S, T Regueira, H Bracht, J Gorrasi, J Takala, S Jakob University MedChemExpress ASP8273 Hospital

S, T Regueira, H Bracht, J Gorrasi, J Takala, S Jakob University MedChemExpress ASP8273 Hospital Inselspital, Bern, Switzerland Critical Care 2007, 11(Suppl 2):P28 (doi: 10.1186/cc5188) Introduction While early aggressive fluid administration has been associated with improved outcome in sepsis [1], this approach may increase the risk of lung edema and abdominal compartment syndrome when capillary permeability is increased. The aim of this study was to test two different approaches of volume resuscitation in septic animals. Methods Thirty pigs were anaesthetized and invasively monitored (systemic and regional flows and pressures). They were randomized to control, moderate volume (C; n = 7), control, high volume (CH; n = 8), peritonitis, moderate volume (P; n = 8) and peritonitis, high volume (PH; n = 7). Peritonitis was induced by instillation of 1 g/kg autologous faeces dissolved in glucose solution. Ventilation was adjusted to maintain an arterial pO2 >100 mmHg. Groups CH and PH received 15 ml/kg/hour Ringer’s solution plus 5 ml/kg/hour HES 6 , whereas groups C and P received 10 ml/kg/hour Ringer’s solution. If clinical signs of hypovolaemia were present, additional boluses of HES 6 (maximally 100 ml/hour) were given. The animals were treated and observed for 24 hours or until death. Results Cardiac output was higher in group PH as compared with the other groups (P < 0.05), while mean arterial pressure wasFigure 1 (abstract P28)P27 Beneficial effects of antiplatelet drugs in patients with community-acquired pneumonia and in endotoxin shock in miceJ Winning1, J Baranyai1, R Claus1, I Eisenhut2, J Hamacher2, K Reinhart1, PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20801496 M Bauer1, W L che1 1University Hospital Jena, Germany; 2University Hospital Homburg, Germany Critical Care 2007, 11(Suppl 2):P27 (doi: 10.1186/cc5187) Aims Systemic inflammation and sepsis are associated with blood platelet activation, which may contribute to the development of organ failure. In this study we proved whether antiplatelet drugs have a benefit in patients who may develop sepsis as well as in a mouse model of endotoxin shock. Methods Data obtained from 224 patients with communityacquired pneumonia (CAP) were retrospectively analysed for an association between prehospital treatment with long-acting antiplatelet drugs such as acetyl salicylic acid (n = 36) or thienopyridine ADP-receptor antagonists (clopidogrel or ticlopidin, n = 8) and clinical outcome. Use of statins was an exclusion criterion. BALB/c mice were pretreated with clopidogrel for 4 days prior to an intraperitoneal injection of LPS (Escherichia coli 0111:B4). For platelet counts and blood gas analysis, standard procedures were used. Lung tissues were stained with HE or a FITC-labelled anti-fibrin(ogen) antibody. Results CAP patients with antiplatelet drugs (n = 44) were older than control patients (n = 180; 69 ?7 vs 58 ?13 years, P < 0.00001). At the day of hospital admission there were no differences in platelet or leukocyte counts, CRP and SOFA scores between both groups. However, patients on antiplatelet drugs developed organ failure less frequently than control patients (ICU admission: 9.1 vs 26.1 ; P < 0.02). In the mouse model of endotoxin shock, clopidogrel reduced the drop in platelet count and the degree of lung injury. Compared with controls we found 20 hours after LPS injection in the clopidogrel-treated animals a lower number of thrombi in the lung vasculature (6.1 ?2.3 vs 11.5 ?4.4 thrombi per screen, P < 0.025) as well as higher blood pH and bicarbonate.