T in sepsis and septic shock.gene expression analysis (Affymetrix) was applied to serial cardiac biopsies

T in sepsis and septic shock.gene expression analysis (Affymetrix) was applied to serial cardiac biopsies of sham (n = 2) and E. coli infected pigs (n = 3). Methods Cardiac samples were taken basal and hourly after infection for gene analysis and at the end of the experiment for histopathological examination. Genes were determined to be differentially regulated at a greater than or less than twofold change and P < 0.05. Results Sham pigs had stable heart rate, cardiac output (CO) and core temperature for the PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20801500 5-hour period; infected pigs demonstrated an early elevation in CO and ventricular shortening and/or ejection (assessed by echocardiography) followed by development of hypodynamics. In infected animals, increasing numbers of genes were upregulated or downregulated (36, 278, 514, 842 and 1,238 at 1, 2, 3, 4 and 5 hours) (Figure 1) whereas sham infection altered fewer (247, 67 and 384 genes at 2, 3 and 4 hours). Comparing sham vs infected animals at the same time, numbers of significantly altered genes increased with time (32 at basal, to 74, 189 and 601 at 2, 3 and 4 hours post infection). In hematoxylin osinstained sections, histopathological assessment revealed acute get Paeonol inflammation in pericardium and myocardium in infected pigs. Conclusions These results will provide biomarker and mechanistic insights to pathogenesis of cardiac dysfunction of septic peritonitis and may also help identify some altered novel gene transcription pathways that can serve as new targets for diagnostic tools and therapeutic strategies. All candidate genes will be validated by quantitative PCR.P13 Escherichia coli porcine peritonitis induces histological and transcriptome evidence of cardiac injuryR Goldfarb1, I Cinel1, S Gandhi1, L Cinel2, M Levine1, Q Wang3, A Brooks3, J Parrillo1 1Cooper University Hospital and UMDNJ, Camden, NJ, USA; 2Thomas Jefferson University Hospital, Philadelphia, PA, USA; 3EOHSI, UMDNJ, Piscataway, NJ, USA Critical Care 2007, 11(Suppl 2):P13 (doi: 10.1186/cc5173) Introduction Cardiac dysfunction is a feature of sepsis. In order to gain insight into the fundamental mechanisms of this phenotype,P14 Alkaline phosphatase treatment improves renal function in patients with severe sepsis or septic shockS Heemskerk1, R Masereeuw1, O Moesker2, M Bouw2, J van der Hoeven2,3, W Peters4, M Velders5, F Russel1, P Pickkers2 1Department of Pharmacology and Toxicology, Nijmegen Centre for Medical Life Sciences, 2Department of Intensive Care Medicine, 3Nijmegen University Centre for Infectious Diseases and 4Department of Gastroenterology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 5AM-Pharma, Bunnik, The Netherlands Critical Care 2007, 11(Suppl 2):P14 (doi: 10.1186/cc5174) We previously demonstrated that upregulation of renal inducible nitric oxide synthase (iNOS) during systemic inflammation isSCritical CareMarch 2007 Vol 11 Suppl27th International Symposium on Intensive Care and Emergency Medicineassociated with proximal tubule injury. In several in vitro and animal studies alkaline phosphatase (AP) was found to be effective in attenuating the inflammatory response by dephosphorylating LPS and may prevent organ damage. The objective of this study was to investigate the effect of AP on renal iNOS expression and kidney damage in patients with severe sepsis or septic shock. Fifteen patients (nine male/six female, age 55 ?5 years) with Gram-negative bacterial infection, two out of four SIRS criteria (<24 hours) and acute ons.