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OBJECTIVE To assess the value of measuring circulating concentrations of mediators (endotoxin, tumor necrosis factor-alpha [TNF-alpha], interleukin-1 beta [IL-1 beta], and interleukin-6[IL-6]) and their endogenous antagonists (antiendotoxin core antibody [EndoCAb], interleukin-1 receptor antagonist [IL-1ra], and soluble TNF receptors [sTNF-R]) in predicting(More)
Neutrophils have been implicated in the pathogenesis of the adult respiratory distress syndrome (ARDS). We have measured concentrations of the neutrophil attractant interleukin-8 in blood and bronchoalveolar lavage fluid (BAL) from patients at risk of ARDS. We studied 29 patients from three groups at risk of developing ARDS: multiple trauma (n = 16),(More)
Migration inhibitory factor (MIF) is known to exert significant pro-inflammatory effects and has the potential to override the anti-inflammatory action of glucocorticoids. In this study we have identified significant quantities of MIF in the alveolar airspaces of patients with acute respiratory distress syndrome (ARDS). We show in alveolar cells from(More)
The haemodynamic and gas exchange abnormalities occurring in neurogenic pulmonary oedema (NPO) were examined retrospectively in 20 patients admitted to the Intensive Therapy Unit (ITU) over a 45-month period (February 1992 to November 1995). In 12 patients, where vasoactive therapy with dobutamine was employed, its effect on haemodynamics was examined.(More)
The pharmacokinetics of ketamine in analgesic doses after intravenous, intramuscular, and oral administration was investigated in healthy volunteers. Plasma ketamine concentration-time curves were fitted by a two-compartment open model with a terminal half-life of 186 min. Absorption after intramuscular injection was rapid and the bioavailability was 93%.(More)
The pharmacokinetics of ketamine 2 mg kg-1 i.v. and 6 mg kg-1 i.m. were investigated in nine children undergoing minor surgery. After either route of administration plasma ketamine concentrations were similar to those found in adult patients receiving the same dose, except at later times after i.v. injection, when concentrations were smaller in children.(More)
A randomized, double-blind study of the efficacy, duration of action and side effects of three analgesic regimens following Caesarean section is described. Patients received i.m. diamorphine 5 mg, extradural phenoperidine 2 mg or extradural diamorphine 5 mg. Analgesia was of rapid onset in all groups, as judged by reductions in linear analogue pain scores(More)
The pharmacokinetics and analgesic effects of i.m. and oral ketamine in a dose of 0.5 mg kg-1 were determined in six healthy volunteers. Analgesia was measured by the submaximal effort tourniquet test. Following both routes of administration, ketamine prolonged the period of pain-free ischaemic exercise. Pain thresholds were increased at 15 min and 30 min(More)
The acute lung injury of adult respiratory distress syndrome (ARDS) is characterised by inflammatory cell accumulation and activation in the lung. Selectins are a family of adhesion molecules implicated in leucocyte-endothelial adhesion, whose receptors can exist in a cleaved, soluble form. We investigated whether circulating soluble selectin adhesion(More)