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      The effects of hypertonic fluid administration on the gene expression of inflammatory mediators in circulating leucocytes in patients with septic shock: a preliminary study

      van Haren, Frank MP; Sleigh, James W.; Cursons, Raymond T.; Pine, Mary L.; Pickkers, Peter; van der Hoeven, Johannes
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      The effects.pdf
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      DOI
       10.1186/2110-5820-1-44
      Link
       www.annalsofintensivecare.com
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      van Haren, F.M., Sleigh, J., Cursons, R., Pine, M.L., Pickkers, P. & van der Hoeven, J. (2011). The effects of hypertonic fluid administration on the gene expression of inflammatory mediators in circulating leucocytes in patients with septic shock: a preliminary study. Annals of Intensive Care, 1:44.
      Permanent Research Commons link: https://hdl.handle.net/10289/5904
      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 shock patients, hypertonic fluid administration compared with isotonic fluid may modulate expression of genes that are implicated in leukocyte-endothelial interaction and capillary leakage.

      The study was performed at the Intensive Care Department, Waikato Hospital, and at the Molecular Genetics Laboratory, University of Waikato, Hamilton, New Zealand.

      Trial registration:

      Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12607000259448
      Date
      2011
      Type
      Journal Article
      Publisher
      Springer Verlag
      Collections
      • Science and Engineering Papers [3124]
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