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Shock

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https://www.readbyqxmd.com/read/28207628/earlier-endpoints-are-required-for-hemorrhagic-shock-trials-among-severely-injured-patients
#1
Erin E Fox, John B Holcomb, Charles E Wade, Eileen M Bulger, Barbara C Tilley
BACKGROUND: Choosing the appropriate endpoint for a trauma hemorrhage control trial can determine the likelihood of its success. Recent Phase 3 trials and observational studies have used 24-h and/or 30-day all-cause mortality as the primary endpoint and some have not used exception from informed consent (EFIC), resulting in multiple failed trials. Five recent high-quality prospective studies among 4,064 hemorrhaging trauma patients provide new evidence to support earlier primary endpoints...
February 15, 2017: Shock
https://www.readbyqxmd.com/read/28187039/plasma-neutrophil-elastase-and-elafin-as-prognostic-biomarker-for-acute-respiratory-distress-syndrome-a-multicenter-survival-and-longitudinal-prospective-observation-study
#2
Zhaozhong Zhu, Tiehua Wang, Zhuang Liu, Liang Yi, Zhixu Yang, Weishuai Bian, Wei Chen, Shupeng Wang, Gang Li, Ang Li, Greg S Martin, Xi Zhu
BACKGROUND: Neutrophil elastase (HNE) is a destructive enzyme and plays crucial roles in the pathophysiology of acute respiratory distress syndrome (ARDS). Endogenous proteinase inhibitors elafin (PI3) is important to protect against lung tissue destruction. We proposed to examine whether HNE and PI3 serve as prognostic biomarkers for ARDS. METHODS: This study is a survival and longitudinal analysis of plasma profiles of HNE and PI3 in ARDS patients from a multi-center prospective observational cohort in Beijing, China...
February 9, 2017: Shock
https://www.readbyqxmd.com/read/28187038/minocycline-prevents-the-impairment-of-hippocampal-long-term-potentiation-in-the-septic-mouse
#3
Koji Hoshino, Mineji Hayakawa, Yuji Morimoto
Sepsis-associated encephalopathy is a major complication during sepsis, and an effective treatment remains unknown. Although minocycline (MINO) has neuroprotective effects and is an attractive candidate for treating sepsis-associated encephalopathy, the effect of MINO on synaptic plasticity during sepsis is still unclear. In the present study, we investigated the effects of MINO on long-term potentiation (LTP) in the hippocampus in a cecal ligation and puncture (CLP) mouse model. We divided mice into 4 groups; (1) sham + vehicle, (2) sham + MINO (60 mg/kg, i...
February 9, 2017: Shock
https://www.readbyqxmd.com/read/28181922/burn-serum-stimulates-myoblast-cell-death-associated-with-il-6-induced-mitochondrial-fragmentation
#4
Alvand Sehat, Ryan M Huebinger, Deborah L Carlson, Qun S Zang, Steven E Wolf, Juquan Song
BACKGROUND: Burn patients suffer muscle mass loss associated with hyperinflammation and hypercatabolism. The mitochondria are affected by this metabolic alteration. Mitochondrial fission activates a caspase cascade which ultimately leads to cell death. We postulate that burn-induced muscle loss is associated with increased mitochondrial fission and subsequent functional impairment. Further, we investigated whether the cytokine IL-6 plays a major role in mitochondrial fission-associated cell death after burn...
February 8, 2017: Shock
https://www.readbyqxmd.com/read/28151770/organ-specific-differences-in-endothelial-permeability-regulating-molecular-responses-in-mouse-and-human-sepsis
#5
Adnan Aslan, Matijs van Meurs, Jill Moser, Eliane R Popa, Rianne M Jongman, Peter J Zwiers, Grietje Molema, Jan G Zijlstra
In patients with sepsis-induced MODS, diverging patterns of oedema formation and loss of function in organs such as lung and kidney suggest that endothelial permeability-regulating molecular responses are differentially regulated. This potential differential regulation has been insufficiently studied at the level of components of adherens and tight junctions. We hypothesized that such a regulation by endothelial cells in sepsis takes place in an organ-specific manner. We addressed our hypothesis by studying by quantitative RT-PCR the expression of a predefined subset of EC permeability-related molecules (occludin, claudin-5, PV-1, CD-31, endomucin, Angiopoietin-1, Angiopoietin-2, Tie2, VEGFA, VEGFR1, VEGFR2, and VE-cadherin) in kidney and lung after systemic LPS injection in mice, and in kidneys of patients who died of sepsis...
February 1, 2017: Shock
https://www.readbyqxmd.com/read/28125531/repeated-binge-like-alcohol-intoxication-depot-specific-adipose-tissue-immuno-metabolic-dysregulation
#6
Flavia M Souza-Smith, Stephen M Ford, Liz Simon, Patricia E Molina
Repeated binge-like alcohol intoxication (RBAI) induces whole-body insulin resistance, which is predicted to increase the risk for metabolic syndrome and type 2 diabetes. Previously we showed that acute alcohol intoxication increases mesenteric lymphatic permeability, perilymphatic adipose tissue (PLAT) inflammation, and circulating lipopolysaccharide (LPS) levels in rats. We hypothesize that mesenteric lymphatic hyperpermeability, adipose tissue inflammation and associated dysregulated adipokine expression and insulin signaling are central mechanisms underlying whole body metabolic dysregulation resulting from RBAI...
January 25, 2017: Shock
https://www.readbyqxmd.com/read/28125530/is-leptin-a-key-to-metabolic-inflammation-in-trauma-and-sepsis
#7
Jennifer Kaplan
No abstract text is available yet for this article.
January 25, 2017: Shock
https://www.readbyqxmd.com/read/28125529/postoperative-meld-lactate-and-isolated-lactate-values-as-outcome-predictors-following-orthotopic-liver-transplantation
#8
Sang Kim, Jeron Zerillo, Parissa Tabrizian, David Wax, Hung-Mo Lin, Adam Evans, Sander Florman, Samuel DeMaria
The MELD score is validated to predict pre-transplant mortality. However, as a predictor of postoperative outcomes, its utility has proven inconsistent. Recently developed MELD-Lactate models better predict 30-day survival as compared to the MELD and MELD-Sodium scores. We compared the MELD-Lactate, original MELD, and MELD-Sodium formulae and the initial postoperative lactate as predictors of 30-day and in-hospital mortality following liver transplantation.Adult patients (n = 989) undergoing orthotopic liver transplant between 2002 to 2013 were included...
January 25, 2017: Shock
https://www.readbyqxmd.com/read/28125528/mitochondrial-dna-damage-initiates-acute-lung-injury-and-multi-organ-system-failure-evoked-in-rats-by-intra-tracheal-pseudomonas-aeruginosa
#9
Yann-Leei Lee, Boniface Obiako, Olena M Gorodnya, Mykhaylo V Ruchko, Jamie L Kuck, Viktor M Pastukh, Glenn L Wilson, Jon D Simmons, Mark N Gillespie
Although studies in rat cultured pulmonary artery endothelial cells, perfused lungs, and intact mice support the concept that oxidative mitochondrial (mt) DNA damage triggers acute lung injury (ALI), it has not yet been determined whether enhanced mtDNA repair forestalls development of ALI and its progression to multiple organ system failure (MOSF). Accordingly, here we examined the effect of a fusion protein construct targeting the DNA glycosylase, Ogg1, to mitochondria in a rat model intra-tracheal P. aeruginosa (strain 103; PA103)-induced ALI and MOSF...
January 25, 2017: Shock
https://www.readbyqxmd.com/read/28125527/an-open-lung-strategy-in-the-management-of-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#10
Jun Lu, Xing Wang, Mingqi Chen, Lu Cheng, Qiuhua Chen, Hua Jiang, Zhiguang Sun
PURPOSE: An Open lung strategy (OLS) that includes positive end expiratory pressure (PEEP) and recruitment maneuvers (RMs) during mechanical ventilation is probably an important treatment method in patients with acute respiratory distress syndrome (ARDS). However, the effect of OLS is unknown. We therefore hypothesized that patients with ARDS may benefit from OLS treatment. METHODS: We identified relevant randomized controlled trials by searching through Pubmed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials updated to May 22, 2016...
January 25, 2017: Shock
https://www.readbyqxmd.com/read/28125526/mir-155-alleviates-septic-lung-injury-by-inducing-autophagy-via-inhibition-of-transforming-growth-factor-%C3%AE-activated-binding-protein-2
#11
Fen Liu, Cheng Nie, Ning Zhao, Yan Wang, Yang Liu, Yong Li, Zhenguo Zeng, Chengzhi Ding, Qiang Shao, Cheng Qing, Liang Xia, Zhiyong Peng, Kejian Qian
BACKGROUND: The anti-inflammatory effect of miR-155 was closely linked to transforming growth factor-β-activated kinase-1-binding protein 2 (TAB2) and autophagy. This study investigated the role of miR-155 in attenuation of septic lung injury through TAB2 and autophagy in mouse model and in vitro. METHODS: Patients who underwent fiberoptic bronchoscope examination with or without septic lung injury were recruited for collection of bronchoalveolar lavage fluid (BALF) samples...
January 25, 2017: Shock
https://www.readbyqxmd.com/read/28114167/leptin-protects-against-mortality-and-organ-dysfunction-in-a-two-hit-trauma-sepsis-model-and-is-il-6-dependent
#12
Lukas Leopold Negrin, Andreas Jahn, Martijn van Griensven
INTRODUCTION: Leptin is thought to play an important role in the regulation of the immune system. In patients, leptin is inversely proportional to interleukin-6 (IL-6) levels. Thus, the objective of our study was to evaluate a dose-dependent therapeutic impact of leptin with possible IL-6-dependency on immune actions and outcome in a trauma/sepsis model. MATERIALS AND METHODS: Sixty-nine wild-type and 63 IL-6 mice were subdivided into three groups: trauma/sepsis group (first hit: femur fracture and hemorrhage; second hit: cecal ligation and puncture 2 days later), trauma group (first hit and laparotomy), sham group (laparotomy only)...
January 20, 2017: Shock
https://www.readbyqxmd.com/read/28114166/association-of-delayed-antimicrobial-therapy-with-one-year-mortality-in-pediatric-sepsis
#13
Moonjoo Han, Julie C Fitzgerald, Fran Balamuth, Luke Keele, Elizabeth R Alpern, Jane Lavelle, Marianne Chilutti, Robert W Grundmeier, Vinay M Nadkarni, Neal J Thomas, Scott L Weiss
OBJECTIVE: Delayed antimicrobial therapy in sepsis is associated with increased hospital mortality, but the impact of antimicrobial timing on long-term outcomes is unknown. We tested the hypothesis that hourly delays to antimicrobial therapy are associated with 1-year mortality in pediatric severe sepsis. DESIGN: Retrospective observational study. SETTING: Quaternary academic pediatric intensive care unit (PICU) from February 1, 2012 to June 30, 2013...
January 20, 2017: Shock
https://www.readbyqxmd.com/read/28107215/metabolic-cardiac-and-renal-effects-of-the-slow-hydrogen-sulfide-releasing-molecule-gyy4137-during-resuscitated-septic-shock-in-swine-with-pre-existing-coronary-artery-disease
#14
Benedikt L Nubaum, Josef Vogt, Ulrich Wachter, Oscar McCook, Martin Wepler, José Matallo, Enrico Calzia, Michael Gröger, Michael Georgieff, Mark E Wood, Matthew Whiteman, Peter Radermacher, Sebastian Hafner
Decreased levels of endogenous hydrogen sulfide (H2S) contribute to atherosclerosis, whereas equivocal data are available on H2S effects during sepsis. Moreover, H2S improved glucose utilization in anaesthetized, ventilated, hypothermic mice, but normothermia and/or sepsis blunted this effect. The metabolic effects of H2S in large animals are controversial. Therefore, we investigated the effects of the H2S donor GYY4137 during resuscitated, fecal peritonitis-induced septic shock in swine with genetically and diet-induced coronary artery disease (CAD)...
January 19, 2017: Shock
https://www.readbyqxmd.com/read/28107214/loss-of-syndecan-1-abrogates-the-pulmonary-protective-phenotype-induced-by-plasma-after-hemorrhagic-shock
#15
Feng Wu, Zhanglong Peng, Pyong Woo Park, Rosemary A Kozar
Syndecan-1 is considered a biomarker of injury to the endothelial glycocalyx following hemorrhagic shock, with shedding of sdc1 deleterious. Resuscitation with fresh frozen plasma (FFP) has been correlated with restitution of pulmonary sdc1 and reduction of lung injury, but the precise contribution of sdc1 to FFPs protection in the lung remains unclear. Human lung endothelial cells were used to assess the time and dose dependent effect of FFP on sdc1 expression and the effect of sdc1 silencing on in vitro endothelial cell permeability and actin stress fiber formation...
January 19, 2017: Shock
https://www.readbyqxmd.com/read/28060213/ursodeoxycholyl-lysophosphatidylethanolamide-protects-against-cd95-fas-induced-fulminant-hepatitis
#16
Tanyarath Utaipan, Ann-Christin Otto, Hongying Gan-Schreier, Warangkana Chunglok, Anita Pathil, Wolfgang Stremmel, Walee Chamulitrat
Increased activation of CD95/Fas by Fas ligand in viral hepatitis and autoimmunity is involved in pathogenesis of fulminant hepatitis and liver failure. We designed a bile-acid phospholipid conjugate ursodeoxycholyl lysophosphatidylethanolamide (UDCA-LPE with LPE containing oleate at the sn-1) as a hepatoprotectant that was shown to protect against fulminant hepatitis induced by endotoxin. We herein further assessed the ability of UDCA-LPE to prevent death receptor CD95/Fas-induced fulminant hepatitis. C57BL/6 mice were intravenously administered with CD95/Fas agonistic monoclonal antibody (Jo-2) with or without 1 h pretreatment with 50 mg/kg UDCA-LPE...
January 4, 2017: Shock
https://www.readbyqxmd.com/read/28060212/urinary-mitochondrial-dna-levels-identify-acute-kidney-injury-in-surgical-critical-illness-patients
#17
Qiongyuan Hu, Jianan Ren, Jie Wu, Guanwei Li, Xiuwen Wu, Song Liu, Gefei Wang, Guosheng Gu, Huajian Ren, Zhiwu Hong, Jieshou Li
BACKGROUND: Recent studies showed that mitochondrial injury and mitochondrial DNA (mtDNA) damage are associated with the initiation and progression of acute kidney injury (AKI). However, practical limitations of existing assays of mitochondrial function have limited our ability to study the link between mitochondrial dysfunction and renal injury. Therefore, we evaluated urinary mtDNA (UmtDNA) as a biomarker of AKI in critical illness patients. METHODS: DNA was isolated from urine samples in surgical intensive care unit (SICU) patients and quantified by quantitative polymerase chain reaction (PCR)...
January 4, 2017: Shock
https://www.readbyqxmd.com/read/28009772/acute-kidney-injury-following-exploratory-laparotomy-and-temporary-abdominal-closure
#18
Tyler J Loftus, Azra Bihorac, Tezcan Ozrazgat-Baslanti, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Acute kidney injury (AKI) following exploratory laparotomy and temporary abdominal closure (TAC) is poorly understood but clinically significant. We hypothesized that the prevalence of AKI would be highest 96 hours following TAC, early hypoxemia would predict AKI, and that AKI would be an independent predictor of mortality. METHODS: We performed a retrospective analysis of 251 acute care surgery patients managed with TAC by negative pressure wound therapy (NPWT)...
December 22, 2016: Shock
https://www.readbyqxmd.com/read/28002238/microparticles-from-patients-undergoing-percutaneous-coronary-intervention-impair-vasodilatation-by-uncoupling-endothelial-nitric-oxide-synthase
#19
Sha Ye, Xue-Feng Shan, Wen-Qi Han, Qian-Rong Zhang, Jie Gao, Ai-Ping Jin, Yi Wang, Chao-Feng Sun, Sui-Long Zhang
OBJECTIVES: Percutaneous coronary interventions (PCIs) save countless acute myocardial infarction (AMI) patients. However, endothelial injury is still a inevitable complication. Circulating microparticles (MPs) play important roles in vascular dysfunction. Whether PCI affects function of MPs remains unclear. METHODS: MPs were obtained from AMI patients (n = 38) both preoperatively and 24 hours after PCI, and healthy subjects (n = 20). MPs origins were tested by flow cytometry...
December 20, 2016: Shock
https://www.readbyqxmd.com/read/27984523/etiology-of-shock-in-the-emergency-department-a-12-year-population-based-cohort-study
#20
Jon Gitz Holler, Helene Kildegaard Jensen, Daniel Pilsgaard Henriksen, Lars Melholt Rasmussen, Søren Mikkelsen, Court Pedersen, Annmarie Touborg Lassen
INTRODUCTION: The knowledge of the etiology and associated mortality of undifferentiated shock in the emergency department (ED) is limited. We aimed to describe the etiology based proportions and incidence rates (IR) of shock, as well as the associated mortality in the ED. METHODS: Population-based cohort study at an University Hospital ED in Denmark from January 1, 2000, to December 31, 2011. Patients aged ≥18 years living in the ED-catchment area (N = 225,000) with a first time ED presentation with shock (n = 1,646) defined as hypotension (systolic blood pressure ≤100 mmHg)) and ≥1 organ failures were included...
December 14, 2016: Shock
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