Design and setting: A prospective online survey of CRRT practice

Design and setting: A prospective online survey of CRRT practice was sent to intensive care unit medical and nursing clinicians via three national

databases in Australian and New Zealand ICUs in December 2013 to March 2014. Results: There were 194 respondents from 106 ICUs; 49 ICUs (47%) were in tertiary metropolitan hospitals. One hundred and two respondents (54%) reported continuous venovenous haemodiafiltration selleck compound as the most common CRRT technique, with a combination of predilution and postdilution of CRRT solutions. The prescription for CRRT was variable, with respondents indicating preferences for therapy based on L/hour (53%) or a weight-adjusted treatment in mL/kg/hour (47%). For all modes of CRRT, the common blood flow rates applied were 151-200 mL/minute and 201-250 mL/minute. Few respondents reported preferring flow rates smaller than 150 mL/minute or bigger than 300 mL/minute. Unfractionated heparin learn more was the most commonly used anticoagulant (83%), followed by regional citrate. Femoral vein vascular access was preferred and, typically, a 20 cm length catheter was used. Bard Niagara and Arrow catheters were most frequently used. The Gambro Prismaflex was the dominant machine used (71%). Conclusions: Our results provide insight into existing clinical management of CRRT. There is considerable variation in the

prescription of CRRT in Australian and New Zealand ICUs.”
“The Mac-1 integrin is expressed mainly on myeloid cells and binds several ligands, including members of the ICAM family and the complement factor iC3b. It is involved in essential immunological processes, such

as leukocyte extravasation and phagocytosis. In addition, Mac-1 has been described to negatively regulate C188-9 in vitro immune cell signaling. Recently, a single nucleotide polymorphism conferring an amino acid change in the Mac-1 integrin extracellular domain, R77H, was shown to be associated with systemic lupus erythematosus. Here, we demonstrate that the R77H-substituted Mac-1 can be expressed on the cell surface in transfected cells and can undergo conformational changes in response to integrin activation. The affinity of the integrin for ICAMs is only partially reduced, but cell adhesion to ICAM-1 and ICAM-2 is severely compromised, and J beta 2.7 cells expressing R77H substituted integrins are deficient in adhesion to ICAM-1 under shear flow conditions. Importantly, cell adhesion to the complement factor iC3b is also diminished, and COS cells expressing R77H-substituted integrins display reduced iC3b-dependent phagocytosis. In addition, U937 cells expressing R77H-CD11b display increased IL-6 production as compared with WT-CD11b-expressing cells. These results suggest that the R77H substitution results in the deficiency of the mutated integrin to mediate cell adhesion to ligands such as ICAMs and iC3b.

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