Click here for file(252K, DOC)NotesSee related letter by Jacobs,

Click here for file(252K, DOC)NotesSee related letter by Jacobs, http://ccforum.com/content/15/5/442AcknowledgementsWe thank the nursing staff learn more and doctors from the Service de R��animation M��dicale, H?pital La Source, Orl��ans, and from the Service de R��animation Polyvalente – H?pital Bretonneau, Tours, France, for their help with the data collection. We thank Dr Karim Lakhal for his advices in writing the manuscript.
From 1997 to 2001, 17 patients who died from septic shock were included. Patient characteristics are presented in Table Table1.1. Septic shock had a median duration of four days and was mainly secondary to pneumonia or cellulitis. Four patients had pre-existing diabetes mellitus. Median BG over ICU stay was 2.17 g/l. Episodes of hyperglycaemia were observed in all patients and hypoglycaemia occurred in five (29%) patients.

Nine (53%) patients developed prolonged hyperglycaemia and six (35%) were treated with insulin (with mean BG level of 2.7 g/L (1.9 to 3.0)). Macroscopic findings were ischaemia (n = 12), haemorrhage (n = 9) and disseminated abcesses (n = 3). Oedema was observed in only one patient.Table 1Patients’ characteristicsIn contrast to HLA-DR, expression of microglial CD68 tended to be correlated with AUBGC > 2 g/l (rho = 0.44, P = 0.08). Intensity of neuronal and microglial apoptosis was correlated with AUBGC > 2 g/l (rho = 0.53; P = 0.03 and rho = 0.70; P = 0.002) (Table (Table2,2, Figure Figure1).1). Intensity of neuronal beta-APP expression correlated with AUBGC > 2 g/l (rho = 0.61; P = 0.03) (Figure (Figure2).2).

Endothelial iNOS expression was correlated with intensity of neuronal apoptosis (rho = 0.68, P = 0.005) but not with that of microglial apoptosis (rho = 0.34, P = 0.17). The intensities of neuronal and microglial apoptosis were correlated (rho = 0.56, P = 0.02). Immunostaining of GLUT3 was not satisfactory. GLUT1 rather stained endothelial cells than neurons and its expression Drug_discovery did not vary among patients. Neuronal GLUT4 (Figure (Figure3)3) and microglial GLUT5 expression (Figure (Figure4)4) did not correlate with prolonged hyperglycaemia nor with neuronal or microglial apoptosis (Table (Table3).3). Expressions of endothelial iNOS and microglial GLUT5 were inversely correlated (rho = -0.54; P = 0.03). Neuronal and microglial apoptosis were not correlated with SAPS-II at admission, highest SOFA score, duration of septic shock, or with serum sodium (especially hyponatremia), lowest systolic arterial pressure, PaO2 and SaO2. Intensity of neuronal apoptosis and ischaemia tended to be correlated with cumulative time of hypotension (rho = 0.45, P = 0.06 and rho = 0.38, P = 0.11).

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