Acute Renal Failure in the Intensive Therapy Unit by J. S. Cameron (auth.), David Bihari MA, MRCP, Guy Neild MD,

By J. S. Cameron (auth.), David Bihari MA, MRCP, Guy Neild MD, FRCP (eds.)

A workshop used to be organised with a view to in achieving multi-discipli- nary assessment of the pathogenesis and administration of acute failure, rather because it happens and is controlled in in depth remedy devices. The booklet offers with the realities and practicalities of this crucial sector of acute drugs. each one bankruptcy is through a dialogue, in order that a concen- sus view is got from a global physique of experts.

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By J. S. Cameron (auth.), David Bihari MA, MRCP, Guy Neild MD, FRCP (eds.)

A workshop used to be organised with a view to in achieving multi-discipli- nary assessment of the pathogenesis and administration of acute failure, rather because it happens and is controlled in in depth remedy devices. The booklet offers with the realities and practicalities of this crucial sector of acute drugs. each one bankruptcy is through a dialogue, in order that a concen- sus view is got from a global physique of experts.

Show description

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Sample text

Pathophysiology of Gram-Negative Septicaemia Endotoxin can trigger all the pathophysiological effects induced by whole Gramnegative rod cells - living or dead. The effects are complex and still not fully understood (Fig. 2). There is also a problem of translating the effects produced in one mammalian species to another. It does seem that man is one of the more susceptible species, especially to pyrogenic effects. Endotoxin switches on at least four different physiological systems. Hageman Factor (Factor XII) is activated and this in turn activates the complement cascade, coagulation, fibrinolysis and the kallikrein-kinin system.

Renal failure is therefore more likely with Gramnegative rod sepsis in such patients. Raised plasma thromboxane levels have been associated with an increase in pulmonary vascular resistance in the early phase of septic shock (Oettinger et al. 1987). This may be important in the development of adult respiratory distress syndrome. All the problems associated with Gram-negative rod endotoxaemia and systicaemia (DIC, renal failure, shock, ARDS) have been reported also with Gram-positive and fungal infections (Turner and Naumburg 1987; Ramsay et al.

2). There is also a problem of translating the effects produced in one mammalian species to another. It does seem that man is one of the more susceptible species, especially to pyrogenic effects. Endotoxin switches on at least four different physiological systems. Hageman Factor (Factor XII) is activated and this in turn activates the complement cascade, coagulation, fibrinolysis and the kallikrein-kinin system. Complement activation results in the release of factors causing the migration of phagocytic cells into the tissues.

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