable and multivariable binary logistic regression analysis were implemented to demonstrate the factors that predict SIRS postoperatively. Results The entire study included a cohort of 572 patients. The rate of SIRS following SUL was 1.7%. Predictive factors for SIRS were listed as stone volume, surgical time, and history of recurrent urinary tract infection. No significant difference was detected in terms of the duration between PBUC and SUL when comparing the SIRS group with the other group. Conclusion The duration between PBUC and SUL is not efficacious factor for SIRS. It may be useful to conduct prospective studies to enlighten this issue as endourologists deal with this duration dilemma often in daily practice. Keywords: Semirigid ureteroscopic lithotripsy, Systemic inflammatory response syndrome, Preoperative bladder urine culture.

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THE USE FGSI AS PREDICTIVE OF UROLOGICAL SIRS PATIENTS

Indonesian Journal of Urology ◽

10.32421/juri.v20i2.10 ◽

2013 ◽

Vol 20 (2) ◽

Author(s):

Basuki Bambang Purnomo

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Vital Signs ◽

Severity Index ◽

Fournier’S Gangrene ◽

Systemic Inflammatory Response ◽

Outcome Predictor ◽

Fournier's Gangrene ◽

Laboratory Findings ◽

Significant Difference

Objective: To demonstrate the usefulness of Fournier’s Gangrene Severity Index (FGSI) score for differentiating the outcome between Systemic Inflammatory Response Syndrome (SIRS) patients with upper and lower urological abnormalities. Material & Method:A retrospective study of case records from year 2009-2012 of SIRS patients with urological abnormalities at Saiful Anwar General Hospital (SAGH) Malang was carried out. The data were collected from the Medical Record Division in SAGH Malang. SIRS was clinicaly diagnosed based on medical history, physical examination and laboratory findings. SIRS without urological abnormalities were excluded from the analysis. The FGSI, which was developed to assign a numerical score that describes the severity of disease, was used in our study. This index presents patients vital signs (temperature, heart and respiratory rates) and metabolic parameters (sodium, potassium, creatinine, and bicarbonate levels, hematocrit, and white blood cell count). Patients with SIRS and urological abnormalities were divided according to upper tract and lower tract urological abnormalities. Total FGSI score was classified as mild (0-8), moderate (9-17), severe (> 17). The data were assessed according to whether the patient survived or died.Results:75 of the 203 evaluated patients died. From those 75 patients, 67% were male and 33% were female, 75% with upper urological abnormalities and 25% with lower abnormalities (p < 0,05). From those 203 patients; the results were analyzed with binary logistical regression and Spearman correlation analysis using SPSS 15 softwarewith 95% confidence interval (CI). There is significant relationship between FGSI and outcome of the patient with upper urological abnormalities and lower urological abnormalities, with correlation coefficient more high in relationship between FGSI and outcome of the patient with upper urological abnormalities (0,4 vs 0,1). Conclusion: FGSI is simple and objective outcome predictor to differentiate survival between SIRS patients with upper urological abnormalities and lower urological abnormalities. There is a significant difference in outcome between SIRS patient with upper urological abnormalities and lower urological abnormalities even with same level of FGSI score.Keywords: Fournier’s gangrene severity index, systemic inflammatory response syndrome, upper urological abnormalities, lower urological abnormalities, outcome predictor.

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