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Shock

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https://www.readbyqxmd.com/read/27902530/cardiac-troponin-release-is-associated-with-biomarkers-of-inflammation-and-ventricular-dilatation-during-critical-illness
#1
Marlies Ostermann, Salma Ayis, Emma Tuddenham, Jessica Lo, Katie Lei, John Smith, Barnaby Sanderson, Carl Moran, Paul Collinson, Janet Peacock, Andrew Rhodes, David Treacher
INTRODUCTION: Troponin release is common during critical illness. We hypothesized that there was an association between cardiac troponin T (cTnT) and biomarkers of systemic inflammation and ventricular dilatation. METHODS: In an observational prospective cohort study, we enrolled consecutive adult patients admitted for non-cardiac reasons to the Intensive Care Unit (ICU) in 2 tertiary care centers. We measured cTnT, C-reactive protein (CRP), Interleukin-6 (IL-6), procalcitonin (PCT) and N-terminal pro brain natriuretic peptide (NT-proBNP) daily in the first week, and on alternate days in the second week...
November 29, 2016: Shock
https://www.readbyqxmd.com/read/27879562/effects-of-transport-temperature-on-the-stability-of-inflammatory-hemostasis-endothelial-function-and-oxidative-stress-plasma-biomarker-concentrations
#2
Octavia M Peck Palmer, Melinda Carter, Chung-Chou H Chang, Nicole Lucko, Vanessa M Jackson, Qian Sun, Xinyan Xie, Melanie Scott, John A Kellum, Arvind Venkat, Sachin Yende
BACKGROUND: A number of studies in critically ill patients are conducted outside the hospital. Specimens should ideally be transported from out-of-hospital setting to a laboratory using dry ice, but this approach is expensive and may not be feasible in some circumstances. We, therefore, examined the impact of temperature during transport of specimens on the precision of biomarker concentrations. OBJECTIVE: To determine the effects of transport temperature conditions on biomarker concentrations in specimens processed within 1 hour of collection...
November 22, 2016: Shock
https://www.readbyqxmd.com/read/27879561/late-therapeutic-intervention-with-antibiotics-and-fluid-resuscitation-allows-for-a-prolonged-disease-course-with-high-survival-in-a-severe-murine-model-of-sepsis
#3
Allison M Steele, Marlene E Starr, Hiroshi Saito
Current animal models of sepsis often incorporate antibiotics to be consistent with clinical standards for treatment of patients in the ICU. However, such experimental intervention is commonly initiated very early after infectious insult, which likely blunts the progression of systemic inflammation and downstream pathology. The objective of this study was to establish an animal model of sepsis with delayed therapeutic intervention, allowing a longer disease course and downstream pathology, but still resulting in a high survival rate...
November 22, 2016: Shock
https://www.readbyqxmd.com/read/27879560/temporal-changes-in-microrna-expression-in-blood-leukocytes-from-patients-with-the-acute-respiratory-distress-syndrome
#4
Purushottam Narute, Nitin Seam, Margaret Tropea, Carolea Logun, Rongman Cai, Junfeng Sun, James H Shelhamer, G Umberto Meduri, Anthony F Suffredini
BACKGROUND: MicroRNA (miRNA) control gene transcription by binding to and repressing the translation of messenger RNA (mRNA). Their role in the acute respiratory distress syndrome (ARDS) is undefined. METHODS: Blood leukocytes from 51 patients enrolled in a prior randomized trial of corticosteroids for ARDS were analyzed. After screening eight patients with microarrays for altered miRNA expression, 25 miRNAs were selected for further analysis using RT-PCR in all 51 patients...
November 21, 2016: Shock
https://www.readbyqxmd.com/read/27879559/angiotensin-ii-in-refractory-septic-shock
#5
Elio Antonucci, Patrick J Gleeson, Filippo Annoni, Sara Agosta, Sergio Orlando, Fabio Silvio Taccone, Dimitrios Velissaris, Sabino Scolletta
Refractory septic shock is defined as persistently low mean arterial blood pressure despite volume resuscitation and titrated vasopressors/inotropes in patients with a proven or suspected infection and concomitant organ dysfunction. Its management typically requires high doses of catecholamines, which can induce significant adverse effects such as ischemia and arrhythmias. Angiotensin II (Ang II), a key product of the renin-angiotensin-aldosterone system (RAAS), is a vasopressor agent that could be used in conjunction with other vasopressors to stabilize critically ill patients during refractory septic shock, and reduce catecholamine requirements...
November 21, 2016: Shock
https://www.readbyqxmd.com/read/27861257/pulmonary-phototherapy-to-treat-carbon-monoxide-poisoning-in-rats
#6
Luca Zazzeron, Chen Liu, Walfre Franco, Akito Nakagawa, William A Farinelli, Donald B Bloch, R Rox Anderson, Warren M Zapol
BACKGROUND: Carbon monoxide (CO) poisoning is a common cause of poison-related mortality. CO binds to hemoglobin in the blood to form carboxyhemoglobin (COHb), impairing oxygen delivery to peripheral tissues. Current treatment of CO poisoned patients involves oxygen administration to rapidly remove CO and restore oxygen delivery. Light dissociates CO from COHb with high efficiency. Exposure of murine lungs to visible laser-generated light improved the CO elimination rate in vivo. The aims of this study were to apply pulmonary phototherapy to a larger animal model of CO poisoning, to test novel approaches to light delivery, and to examine the effect of chemiluminescence-generated light on the CO elimination rate...
November 16, 2016: Shock
https://www.readbyqxmd.com/read/27861258/septic-participation-in-cardiogenic-shock-exposure-to-bacterial-endotoxin
#7
Paula Ramirez, Esther Villarreal, Monica Gordon, María Dolores Gómez, Luis de Hevia, Karla Vacacela, Teresa Gisbert, Adrian Quinzá, Jesús Ruiz, Ricardo Alonso, Juan Bonastre, Jordi Vila
OBJECTIVE: In cardiogenic shock (CS), presence of fever, leukocytosis, relatively low systemic vascular resistances and high serum procalcitonin levels are quite frequent and recurrently involve the search for an infectious complication. We hypothesized that endotoxin exposure in CS could explain this sepsis-like syndrome. DESIGN AND SETTING: Prospective observational study of consecutive CS patients admitted to our intensive care unit (ICU). Patients were followed during the first three days after SC onset...
November 15, 2016: Shock
https://www.readbyqxmd.com/read/27849678/fc-gamma-receptor-iib-deficient-mice-a-lupus-model-with-increased-endotoxin-tolerance-related-sepsis-susceptibility
#8
Thunnicha Ondee, Saowapha Surawut, Sujittra Taratummarat, Nattiya Hirankan, Tanapat Palaga, Prapaporn Pisitkun, Trairak Pisitkun, Asada Leelahavanichkul
Hyper-elevated immune response of FcGRIIb-/- mice, a lupus model with an inhibitory-signaling defect, can become exhausted (less subsequent immune-response than the first response) with sequential LPS stimulation. Endotoxin tolerance-related modifications of inflammatory response were investigated in FcGRIIb-/- mice in both an in vivo sepsis model and in vitro using cultured macrophages. Serum cytokine concentrations, after the second LPS injection (at 5-fold higher levels than the first dose) did not exceed the first dose levels in either FcGRIIb-/- or wild-type mice...
November 15, 2016: Shock
https://www.readbyqxmd.com/read/27849677/use-of-a-short-acting-%C3%AE-1-blocker-during-endotoxemia-may-reduce-cerebral-tissue-oxygenation-if-haemodynamics-are-depressed-by-a-decrease-in-heart-rate
#9
Tadayoshi Kurita, Shingo Kawashima, Koji Morita, Yoshiki Nakajima
BACKGROUND: A decrease in heart rate (HR) using a short-acting β blocker has potential benefits in sepsis; however, depression of haemodynamics and reduction of cerebral oxygenation may also occur in endotoxemia. METHODS: Seventeen swine were allocated to landiolol or control groups. In the landiolol group, the dose was sequentially changed from 0 to 40 to 200 μg kg min, and stopped. Haemodynamics, blood variables and the cerebral tissue oxygenation index (TOI) were recorded by near infrared spectroscopy at each dose...
November 15, 2016: Shock
https://www.readbyqxmd.com/read/27849676/platelet-transfusion-in-critical-care-and-surgery-evidence-based-review-of-contemporary-practice-and-future-directions
#10
Eric W Etchill, Sara P Myers, Jay S Raval, Adnan Hassoune, Anirban SenGupta, Matthew D Neal
Thrombocytopenia is prevalent in critical care, surgical, and trauma settings. Despite the fact that a significant proportion of these patients receive platelet transfusion during their hospital course, much work remains to be done with regard to development of platelet transfusion guidelines. Given the wide variety of platelet transfusion practices and the frequency with which patients present with thrombocytopenia, it is paramount to understand standards of care and to identify deficiencies that may exist...
November 15, 2016: Shock
https://www.readbyqxmd.com/read/27841847/high-versus-low-blood-pressure-target-in-experimental-ischemic-prolonged-cardiac-arrest-treated-with-extra-corporeal-life-support
#11
Caroline Fritz, Antoine Kimmoun, Fabrice Vanhuyse, Bogdan Florin Trifan, Sophie Orlowski, Aude Falanga, Vanessa Marie, Frederique Groubatch, Eliane Albuisson, N'Guyen Tran, Bruno Levy
BACKGROUND: There is currently no recommendation for the mean arterial pressure target in the particular setting of Extracorporeal Cardiopulmonary Resuscitation (ECPR) in the first hours following cardiogenic shock complicated by cardiac arrest. This study aimed to assess the effects of two different levels of mean arterial pressure on macrocirculatory, microcirculatory and metabolic functions. DESIGN: Randomized animal study. SETTING: University research laboratory...
November 10, 2016: Shock
https://www.readbyqxmd.com/read/27841846/novel-function-of-isoamylamine-improves-survival-in-endotoxemic-mice-by-ameliorating-coagulopathy-and-attenuating-mmp-9-expression-through-p-erk-p-p38-signaling-at-early-stage
#12
Yong-Ren Yen, Yu-Hsun Wang, Li-Na Wang, Lien-Cheng Chen, Fung-Jou Lu, Soo-Ray Wang
When a host suffers endotoxemic shock or septic shock, it results in many symptoms including disseminated intravascular coagulation (DIC). Septic shock (SS) causes coagulation time to decrease and then gradually increase, finally becoming prolonged and giving rise to DIC. Isoamylamine (IA) is one of the main components of grape products and can improve the survival rate of endotoxin lipopolysaccharide (LPS)-induced endotoxemic shock. The aim of this study was to elucidate if IA ameliorates coagulopathy in the early phase of LPS-induced damage...
November 10, 2016: Shock
https://www.readbyqxmd.com/read/27831972/the-role-of-thioredoxin-1-in-suppression-sepsis-through-inhibiting-mitochonrial-induced-apoptosis-in-spleen
#13
Guobing Chen, Xiang Li, Mengbing Huang, Xiaoshuang Zhou, Ye Li, Xiaoqin Mao, Jie Bai
Sepsis is a serious public health issue and the leading cause of death in critically ill patients in intensive care units. Thioredoxin-1 (Trx-1) is a protein of regulating redox, as well as a modulator of inflammation and apoptosis. Our previous study reported that Trx-1 decreased endoplasmic reticulum mediated inflammation involved in lung in a model of experimental sepsis. However, its effect on mitochondrial -mediated apoptosis in spleen has not been reported. We studied whether Trx-1 could prevent spleen cells apoptosis in sepsis...
November 9, 2016: Shock
https://www.readbyqxmd.com/read/27820776/muscle-oxygenation-as-an-early-predictor-of-shock-severity-in-trauma-patients
#14
Lorilee S L Arakaki, Eileen M Bulger, Wayne A Ciesielski, David J Carlbom, Dana M Fisk, Kellie J Sheehan, Karin M Asplund, Kenneth A Schenkman
INTRODUCTION: We evaluated the potential utility of a new prototype noninvasive muscle oxygenation (MOx) measurement for the identification of shock severity in a population of patients admitted to the trauma resuscitation rooms of a Level I regional trauma center. The goal of this project was to correlate MOx with shock severity as defined by standard measures of shock: systolic blood pressure, heart rate, and lactate. METHODS: Optical spectra were collected from subjects by placement of a custom-designed optical probe over the first dorsal interosseous muscles on the back of the hand...
November 3, 2016: Shock
https://www.readbyqxmd.com/read/27798537/contemporary-patterns-of-multiple-organ-dysfunction-in-trauma
#15
Joanna M Shepherd, Elaine Cole, Karim Brohi
BACKGROUND: Multiple organ dysfunction syndrome (MODS) is associated with poor outcomes for trauma patients. Different forms of MODS may exist and have different consequences. The ability to distinguish them clinically may have implications for prognosis and treatment. We wished to study whether prolonged MODS (PRMODS) could be observed as a distinct clinical entity to early resolving MODS (ERMODS) in critically injured patients. METHODS: Adult major trauma patients recruited to a prospective observational study at a single major trauma centre were eligible for inclusion...
October 28, 2016: Shock
https://www.readbyqxmd.com/read/27792125/impact-of-metformin-use-on-lactate-kinetics-in-patients-with-severe-sepsis-and-septic-shock
#16
Joongmin Park, Sung Yeon Hwang, Ik Joon Jo, Kyeongman Jeon, Gee Young Suh, Tae Rim Lee, Hee Yoon, Won Chul Cha, Min Seob Sim, K C Carriere, Seungmin Yeon, Tae Gun Shin
BACKGROUND: We aimed to evaluate the impact of metformin use on lactate kinetics in patients with severe sepsis and septic shock. METHODS: We analyzed data from a registry that included patients who presented to the emergency department and met criteria for severe sepsis or septic shock. Patients were divided into two groups based on metformin use. We compared lactate concentrations, lactate clearance (LC), and normalization at 6 hours (H6) and 24 hours (H24) after the initial (H0) measurement...
October 27, 2016: Shock
https://www.readbyqxmd.com/read/27792124/erythrocyte-derived-microparticles-activate-pulmonary-endothelial-cells-in-a-murine-model-of-transfusion
#17
Alex L Chang, Young Kim, Aaron P Seitz, Rebecca M Schuster, Alex B Lentsch, Timothy A Pritts
Erythrocyte-derived microparticles (MPs) are sub-micrometer, biologically active vesicles shed by red blood cells as part of the biochemical changes that occur during storage. We hypothesized that MPs from stored red blood cells would activate endothelial cells. MPs from aged murine packed red blood cells (pRBCs) were isolated and used to treat confluent layers of cultured endothelial cells. Endothelial expression of leukocyte adhesion molecules, ELAM-1 and ICAM-1, and inflammatory mediator, IL-6, were evaluated at 0...
October 27, 2016: Shock
https://www.readbyqxmd.com/read/27798536/influences-of-vagotomy-on-gut-ischemia-reperfusion-injury-in-mice
#18
Motonari Ri, Kazuhiko Fukatsu, Taiki Miyakuni, Masashi Yanagawa, Satoshi Murakoshi, Hiroshi Yasuhara, Yasuyuki Seto
BACKGROUND: How vagotomy affects host responses to gut ischemia-reperfusion (I/R) is unclear. MATERIALS AND METHODS: Exp.1: Male Institute of Cancer Research mice (n = 22) were assigned to the I/R or the vago-I/R group. The I/R mice underwent 45-minute superior mesenteric artery (SMA) occlusion. The vago-I/R mice received vagotomy before SMA occlusion. Survival was observed for 48 hours.Exp.2: Mice (n = 55) were divided into 4 groups (Sham, vago, I/R, vago-I/R)...
October 26, 2016: Shock
https://www.readbyqxmd.com/read/27798535/urinary-biomarkers-are-associated-with-severity-and-mechanism-of-injury
#19
Jud C Janak, Ian J Stewart, Jonathan A Sosnov, Jeffrey T Howard, Edward D Siew, Mallory M Chan, Nancy Wickersham, T Alp Ikizler, Kevin K Chung
Combat-related blast trauma results in massive tissue injury and tends to involve multiple systems. Further, an acute measure of injury severity based on underlying biological mechanisms may be important for the triage and treatment of these types of patients. We hypothesized that urinary biomarkers (UBs) would reflect severity of injury and that they would be elevated for blast injuries compared to gunshot wounds (GSW) in a cohort of combat casualties. We also postulated that UBs would be higher in patients with burns compared to patients with non-burn trauma in a civilian cohort...
October 26, 2016: Shock
https://www.readbyqxmd.com/read/27787407/vasodilators-in-septic-shock-resuscitation-a-clinical-perspective
#20
Thiago Domingos Corrêa, Roberto Rabello Filho, Murillo Santucci Cesar Assunção, Eliézer Silva, Alexandre Lima
Microcirculatory abnormalities have been shown to be frequent in patients with septic shock despite "normalization" of systemic hemodynamics. Several studies have explored the impact of vasodilator therapy (prostacyclin, inhaled nitric oxide, topic acetylcholine and nitroglycerin) on microcirculation and tissue perfusion, with contradictory findings.In this narrative review, we briefly present the pathophysiological aspects of microcirculatory dysfunction, and depict the evidence supporting the use of vasodilators and other therapeutic interventions (fluid administration, blood transfusion, vasopressors and dobutamine) aiming to improve the microcirculatory flow in septic shock patients...
October 26, 2016: Shock
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