Objective To study endotoxin release induced by differential antibiotics in gram negative bacterial infection. Methods Thirty critical patients accompanied with gram negative bacterial infection were divided into group A (imipenem group, n=15) and group B (ceftazidine group, n=15). Imipenem (0.5 g iv q8h) and ceftazidine (1.0 g iv q8h) were given respectively. White blood cell (WBC), systolic blood pressure (SBP), lipopoly sacchride (LPS), tumor necrosis factor alpha (TNFα) and high density lipoprotein (HDL) were determined in 0, 1, 2, 3, 5 and 7 day. Results There was no difference in the change of WBC between two groups. Group A had a more stable SBP than group B. There was lower endotoxin release in group A than in group B and so were the cytokines release. HDL level was lower in group B than in group A. Conclusion Imipenem has lower endotoxinliberating potential than ceftazidine and mediate lower cytokines release. HDL may protect the patients from LPS damage.
For patients with suspected or confirmed coronavirus disease 2019, how to take lavage fluid specimens correctly is the current clinical focus during the epidemic. At the same time, since alveolar lavage is an invasive operation of the airway, it is necessary to follow standard procedures for protection and operation to prevent occupational exposure risks of medical staff. The Department of Intensive Care Unit of West China Hospital of Sichuan University formulated the operation procedure of alveolar lavage for patients with coronavirus disease 2019 based on the original operation procedure of alveolar lavage. This article introduces the indications and contraindications of the operation procedure, preparation before operation, operation procedure and precautions, post-operation processing and operation protection for clinical reference and implementation.