By J. S. Cameron (auth.), David Bihari MA, MRCP, Guy Neild MD, FRCP (eds.)
A workshop used to be organised which will in achieving multi-discipli- nary assessment of the pathogenesis and administration of acute failure, fairly because it happens and is controlled in extensive treatment devices. The ebook offers with the realities and practicalities of this crucial region of acute medication. every one bankruptcy is by means of a dialogue, in order that a concen- sus view is got from a global physique of experts.
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Extra resources for Acute Renal Failure in the Intensive Therapy Unit
Both Gram-negative and Grampositive organisms and yeasts can cause systemic infection with renal failure. The clinical pictures overlap considerably but there is little doubt that in the past 40 years, aerobic Gram-negative rod infection has proved to be the major microbial problem in hospitalized patients, especially the immunocompromised, both in terms of morbidity and mortality. Epidemiology Finland and his coJlaborators (McGowan et al. 1975) have most clearly charted the change in nosocomial infections from Gram-positive to Gram-negative organisms and by the 1970s there was worldwide recognition of this epidemiological shift.
1 shows the structure of the Gram-negative rod cell wall. Outside the cytoplasmic membrane there is a solid membrane of mucopeptide or peptidoglycan (a much thinner layer than found in Gram-positive organisms) and then outside that the outer membrane of lipoprotein and polysaccharide. The latter is specific and is the basis for "0" (somatic) antigen typing schemes. Outside the outer membrane many bacteria have a capsule or envelope of polysaccharide 26 Acute Renal Failure in the Intensive Therapy Unit ,..
Coratelli et al. (1987) also state that sepsis is the major cause of death in up to 70% of patients with acute renal failure and is the usual cause of multiple organ failure. They estimate that Gram-positive infections account for 30% of such cases, but Gram-negative rods for 70% of cases. Fry et al. (1980) and Manship et al. (1984) also noted sepsis as the major cause of organ failure in their ITU practice. Peng-Fei Shen and Shi-Chun Zhang (1987) confirm the same trend in 24 Acute Renal Failure in the Intensive Therapy Unit China.
Acute Renal Failure in the Intensive Therapy Unit by J. S. Cameron (auth.), David Bihari MA, MRCP, Guy Neild MD, FRCP (eds.)