Right man, right time, right place - On the time course of the mediator orchestra in septic shock 英文参考文献.docVIP

Hauser and Radermacher Critical Care 2010,14:190 /content/14/4/190 COMMENTARY Right man, right time, right place? – On the time course of the mediator orchestra in septic shock Balázs Hauser* and Peter Radermacher 1 2 See related research by Lange et al., /content/14/4/R129 ‘Downstream e? ects’ were evaluated by measuring NOS activity, nitric oxide (NO) production, and interleukin-8 concentrations. During the early phase (that is, 4 to Abstract Appropriate timing of treatment assumes particular importance in critical care. Lange and colleagues 12 hours after induction of pneumonia), eNOS expression was increased, and this coincided with increased tissue levels of nitrotyrosine, poly(ADP-ribose), and NF-κB activation, whereas in the later phase (that is, until 24 hours of pneumonia), measurable NOS activity and NO produc tion were related mainly to iNOS recently reported on the time course of the di?erent nitric oxide synthase (NOS) isoforms, nitrosative stress, and poly(ADP-ribosylation) during Pseudomonas aeruginosa pneumonia-induced ovine septic shock. Initially, endothelial NOS expression was increased together with markers of peroxynitrite formation, DNA damage, and nuclear factor-kappa-B activation. Later on, measurable NOS activity and nitric oxide production resulted mainly from inducible NOS activation. These results emphasize the need for long- term, large-animal studies investigated over days so that future therapeutic interventions can be better tailored and matched to the exact time course of the activation of the mediator orchestra. activa e authors’ ‘two-hit’ model of cotton smoke inhalation and subse quent instillation of live bacteria is characterized by a hyperdynamic circulation, hypo ten- sion, tissue acidosis, and progressive impairment of gas exchange, lung mech anics, and morphological alterations typ