In the mixed model approach more sex, medi cal surgical admission or the use of corticosteroids for the treatment of septic shock refractory to vasopressor therapy, were used one by one as an adjusting covariate if their impact on the model was significant. The P values are reported as follows Pg, indicates a significant level differ ence between the groups, Pt g indicates time group interac tion and Pt indicates the change over time. The statistical analyses were performed using SPSS and SAS statistical software. Two tailed significance levels are reported. Readers should take into account that where several comparisons are made no P value correction coefficient method is used. Inhibitors,Modulators,Libraries Results Patients Of the 1,361 patients admitted to the ICU during the period from May 2005 to December 2006, 238 adults met the inclusion criteria.

One hundred and seventy two patients were excluded and 44 of the remaining 66 patients or their next of kin gave written informed consent. The control group consisted of age and sex matched healthy volunteers Inhibitors,Modulators,Libraries with a median age of 60 years. Seven of them were females and eight were males. The patient demographics and clinical characteris tics have been reported previously and are summarized in Table 1. The overall median age was 63 years. The overall median APACHE II score at admission was 26. Of the cases, 68% developed MOF and 86% required noradrena line and 73% hydrocortisone therapy for septic shock. The non survivors had significantly higher APACHE II score on admission and maximum SOFA scores vs. 24, P 0. 005 and 16 vs. 8, P 0. 003, respectively.

Lungs were the most common infection focus and blood culture was posi tive in 13 cases. MMP 8, MMP 2 and MMP 9 in blister fluid in patients and healthy controls The MMP 8 levels Inhibitors,Modulators,Libraries in blister fluid samples were signifi cantly higher in patients with severe sepsis in comparison with the controls on both days. The blister fluid levels Inhibitors,Modulators,Libraries of the 72 kDa proMMP 2 were slightly elevated on both study days. The form spliced to active con formation, the 62 kDa MMP 2, was found in all patients with severe sepsis on the first day and on the fifth day but not in controls. The 92 kDa proMMP 9 was lower on both first and fifth day in patients with severe sep sis in comparison with the controls.

The 82 kDa MMP 9, the form spliced to active conformation, was found in blister fluid samples of five patients out of 44 on the first day and of five patients out of 38 patients on the fifth day, but not in control samples. Three and six months after severe sepsis no marked differences Inhibitors,Modulators,Libraries could be observed in comparison with trichostatin a clinical trials the controls. Active form of MMP 2 could be detected in one of the sur vivors at three months, and the active form of MMP 9 in three survivors at three months and in one even at six months.