Tzmann Institute for Experimental and Clinical Traumatology in the Trauma Research Center of AUVA, Vienna, Austria; 2University of Boston, School of Medicine, Boston, MA, USA Critical Care 2009, 13(Suppl 4):P48 (doi: 10.1186/cc8104) Introduction Multiple organ dysfunction syndrome (MODS) frequently complicates sepsis contributing to poor outcome. Yet the evolution of MODS in the early septic mortality (ESM) is unclear. To delineate the ESM ODS relationship, we compared the development and magnitude of organ injury between dying and surviving mice in the acute phase (days 1 to 5) of polymicrobial sepsis. Methods Female OF-1 mice were subjected to cecal ligation and puncture (CLP). In the first mouse subset, 20 l blood was collected daily for 5 days or until death (mice followed for 28 days). To define the pre-lethal changes in circulating parameters, mice were retrospectively divided into two groups based on outcome in the acute sepsis: DEAD (all died within 5 days, n = 39) and survivors (SUR; alive at day 28, n = 40). In the second subset, mice were sacrificed within 24 hours of projected death (based on the body T <28 , 100 specificity, n = 7) and matched with SUR (body T >35 , 100 sensitivity) from the same post-CLP day and controls. Results In the first subset, significant difference was observed between SUR and DIED in the circulating urea, ALT, LDH and glucose during the 1-day to 5-day time course but the magnitude of these changes varied among post-CLP days. Therefore, we used the day of death as a reference point clustering all pre-lethal parameter values as the 72, 48 and 24 hours prior-to-death (on any 1 to 5 post-CLP day) time points for comparison with the SUR values. A significant separation between SUR and DIED occurred generally at 24 hours prior to death: pre-lethal urea increased to 78 (vs. 40 mg/dl in SUR), ALT to 173 (vs. 106 U/l) and LDH to 798 (vs. 445 U/l), while pre-lethal glucose declined to 41 (vs. 74 mg/dl). In the second subset (only 24 hours prior-to-death time point), acute deaths were not preceded by a significant rise in creatinine (DIED 6.8 vs. 4.3 M/l in SUR) and troponin I (239 vs. 119 pg/ml). Similarly, respiratory function of mitochondria in the liver and kidney was not impaired in either DIED and SUR compared with controls. Injury scores in the liver, kidney, heart and lung showed no apparent morphological disparity between moribund, surviving or control mice. Incidence of cell apoptosis (TUNEL) in organs was not increased in either of the groups. Conclusions The increase of selected organ function/metabolic markers was manifested at least 24 hours prior to death. Despite statistical significance, the relatively small magnitude of these changes questions organ failure as a direct cause of death in the early phase of CLP sepsis.Table 1 (abstract P47) Outcomes for statin and nonstatin patients following colorectal surgery Parameter Overall mortality Nosocomial infections Sepsis SIRS Wound infection Admitted to the ICU Statin 9/125 (7.2 ) 42/125 (33.6 ) 10/75 (13.3 ) 16/125 (12.8 ) 11/125 (8.8 ) 34/125 (27.2 ) Nonstatin 27/452 (6.4 ) 132/452 (29.2 ) 42/203 (20.7 ) 148/452 (32.7 ) 66/452 (14.6 ) 63/452 (13.9 ) Sig. 0.77 0.40 0.22 <0.001 0.04 <0.SSig,. significance.Available online http://ccforum.com/supplements/13/SP49 Mathematical modeling of community-acquired pneumonia patientsJ Sarkar1, PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/26740125 DD Marathe1, AM Inglis1, KW Hurst1, JA Kellum2, DC Angus2, Y Vodovotz3, S MK-5172MedChemExpress Grazoprevir Chang1 1Immunetrics Inc., Pittsburgh, PA.
