Critical Care 2011, Volume 15 Suppl 1 http://ccforum.com/supplements/15/S1 MEETING ABSTRACTS 31st International Symposium on Intensive Care and Emergency Medicine Brussels, Belgium, 22-25 March 2011 Published: 1 March 2011 P1 QT dispersion has been suggested to give information about the Eff ects of thyroid hormones on major cardiovascular risk in acute heterogeneity of myocardial repolarization. coronary syndromes Methods Our study included 60 patients presented with acute A Bayrak1, A Bayır2, K Uçar Karabulut3 STEMI, the study populations were divided into two groups: Group 1Selçuk University, Meram Faculty of Medicine, Konya, Turkey; 2Selçuk I: 30 patients who underwent primary PCI. Group II: 15 patients who University, Selçuklu Faculty of Medicine, Emergency Department, Konya, received streptokinase. Group III: 15 patients who did not receive Turkey; 3Emergency Sercice of Şırnak State Hospital, Şırnak, Turkey reperfusion therapy. QTd and QTcd were measured and compared in Critical Care 2011, 15(Suppl 1):P1 (doi: 10.1186/cc9421) the three groups on admission, after 24 hours and after 5 days. Results QTd and QTcd were signifi cantly higher in patients with anterior Introduction In this study we aimed to investigate the relationship compared with inferior MI (79.16 ± 25.67 ms vs. 62 ± 18.17 ms, P = 0.004 between thyroid hormone abnormalities and major cardiovascular regarding QTd and 91.95 ± 28.76 ms vs. 68.33 ± 23.52 ms, P <0.001 events and sudden cardiac death at 3 and 6 months after discharge in regarding QTcd). After 24 hours, QTd and QTcd were signifi cantly lower patients who were admitted to the Emergency Department with acute in group I than groups II and III (34.33 ± 13.56 ms vs. 48 ± 18.2 ms vs. coronary syndrome. 66 ± 24.43 ms respectively, P <0.05 as regards QTd and 39.33 ± 11.72 Methods The study group included 110 patients without known ms vs. 56 ± 23.84 ms vs. 74.60 ± 26.7 ms respectively, P <0.05 as regards thyroid dysfunction who were referred to the Emergency Department QTcd). On the 5th day reduction in QTd and QTcd was statistically with acute coronary syndrome. FT3, FT4 and TSH levels were measured signifi cantly lower in group I than groups II and III (23 ± 9.52 ms vs. in all patients on admission. Patients were divided into STEMI, NSTEMI 45.33 ± 15.97 ms vs. 58.66 ± 23.25 ms respectively, P <0.05 for QTd and and UAP groups. Patient records were checked at 3 and 6 months of 26 ± 11.63 ms vs. 52.66 ± 21.2 ms vs. 60.66 ± 23.25 ms respectively, discharge in terms of sudden cardiac death and major cardiovascular P <0.05 for QTcd). QT and QTcd on admission were higher in patients events. The relationship between thyroid hormone levels and acute who developed ventricular arrhythmias than patients who did not cardiac death and major cardiovascular disorders at 3 and 6 months of (90 ± 11.55 ms vs. 70 ± 24.54 ms; P = 0.05 regarding QTd and 110 ± 8.61 discharge was evaluated. ms vs. 80.53 ± 28.78 ms with P = 0.028 regarding QTcd). Patients with Results The mean TSH, FT3 and FT4 levels of the study group versus early peaking of enzymes had more reduction in QTd and QTcd early control group were as follows: TSH levels of study group 1.87 ± 1.73 μIU/ after reperfusion (43.2 ± 11.44 vs. 60.5 ± 13.16, P <0.001 regarding QTd ml, FT3 3.2 ± 1.34 pg/ml, FT4 1.45 ± 0.64 ng/dl. Abnormalities in the and 49.60 ± 15.93 vs. 68.5 ± 17.55, P <0.001 regarding QTcd). thyroid function tests were noted in 26 patients (23.6%). Of these seven Conclusions QTd is higher in patients with acute MI (AMI) who patients (6.36%) had subclinical hypothyroidism, two patients (1.8%) developed ventricular arrhythmias. So QTd and QTcd on admission may had euthyroid sick syndrome and 10 patients (9%) had high serum FT4 be a helpful parameter that can detect patients with AMI who are at levels despite normal FT3 and TSH values. risk for development of ventricular arrhythmias. Reperfusion therapy Conclusions We noted subclinical hypothyroidism, less frequently with primary PCI or thrombolytic agents reduces QTd and QTcd in euthyroid sick syndrome and hyperthyroidism. No relationship was patients with AMI, however; QTd and QTcd are shorter with primary PCI noted between thyroid hormone levels and sudden cardiac death and compared with thrombolytic therapy. major cardiovascular disorders at 3 and 6 months follow-up. However, studies including larger patient groups are needed to clarify if there is a relationship between thyroid hormone levels on admission and P3 sudden death and major cardiovascular events in patients with acute Biochemical studies of some diagnostic enzymes in myocardial coronary syndrome. infarction References M Samir, H Khaled Nagi, D Ragab, M Refaie 1. Paulou HN, et al.: Angiology 2002, 53:699-707. Cairo University, Cairo, Egypt 2. Pingitore A, et al.: Am J Med 2005, 118:132-136. Critical Care 2011, 15(Suppl 1):P3 (doi: 10.1186/cc9423) Introduction Myocardial infarction (MI) is a key component of the P2 burden of cardiovascular disease (CVD). The main causal and treatable Eff ect of reperfusion therapy on QTd and QTcd in patients with risk factors for MI include hypertension, hypercholesterolemia or acute STEMI dyslipidemia, diabetes mellitus, and smoking. Acute MI results in D Ragab, H Elghawaby, M Eldesouky, T Elsayed cellular necrosis with release of constituent proteins into the circulation. Cairo University, Cairo, Egypt Measurement of specifi c enzymes has become an important clinical Critical Care 2011, 15(Suppl 1):P2 (doi: 10.1186/cc9422) tool for the diagnosis and management of MI. The aim of this study was to demonstrate the role of arginase and adenosine deaminase (ADA) in Introduction Acute ischemia alters action potentials and aff ects patients suff ering from MI, and in a group of patients with chronic renal myocardial repolarization. Dispersion of repolarization is arrhythmogenic. failure (CRF) with cardiovascular diseases (CVD). Methods In this prospective study including 90 consecutive subjects were included the MI group (GI) consisting of 30 patients with mean © 2010 BioMed Central Ltd © 2011 BioMed Central Ltd age = 51.7 admitted to critical care medicine (CCM) in Cairo University Critical Care 2011, Volume 15 Suppl 1 S2 http://ccforum.com/supplements/15/S1 Hospital, Egypt. (GII) included 30 patients of the CRF with CVD group with graft (CABG) patients and to determine if metabolic syndrome aff ects mean age = 49.1 undergoing periodic hemodialysis three times per week, clinical outcomes in the perioperative setting. compared with 30 normal volunteers included as the control group. Methods A cohort study of elective CABG surgery patients. Results The mean value of serum arginase enzyme activity in the control Metabolic syndrome was defi ned using recent established criteria [1]. group was 27.9 ± 4.59 U/l. In (GI) the mean value was 70.42 ± 11.9 U/l. On Demographic variables, comorbid conditions, surgical procedures and the other hand, the activity of serum arginase enzyme in patients with postoperative variables were collected. SPSS 15 was used. CRF with CVD has mean value 32.43 ± 6.5 U/l, P <0.05 compared with Results We studied 508 patients. MS was defi ned in 333 (66%) patients, the control group. ADA in the control group was 20.1 ± 2.39 U/l. But in 241 (72%) males and 92 (28%) females, mean age 66 ± 9 years. MS had (GI) the mean value was 44.99 ± 9.4 U/l, indicating a highly signifi cantly greater glucose levels at all postoperative time points (F: 41.6, P <0.001), increase was observed as compared with the control group (P <0.001). higher leptins levels (F: 4.7, P <0.044), higher thrombomodulin at The activity of ADA in CRF (GII) was also high (59.83 ± 9.8 U/l; P <0.001). 0 hours and 4 hours after surgery (F: 6, P = 0.016), and lower 24-hour- Conclusions ADA may be considered good diagnostic enzymes in postoperative blood loss after adjusting by tranexamic acid (F: 4.6, patients suff ering from MI, and ADA for patients with CRF with CVD. P = 0.032). MS had higher incidence of renal dysfunction (RIFLE: I) 13 (4%) versus 1 (0.6%) (P = 0.027). Conclusions MS was associated with a procoagulant state that may P4 decrease postoperative blood loss. Nevertheless MS was associated Pharmacological CCR1 blockade limits infarct size and with worse adverse events as renal dysfunction. preserves cardiac function in a chronic model of myocardial Reference ischemia/reperfusion 1. Alberti RH, et al.: Circulation 2009, 120:1640-1645. A Van de Sandt, S Zander, S Becher, R Ercan, C Quast, J Ohlig, T Lauer, T Rassaf, M Kelm, MW Merx Department of Cardiology, Pulmonary Diseases and Vascular Medicine, P6 University Hospital, Düsseldorf, Germany Perioperative risk factors for serious gastrointestinal complications Critical Care 2011, 15(Suppl 1):P4 (doi: 10.1186/cc9424) treated by laparotomy after cardiac surgery using cardiopulmonary bypass Introduction This study sought to determine the chronic eff ects P Soos1, B Schmack2, A Weymann2, G Veres1, B Merkely1, M Karck2, of pharmacological blockade of the chemokine receptor CCR1 via G Szabó2 application of the potent, selective antagonist BX471 in a murine model 1Semmelweis University, Budapest, Hungary; 2University of Heidelberg, of myocardial ischemia/reperfusion (I/R). CCR1 is a prominent receptor in Germany mediating infl ammatory leukocyte recruitment. The intense infl ammatory Critical Care 2011, 15(Suppl 1):P6 (doi: 10.1186/cc9426) response is considered to be a key component of cardiac remodelling.