The findings

reveal intriguing differences between the countries in both the number and content of the reports. The issue of priority setting is much less salient in Korean than in Israeli LBH589 solubility dmso society. While the complexity of the task was the most prevalent theme in the Israeli reports sampled, benefits package expansion decisions were most common in the Korean reports. Similarly, the Israeli reports emphasized the qualifications and backgrounds of individual members of the decision making committee, but the equivalent Korean committee was not portrayed as a major actor, and so received less attention. The least reported theme in both countries was priority-setting procedures and principles. These findings, along with results from previous studies which indicate that public satisfaction with the two systems differs between the countries,

provoke several interesting future research questions. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“Aims: Gut dysfunction is suspected to play a major role in the pathophysiology of post-resuscitation disease through an increase in intestinal permeability and endotoxin release. However this dysfunction often remains occult and is poorly investigated. The aim of this pilot study was to explore intestinal failure biomarkers in post-cardiac arrest patients and to correlate them with endotoxemia.

Methods: Following resuscitation after cardiac arrest, 21 patients were prospectively studied. Urinary intestinal fatty acid-binding protein (IFABP), see more which marks intestinal buy Galardin permeability, plasma citrulline, which reflects the functional enterocyte mass, and whole

blood endotoxin were measured at admission, days 1-3 and 6. We explored the kinetics of release and the relationship between IFABP, citrulline and endotoxin values.

Results: IFABP was extremely high at admission and normalized at D3 (6668 pg/mL vs 39 pg/mL, p = 0.01). Lowest median of citrulline (N = 20-40 mu mol/L) was attained at D2 (11 mu mol/L at D2 vs 24 mu mol/L at admission, p = 0.01) and tended to normalize at D6 (21 mu mol/L). During ICU stay, 86% of patients presented a detectable endotoxemia. Highest endotoxin level was positively correlated with highest IFABP level (R-2 = 0.31, p = 0.01) and was inversely correlated with lowest plasma citrulline levels (R-2 = 0.55, p < 0.001). Endotoxin levels increased between admission and D2 in patients with post-resuscitation shock, whereas it decreases in patients with no shock (median +0.33 EU vs -0.19 EU, p = 0.03). Highest endotoxin level was positively correlated with D3 SOFA score (R-2 = 0.45, p = 0.004).

Conclusion: Biomarkers of intestinal injury are altered after cardiac arrest and are associated with endotoxemia. This could worsen post-resuscitation shock and organ failure. (C) 2012 Elsevier Ireland Ltd. All rights reserved.