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Yuichiro Sakamoto,Satoshi Inoue,Takashi Iwamura,Tomoko Yamashita,Atsushi Nakashima,Yoichi Nishimura,Hiroyuki Koami,Hisashi Imahase,Akiko Goto,Kosuke Chris Yamada,Kunihiro Mashiko,Hiroyuki Yokota 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.3
Purpose: Few reports have been made on the therapeutic effects as well as pathological features of an antithrombin preparation in patients diagnosed with septic disseminated intravascular coagulation (DIC) by the diagnostic criteria for acute DIC. Materials and Methods: A total of 88 sepsis patients who had received inpatient hospital care during the period from January 2000 through December 2008 were divided into two groups, an antithrombin group and a non-antithrombin group, to study the outcomes. Furthermore, the relationship between sepsis-related factors and DIC in 44 patients was studied. Results: The antithrombin group contained 34 patients, and the non-antithrombin group contained 54 patients. The outcomes were significantly better in the antithrombin group. The levels of protein C were low in DIC patients. Conclusion: Our results suggest that early administration of antithrombin might improve outcomes of septic DIC patients in the diagnostic criteria for Japanese Association for Acute Medicine acute DIC.
Usefulness of the Endotoxin Activity Assay to Evaluate the Degree of Lung Injury
Yuichiro Sakamoto,Satoshi Inoue,Takashi Iwamura,Tomoko Yamashita,Atsushi Nakashima,Hiroyuki Koami,Toru Miike,Mayuko Yahata,Hisashi Imahase,Akiko Goto,Showgo Narumi,Miho Ohta,Chris-Kosuke Yamada 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.4
Purpose: It has been reported that the Pulse Contour Cardiac Output (PiCCO) is very useful mainly in the field of intensive care and treatment to grasp the pathophysiologicalconditions of pulmonary edema because of its capability of obtainingdata such as Pulmonary Vascular Permeability Index (PVPI) and Extra VascularLung Water (EVLW). Furthermore, a high degree of usability of various markers has been reported for better understanding of the pathological conditions in cases with septicemia. Materials and Methods: The correlation between the cardiorespiratory status based upon the PiCCO monitor (EVLW and PVPI) and inflammatorymarkers including C reactive protein, procalcitonin (PC), and EndotoxinActivity Assay (EAA) were evaluated in 11 severe cases that required treatmentwith a respirator in an intensive care unit. Results: The EAA values were significantly higher in patients with abnormal EVLW at 0.46±0.20 compared to the normal EVLW group at 0.21±0.19 (p=0.0064). In a similar fashion, patients with abnormal PVPI values tended to have higher PC levels at 18.9±21.8 comparedto normal PVPI cases at 2.4±2.2 (p=0.0676). On the other hand, PVPI was significantly higher in the abnormal EAA group at 3.55±0.48 in comparison with the normal EAA group at 1.99±0.68 (p=0.0029). The abnormal EAA group tended to have higher PVPI values than the normal EAA group. Conclusion: The EAA is a measurement method designed to estimate the activity of endotoxins in the whole blood. Our results suggest that the EAA value, which had the greatest correlationwith lung disorders diagnosed by the PiCCO monitoring, reflects inflammatoryreactions predominantly in the lungs.