amphotericin-b and Ischemia

The significance of acute renal insufficiency has grown in the past decade. The increase in the prevalence and mortality of the disease has played a role in this tendency. When judging the significance of acute renal insufficiency, one cannot ignore the fact that the rate of acute renal insufficiency emerging due to medical interventions is rising. The wide-spread diagnostic processes, the interventions and the medicines also promote the emergence of acute renal insufficiency. As for prevention, it is a key task to recognize the high-risk population, assess the renal function and utilize the nephroprotective facilities.

Topics: Acetaminophen; Acute Kidney Injury; Aminoglycosides; Amphotericin B; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Anti-Inflammatory Agents, Non-Steroidal; Cisplatin; Contrast Media; Cyclosporine; Foscarnet; Humans; Hungary; Ischemia; Kidney; Kidney Function Tests; Pentamidine; Prognosis

To evaluate the possible related factors to endotoxemia and cytokine activation during the ischemic phase of extracorporeal surgery, and the effect of selective digestive decontamination (SDD) as a preventive measure.. Prospective, open, randomized trial.. Two multidisciplinary ICUs (tertiary care hospitals).. One hundred consecutive patients undergoing cardiopulmonary bypass (CPB), randomly allocated to two groups; gut decontamination (group I = 50 cases) and controls (group II = 50 cases).. Preoperative administration of oral non-absorbable antibiotics (polymyxin E, tobramycin and amphotericin B) versus no administration.. The assessment of decontamination by means of the bacteriologic control of rectal swabs. Determinations of gastric intramucosal pH (gastric pHi) and plasma endotoxin, tumor necrosis factor (TNF) aNd interleukin-6 (IL-6) before surgery and during the ischemic and reperfusion phases of bypass. Rectal aerobic Gram-negative bacilli (AGNB) were significantly reduced in the treated patients and in 56% total eradication was achieved. Endotoxin, TNF and IL-6 plasma levels were significantly lower in this group. By contrast, both endotoxin and TNF/IL-6 levels and gastric pHi correlated with the type of surgical flow (pulsatile versus non-pulsatile).. SDD reduces the gut content of enterobacteria. This may explain the lower endotoxin and cytokine levels detected in decontaminated patients. In addition to SDD, the type of flow employed during bypass seems to influence endotoxemia and cytokine levels.

Topics: Amphotericin B; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cardiopulmonary Bypass; Colistin; Cytokines; Endotoxemia; Enterobacteriaceae; Female; Humans; Intestinal Diseases; Intestines; Ischemia; Male; Middle Aged; Prospective Studies; Surgical Procedures, Operative; Tobramycin

Topics: Abducens Nerve; Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Fatal Outcome; Flucytosine; Humans; Ischemia; Male; Meningitis, Cryptococcal; Oculomotor Nerve; Oculomotor Nerve Diseases; Pulmonary Embolism; Vasculitis

Topics: Adult; Amphotericin B; Antineoplastic Combined Chemotherapy Protocols; Appendicitis; Appendix; Aspergillosis; Combined Modality Therapy; Cytarabine; Daunorubicin; Humans; Ileal Diseases; Iliac Vein; Intestinal Perforation; Ischemia; Leukemia, Myeloid, Acute; Male; Mitoxantrone; Neutropenia; Thrombosis

Topics: Amphotericin B; Animals; Calcium; Cell Membrane; Chemical Precipitation; Constriction; Epithelium; Female; Ischemia; Kidney; Kidney Glomerulus; Kidney Tubules, Distal; Kidney Tubules, Proximal; Microscopy, Electron; Rats