the effects of hypertonic fluid administration on the gene expression of inflammatory mediators in circulating leucocytes in patients with septic shock a preliminary study基因表达的影响高渗液体管理循环白细胞炎症介质的脓毒性休克患者的初步研究.pdfVIP

van Haren et al. Annals of Intensive Care 2011, 1:44 /content/1/1/44 RESEARCH Open Access The effects of hypertonic fluid administration on the gene expression of inflammatory mediators in circulating leucocytes in patients with septic shock: a preliminary study 1* 2 3 2 4 Frank MP van Haren , James Sleigh , Ray Cursons , Mary La Pine , Peter Pickkers and Johannes G van der Hoeven4 Abstract Objective: This study was designed to investigate the effect of hypertonic fluid administration on inflammatory mediator gene expression in patients with septic shock. Design and setting: Prospective, randomized, controlled, double-blind clinical study in a 15-bed mixed intensive care unit in a tertiary referral teaching hospital. Interventions: Twenty-four patients, who met standard criteria for septic shock, were randomized to receive a bolus of hypertonic fluid (HT, 250 ml 6% HES/7.2% NaCl) or isotonic fluid (IT, 500 ml 6% HES/0.9% NaCl) administered over 15 minutes. Randomization and study fluid administration was within 24 hours of ICU admission for all patients. This trial is registered with ANZCTR.org.au as ACTRN12607000259448. Results: Blood samples were taken immediately before and 4, 8, 12, and 24 hours after fluid administration. Real- time reverse transcriptase polymerase chain reaction (RT rtPCR) was used to quantify mRNA expression of different inflammatory mediators in peripheral leukocytes. In the HT group, compared with the IT group, levels of gene expression of MMP9 and L-selectin were significantly suppressed (p = 0.0002 and p = 0.007, respectively), and CD11b gene expression tended to be elevated (p = NS). No differences were found in the other mediators examined. Conclusions: In septic