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Xuan Zhang, Long Cheng, Longhe Xu, Yunliang Zhang, Yitian Yang, Qiang Fu, Weidong Mi, Hao Li
BACKGROUND: Ischemic postconditioning (I/Post) is an endogenous protection mechanism that reduces injury induced by ischemia-reperfusion (I/R). It remains controversial whether I/Post protects against I/R injury to the aging heart. The long non-coding RNA, H19 protects H9c2 cells against hypoxia-induced injury. This study aimed to elucidate the role of H19 in the hypoxic postconditioning (H/Post) of aged cardiomyocytes. METHODS: Senescence induced by D-galactose in primary cardiomyocytes from neonatal Sprague-Dawley rats was measured by senescence-associated β-galactosidase staining...
June 27, 2018: Shock
Duraid Younan, Russell Griffin, Ahmed Zaky, Jean-Francois Pittet, Bernard Camins
BACKGROUND: The Centers for Disease Control and Prevention replaced the definition for ventilator-associated pneumonia with an algorithm comprised of three categories-ventilator associated condition (VAC), infection -related ventilator associated complication (IVAC) and possible ventilator associated pneumonia (PVAP). We sought to compare the outcome of trauma patients with VAEs to those with No VAEs. METHODS: Patients admitted from 2013-2017 were identified from trauma registry...
June 27, 2018: Shock
Susannah E Nicholson, Lora T Watts, David M Burmeister, Daniel Merrill, Shannon Scroggins, Yi Zou, Zhao Lai, Ramesh Grandhi, Aaron M Lewis, Larry M Newton, Brian J Eastridge, Martin G Schwacha
The microbiome is defined as the collective genomes of the microbes (composed of bacteria, bacteriophage, fungi, protozoa and viruses) that colonize the human body, and alterations have been associated with a number of disease states. Changes in gut commensals can influence the neurologic system via the brain-gut axis, and systemic insults such as trauma or traumatic brain injury (TBI) may alter the gut microbiome. The objective of this study was to evaluate the gut microbiome in a pre-clinical TBI cortical impact model...
June 26, 2018: Shock
Martin Wepler, Tamara Merz, Ulrich Wachter, Josef Vogt, Enrico Calzia, Angelika Scheuerle, Peter Möller, Michael Gröger, Sandra Kress, Marina Fink, Britta Lukaschewski, Grégoire Rumm, Bettina Stahl, Michael Georgieff, Markus Huber-Lang, Roberta Torregrossa, Matthew Whiteman, Oscar McCook, Peter Radermacher, Clair Hartmann
Hemorrhagic shock (HS) accounts for 30-40% of trauma-induced mortality, which is due to multi-organ-failure subsequent to systemic hyper-inflammation, triggered by hypoxemia and tissue ischemia. The slow-releasing, mitochondria-targeted H2S donor AP39 exerted beneficial effects in several models of I/R-injury and acute inflammation. Therefore, we tested the effects of AP39-treatment in a murine model of combined blunt chest trauma (TxT) and HS with subsequent resuscitation. METHODS: After blast wave-induced TxT or sham procedure, anesthetized and instrumented mice underwent 1 hour of hemorrhage followed by 4 hours of resuscitation comprising an i...
June 20, 2018: Shock
John D Lyons, Ching-Wen Chen, Zhe Liang, Wenxiao Zhang, Deena B Chihade, Eileen M Burd, Alton B Farris, Mandy L Ford, Craig M Coopersmith
Patients with cancer who develop sepsis have a markedly higher mortality than patients who were healthy prior to the onset of sepsis. Potential mechanisms underlying this difference have previously been examined in two preclinical models of cancer followed by sepsis. Both pancreatic cancer/pneumonia and lung cancer/cecal ligation and puncture (CLP) increase murine mortality, associated with alterations in lymphocyte apoptosis and intestinal integrity. However, pancreatic cancer/pneumonia decreases lymphocyte apoptosis and increases gut apoptosis while lung cancer/CLP increases lymphocyte apoptosis and decreases intestinal proliferation...
June 20, 2018: Shock
Judith Hellman, Soheyl Bahrami, Mihaly Boros, Irshad Chaudry, Gerhard Fritsch, Waldemar Gozdzik, Shigeaki Inoue, Peter Radermacher, Mervyn Singer, Marcin F Osuchowski, Markus Huber-Lang
As outlined in the "International Guidelines for Management of Sepsis and Septic Shock: 2016", initial fluid resuscitation and administration of antibiotics are key steps in the early management of sepsis and septic shock. However, such clear guidelines do not exist for pre-clinical sepsis models. To address these shortcomings, the Wiggers-Bernard conference on pre-clinical sepsis models was held in Vienna in May, 2017. The participants reviewed 260 of the most highly cited papers between 2003 and 2012 that used sepsis models...
June 19, 2018: Shock
Anita C Randolph, Satoshi Fukuda, Koji Ihara, Perenlei Enkhbaatar, Maria-Adelaide Micci
Only a handful of published reports exist today that describe neurological complications following smoke inhalation injury. In this study, we characterize acute pathophysiological changes in the brain of sheep exposed to smoke inhalation, with- and without third-degree skin burn that models the injuries sustained by human victims of fire accidents. Blood-brain barrier integrity and hemorrhage were analyzed throughout the brain using specific histological stains: Hematoxylin & Eosin, Luxol fast blue, Periodic acid-Schiff (PAS), and Martius, Scarlet and Blue (MSB)...
June 13, 2018: Shock
David H Jang, Clinton J Orloski, Shawn Owiredu, Frances S Shofer, John C Greenwood, David M Eckmann
OBJECTIVE: Mitochondrial dysfunction has been implicated as a key cellular event leading to organ dysfunction in sepsis. Our objective is to measure changes in mitochondrial bioenergetics in subjects with early presentation of sepsis to provide insight into the incompletely understood pathophysiology of the dysregulated host response in sepsis. DESIGN: Prospective observational study SETTING:: Single site tertiary academic emergency department SUBJECTS:: We enrolled a total of 48 subjects were enrolled in the study, 10 with sepsis or septic shock, 10 with infection without sepsis, 14 older and 14 younger healthy controls...
June 13, 2018: Shock
Feng Wu, Rosemary A Kozar
BACKGROUND: We have shown that fresh frozen plasma's (FFP) protection of pulmonary endothelial barrier integrity following hemorrhage shock is due in part to restoration of endothelial syndecan-1. In the present study, we investigated the role of fibrinogen, a major component of FFP, as an endothelial protector and hypothesize that fibrinogen stabilizes cell surface syndecan-1 to restore endothelial barrier integrity. METHODS: Pulmonary endothelial cells were incubated in FFP, fibrinogen, or lactated Ringers (LR) then immunostained with anti-syndecan-1 or fibrinogen and barrier integrity assessed...
June 13, 2018: Shock
Dinesh Kumar Patel, Sandeep Mittal, Nimisha Tiwari, Anil Kumar Maurya, Dhirendra Singh, Alok Kumar Pandey, Anirban Pal
Impairment of host immune response in malaria favours bacteraemia caused by typhoidal or non-typhoidal serovars of Salmonella enterica. Ofloxacin and Artesunate are the drugs that are clinically proven for treating typhoid and malaria respectively. The study evaluates the host responses upon treatment with antibiotic (Ofloxacin) and anti-malarial (Artesunate) in a standardized mice model harbouring co-infection. BALB/c mice (18-22 gm) were simultaneously co-infected with Plasmodium yoelii nigeriensis (Pyn) and Salmonella enterica Serovar Typhimurium (STm) and then treated with Ofloxacin or/and Artesunate from day 4 to day 7...
June 13, 2018: Shock
Dominik Langgartner, Ulrich Wachter, Clair Hartmann, Michael Gröger, Josef Vogt, Tamara Merz, Oscar McCook, Marina Fink, Sandra Kress, Michael Georgieff, Julia F Kunze, Peter L Radermacher, Stefan O Reber, Martin Wepler
BACKGROUND: Hypoxemia and tissue ischemia during hemorrhage as well as formation of oxygen and nitrogen radicals during resuscitation promote hyperinflammation and, consequently, trigger severe multiple-organ-failure (MOF). Individuals diagnosed with stress-related disorders or reporting a life history of psychosocial stress are characterized by chronic low-grade inflammation and a reduced glucocorticoid (GC) signaling. We hypothesized that exposure to chronic psychosocial stress during adulthood prior to hemorrhagic shock increases oxidative/nitrosative stress and therefore the risk of developing MOF in mice...
June 8, 2018: Shock
Hongmei Li, Yun Xing, Duomeng Yang, Xiangxu Tang, Daxiang Lu, Huadong Wang
It was demonstrated that α1 adrenergic receptor (α1-AR) activation by phenylephrine (PE) attenuated cardiac dysfunction in lipopolysaccharide (LPS) - challenged mice. However, it is unclear whether PE suppresses sepsis-induced cardiomyocyte apoptosis. Here, we investigated the effects of PE on cardiomyocyte apoptosis in LPS-treated adult rat ventricular myocytes (ARVMs) and septic rats induced by cecal ligation and puncture. Cardiomyocyte apoptosis and caspase activity were detected by TUNEL and spectrophotometrical assay, respectively...
June 8, 2018: Shock
Yuhan Zhu, Yongyao Wen, Qimin Jiang, Nan Guo, Yangping Cai, Xiaoxu Shen
OBJECTIVE: To investigate the effectiveness and safety of corticosteroids therapy in adult critical ill patients with septic shock. METHODS: The PUBMED, EMBASE, Web of Science, Cochrane Library databases were systematically searched from the inception dates to March 24, 2018. To identify randomized controlled trials that evaluating the role of corticosteroids therapy in adult critical ill patients with septic shock. The primary outcome was 28-day mortality. The second outcomes included 90-day mortality, ICU mortality, In-hospital mortality, length of stay in ICU, length of stay in hospital, reversal of shock and superinfection...
June 8, 2018: Shock
Yong Soo Cho, Jeong Mi Moon, Byeong Jo Chun, Byung Kook Lee
AIM: This study aimed to identify whether quick sequential organ failure assessment (qSOFA) performed immediately upon arrival can predict the outcome of patients with glyphosate surfactant herbicide (GlySH) poisoning. METHODS: Adult patients with GlySH poisoning between January 2006 and April 2017 were included in this retrospective observational study. The qSOFA score (respiratory rate ≥22 breaths per min, systolic blood pressure <100 mmHg, and altered mental status) was assessed immediately upon arrival at the emergency department...
June 8, 2018: Shock
Lillian Hesselink, Marjolein Heeres, Fotis Paraschiakos, Maarten Ten Berg, Albert Huisman, Imo E Hoefer, Mark C H de Groot, Wouter W van Solinge, Marcel Dijkgraaf, Pien Hellebrekers, Karlijn J P Van Wessem, Leo Koenderman, Luke P H Leenen, Falco Hietbrink
INTRODUCTION: Organ dysfunction remains a major cause of morbidity after trauma. The development of organ dysfunction is determined by the inflammatory response, in which neutrophils are important effector cells. A femoral fracture particularly predisposes for the development of organ dysfunction. This study investigated the chronologic relation between neutrophil characteristics and organ dysfunction in trauma patients with a femoral fracture. METHODS: Patients with a femoral fracture presenting at the University Medical Center (UMC) Utrecht between 2007 and 2013 were included...
June 8, 2018: Shock
M Austin Johnson, Emily M Tibbits, Guillaume L Hoareau, Meryl A Simon, Anders J Davidson, Erik S DeSoucy, E Robert Faulconer, J Kevin Grayson, Lucas P Neff, Timothy K Williams
BACKGROUND: The resuscitation of patients in shock is materially intensive and many patients are refractory to maximal therapy. We hypothesized that partial inflation of an intra-aortic balloon, termed Endovascular Perfusion Augmentation for Critical Care (EPACC), would minimize material requirements while improving physiologic metrics. METHODS: Swine underwent a 25% controlled bleed and 45 minutes of complete aortic occlusion to create a severe ischemia-reperfusion shock state...
June 5, 2018: Shock
Per W Moller, Anisa Hana, Paul Philipp Heinisch, Shengchen Liu, Siamak Djafarzadeh, Matthias Haenggi, Andreas Bloch, Jukka Takala, Stephan M Jakob, David Berger
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is gaining widespread use in the treatment of severe cardiorespiratory failure. Blood volume expansion is commonly used to increase ECMO flow (QECMO), with risk of positive fluid balance and worsening prognosis. We studied the effects of vasoconstriction on recruitment of blood volume as an alternative for increasing QECMO, based on the concepts of venous return. METHODS: In a closed chest, centrally cannulated porcine preparation (n = 9) in ventricular fibrillation and VA-ECMO with vented left atrium, mean systemic filling pressure (MSFP) and venous return driving pressure (VRdP) were determined in Euvolemia, during Vasoconstriction (norepinephrine 0...
June 5, 2018: Shock
Daniel G Remick, Alfred Ayala, Irshad Chaudry, Craig M Coopersmith, Clifford Deutschman, Judith Hellman, Lyle Moldawer, Marcin Osuchowski
Sepsis morbidity and mortality exacts a toll on patients and contributes significantly to healthcare costs. Preclinical models of sepsis have been used to study disease pathogenesis and test new therapies, but divergent outcomes have been observed with the same treatment even when using the same sepsis model. Other disorders such as diabetes, cancer, malaria, obesity and cardiovascular diseases have used standardized, preclinical models that allow laboratories to compare results. Standardized models accelerate the pace of research and such models have been used to test new therapies or changes in treatment guidelines...
June 5, 2018: Shock
Dan-Dan Huang, Xiao-Hong Wei, Hong-Na Mu, Chun-Shui Pan, Quan Li, Bai-He Hu, Xin Chang, Li Yan, Jing-Yu Fan, Yu-Ying Liu, Jian-Yuan Luo, Jing-Yan Han
Sirtuin1 (Sirt1) and Sirtuin3 (Sirt3) are known to participate in regulating mitochondrial function. However, whether Total Salvianolic Acid Injection (TSI) protects against myocardial ischemia/reperfusion (I/R) injury through regulating Sirt1, Sirt3, and mitochondrial respiratory chain complexes is unclear. The aim of this study was to explore the effects of TSI on I/R-induced myocardial injury and the underlying mechanism. Male Sprague-Dawley rats were subjected to 30 min occlusion of the left anterior descending coronary artery followed by 90 min reperfusion with or without TSI treatment (8 mg/kg/h)...
June 1, 2018: Shock
Stefan P Kastl, Konstantin A Krychtiuk, Max Lenz, Klaus Distelmaier, Georg Goliasch, Kurt Huber, Johann Wojta, Gottfried Heinz, Walter S Speidl
BACKGROUND: Acute heart failure and cardiogenic shock are associated with an impaired intestinal perfusion, which may lead to a release of cytoplasmatic proteins by hypoxic epithelial injury. Intestinal fatty acid binding protein (iFABP), highly specific for the small bowel enterocyte, may pose a useful novel and very sensitive biomarker for predicting outcome of these patients.The aim of this study was to investigate whether circulating levels of iFABP are associated with mortality in patients with acute heart failure or cardiogenic shock requiring intensive care unit (ICU) admission...
May 29, 2018: Shock
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