Avtor/Urednik		Spindler-Vesel, Alenka
Naslov		Vpliv povečane črevesne prepustnosti na pojav sistemskega vnetnega odziva
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Medicinska fakulteta
Leto izdaje		2004
Obseg		str. 55
Jezik		slo
Abstrakt		Objective. Gut might have a central role in the development of multiple organ failure (MOF) in critically ill patients. Namely, during increased intestinal permeability translocation of intestinal bacteria and endotoxin might occur. The bindings of the bacterial endotoxin to specific receptors on the membrane of monocytes/macrophages starts the synthesis and secretion of tumor necrosis factor a (TNF-alpha), interleukin (IL) 1 and others proinflammatory cytokines. Cytokines have the key role in the systemic inflammatory response. Their excessive secretion could lead to the tissue damage and organ failure. TNF-alpha stimulates the synthesis of proinflammatory cytokines and is the central mediator of sepsis. Among proinflammatory cytokines, that maintain and intensify inflammatory response, IL-6 and IL-8 are the most studied. The aim of our study was therefore to fmd an association between intestinal permeability and systemic inflammatory response. Methods. We prospectively studied adult polytrauma patients (ISS score > 18), admitted to the Central intensive care unit (ICU). Lactulose-mannitol (LlM) test was done on days 2 and 4 after trauma. Blood was taken simultaneously to determine TNF-alpha, IL-6 and IL-8 plasma concentrations. Results. 30 multiply injured patients (mean age 37 +- 19 years, 24 men (80%), APACHE II score 14 +- 7, ISS score 29 +- 9) were enrolled in the study. The patients were treated in ICU for an average period of 18 +- 13 days and were mechanically ventilated for 14 +- 10 days. The average multiple organ failure score in the first four days was 2.33 +- 0.91. We found negative correlation between IL-8 at day 4 and the age of patients (r = -0.41, p < 0.05) and a positive correlation between IL-6 at day 2 and APACHE II (r = 0.53, p < 0.01). (Abstract truncated at 2000 characters).
Deskriptorji		MULTIPLE TRAUMA INTENSIVE CARE UNITS INTESTINAL ABSORPTION TUMOR NECROSIS FACTOR INTERLEUKIN-6 INTERLEUKIN-8 LACTULOSE MANNITOL RESPIRATION, ARTIFICIAL INJURY SEVERITY SCORE CRITICAL ILLNESS MULTIPLE ORGAN FAILURE APACHE PROSPECTIVE STUDIES