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In addition, while interstitial fluid flow may be important in clearing compounds such as amyloid from the brain, the importance of clearance at the NVU/BBB should not be overlooked and may be more important [ 18].
That ventilator-associated pneumonia (VAP) can be reduced by continuous and/or intermittent subglottic suction highlights the importance of clearance of oropharyngeal secretions.
Failure to phagocytose shed outer segments, such as in the Royal College of Surgeons rat (50, 51), leads to rapid photoreceptor cell death, demonstrating the importance of clearance of spent POS by the RPE, and the essential nature of lifelong maintenance of photoreceptors for maintenance of vision.
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Lactate clearance may be an important addition to the monitoring and management bundles of patients with severe sepsis and septic shock, However, specific mechanisms of lactate clearance, the relation of lactate clearance to traditional hemodynamic parameters, and the importance of lactate clearance as a therapeutic target or monitoring tool remain unclear.
In conclusion, the present results recognize the importance of lactate clearance as described by others but also underline the importance of magnitude of lactate values during ICU treatment.
The wear of clinically retrieved implants confirms the predicted low wear of this implant and confirms the importance of the clearance and the type of cobalt-chrome alloy.
It has been reported that some borate glasses exhibited cytotoxicity under static in vitro culture conditions (Fu et al. [2010b]), although no considerable toxicity was detected under more dynamic culture conditions, suggesting the importance of borate clearance (Fu et al. [2010b]).
Understanding the importance of the clearance of small bioparticles and various types of microparticles in many diseases has gained great interest in the recent years [32], [33], [34].
Autophagy is an important mechanism for the clearance of mitochondria [40] following damage and IGF-I has been reported to influence this process [41] but the relative importance of mitochondrial clearance under physiologic conditions is less clear.
In the present study the bacteremic profile was also related with mortality (data not shown), but we further investigated mortality prediction by means of relating bacterial counts in blood in the 8 h-period after the first dose administration with mortality from 8 h on, as a marker of the importance of rapid clearance of bacteria (in vivo bactericidal activity) on the therapeutic outcome.
Regardless, the present study contextualizes the importance of lactate clearance by suggesting persistent hyperlactatemia may be independent of other hemodynamic factors and portends a worse prognosis.
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