digoxin and Bacterial-Infections

Induced abortion via dilation and evacuation (D&E) typically involves cervical preparation. Some clinicians also induce fetal death in the second trimester. We designed this study to determine if the combination of intra-amniotic digoxin and osmotic dilators induced intrauterine inflammatory changes.. Twenty-two women requesting abortion at 19-23 weeks gestation had amniotic fluid sent for measurement of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), white blood cell (WBC) count and anaerobic and aerobic cultures on day 1, before dilators and digoxin amnioinjection. Sampling was repeated on Day 2, prior to D&E.. All subjects had significantly elevated IL-6, IL-8 and TNF-α in the amniotic fluid on Day 2. The median difference for IL-6 was 19,893.4 pg/mL (p<.0001), 7040.7 pg/mL (p<.0001) for IL-8 and 181.0 pg/mL (p<.0001) for TNF-α. There was no significant difference in WBC count. There were no clinically significant positive cultures and no clinical infections.. The administration of intra-amniotic digoxin and the placement of osmotic dilators prior to D&E create an intrauterine inflammatory response.

Topics: Abortion, Induced; Adult; Amniocentesis; Amniotic Fluid; Anti-Arrhythmia Agents; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Infections; Chorioamnionitis; Digoxin; Dilatation and Curettage; Doxycycline; Female; Fetal Death; Humans; Interleukin-1; Interleukin-8; Leukocyte Count; Pilot Projects; Pregnancy; Pregnancy Trimester, Second; Statistics, Nonparametric; Tumor Necrosis Factor-alpha

We studied the inotropic response to dopamine and digoxin in 20 patients with severe sepsis and left ventricular failure. Left ventricular failure was defined as a left ventricular stroke work index less than or equal to 40 g.m/m2 at a pulmonary artery wedge pressure greater than or equal to 15 mm Hg. Hemodynamic assessment was obtained before and following administration of digoxin 10 micrograms/kg IV or dopamine, 5 to 12 micrograms/kg/min IV. Patients treated with digoxin demonstrated a significant increase in LVSWI. The LVSWI increased 13 +/- 10 percent in the dopamine-treated patients compared with 74 +/- 16 percent in the digoxin patients (p less than 0.02). We conclude that digoxin exhibited significant inotropic activity in patients with sepsis.

Topics: Aged; Aged, 80 and over; Bacterial Infections; Blood Circulation; Digoxin; Dopamine; Female; Heart Diseases; Hemodynamics; Humans; Male; Middle Aged; Myocardial Contraction

Topics: Aged; Anuria; Bacterial Infections; Bandages; Burns; Child; Debridement; Digoxin; Hospital Units; Humans; Infusions, Parenteral; Male; Mannitol; Penicillins; Plasma; Postoperative Care; Pseudomonas Infections; Skin Transplantation; Sulfanilamides; Transplantation, Autologous; Transplantation, Homologous; Wound Infection