PubMedCrossRef 11 Wu X, Sha H, Sun Y, Gao L, Liu H, Yuan Q, et a

PubMedCrossRef 11. Wu X, Sha H, Sun Y, Gao L, Liu H, Yuan Q, et al.: N-terminal pro-B-type natriuretic peptide in patients with isolated traumatic brain injury: a prospective cohort study. J Trauma 2011, 71:820–825.PubMedCrossRef 12. Costa KN, Nakamura HM, Cruz LR, Miranda LS, Santos-Neto RC, Cosme Sde L, Casulari LA: Hyponatremia and brain injury: absence of alterations of serum brain natriuretic peptide and vasopressin. Arq Neuropsiquiatr 2009,

67:1037–1044.PubMedCrossRef 13. Kavalci C, Akdur G, Yemenici S, Sayhan MB: The value of serum BNP for the diagnosis of ıntracranial ınjury in head trauma. Tr J Emerg Med 2012, 12:112–116. doı:10.5505/1304.7361.2012.26576CrossRef Competing interests The authors declare that they have no competing interests. Authors’ learn more contributions The quantitative analysis was planned by CK, EDA, AD. Study data were analyzed by CK and interpreted Belinostat ic50 by FY, MAC. The first version of the manuscript was drafted by AD, MSY, BMS. All authors contributed to the edition and revision of the manuscript and the final version of the article was reviewed and approved by all authors.”
CHIR98014 in vivo Introduction In the majority of patients acute pancreatitis is a mild self-limiting disease. About fifteen percent

of the patients develop severe disease defined by development of persistent organ failure [1]. The mortality in acute pancreatitis is mainly associated with multiple organ failure [2] whereas the risk of dying is minimal in patients with no or transient organ dysfunction [3, 4]. In acute pancreatitis, multiple organ failure

is a consequence of excessive activation of a systemic inflammatory response cascade [5]. Inflammatory mediators induce end-organ endothelial cell activation leading to increased permeability [6]. Leaking microvessels MYO10 cause a loss of intravascular fluid and in conjunction with vasodilatation lead to hypotension and shock. Accumulation of inflammatory cells in tissues, increased interstitial fluid and activation of coagulation with microvascular thrombosis further impair oxygen supply of tissues. Clinical manifestation of all this is a multiple organ dysfunction syndrome (MODS), which develops early during the course of acute pancreatitis. Over half of the patients with severe pancreatitis have signs of organ dysfunction on hospital admission [3] and most of the organ dysfunctions develop within the first four days after admission [7]. Over half of the deaths occur within the first week from onset of the disease, and deaths usually occurred within a week after manifestation of MODS [8]. Treatment modalities of MODS are supportive including fluid replacement therapy, vasopressors, mechanical ventilation and renal replacement therapy when necessary. In patients with acute pancreatitis, abdominal compartment syndrome (ACS) may aggravate MODS, and therefore, monitoring of intra-abdominal pressure (IAP) is crucial for identification of patients at risk of ACS [9].

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