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Elina Varis, Ville Pettilä, Meri Poukkanen, Stephan M Jakob, Sari Karlsson, Anders Perner, Jukka Takala, Erika Wilkman
Hyperlactatemia predicts mortality in patients with sepsis and septic shock, and its normalization is a potential treatment goal. We investigated the association of blood lactate and its changes over time with 90-day mortality in septic shock. We performed a post hoc analysis of 513 septic shock patients with admission blood lactate measurements in the prospective, observational, multicenter FINNAKI study. Repetitive lactate measurements were available in 496 patients for analyses of change in lactate values during ICU stay...
October 17, 2016: Shock
Nicolas Lefèvre, Benjamin Noyon, Dominique Biarent, Francis Corazza, Jean Duchateau, Georges Casimir
PURPOSE AND METHODS: The severity and prognosis of various acute inflammatory conditions, such as sepsis, differ between males and females. The mechanisms underlying these sex differences probably involve both hormonal and genetic factors. In order to evaluate a possible genetic influence, we reviewed clinical signs and biological inflammatory markers of prepubertal children with severe sepsis admitted to the pediatric intensive care unit (PICU). FINDINGS: A total of 142 prepubertal children, 66 girls and 76 boys, suffering from severe sepsis and admitted to the PICU were included...
October 17, 2016: Shock
Abdikarim Abdullahi, Mile Stanojcic, Alexandra Parousis, David Patsouris, Marc G Jeschke
The Endoplasmic Reticulum (ER) is a critical organelle that synthesizes secretory proteins and serves as the main calcium storage site of the cell. The accumulation of unfolded proteins at the ER results in ER stress. Although the association between ER stress and the pathogenesis of many metabolic conditions have been well characterized using both in vivo and in vitro models, no standardized model concerning ER stress exists. Here we report a standardized model of ER stress using two well characterized ER stress inducing agents, thapsigargin and tunicamycin...
October 17, 2016: Shock
Erica L Heipertz, Jourdan Harper, Wendy E Walker
IFN regulatory factor (IRF)3 plays a detrimental role in the cecal ligation and puncture (CLP) mouse model of sepsis. However, it is unclear which pathway activates IRF3 in this context. In this report we investigate two pathways that activate IRF3: the Stimulator of Interferon Genes (STING) pathway (which senses cytosolic DNA) and the TIR-domain-containing adapter-inducing interferon-β (TRIF) pathway (which sense dsRNA and LPS via Toll-like receptor (TLR) 3 and 4). Initially, we examine the impact of these pathways using a severe CLP model (∼90% mortality)...
October 17, 2016: Shock
Katalin Gornicsar, Tibor Mózes, Andor Grosz, Edit Bíró, Szabolcs Ládi, Paul Clayton
BACKGROUND: Multiple studies have found gender-based disparities in ICU admission rates and in complications following trauma. Female gender was associated with lower mortality when comparing patients less than 50 years of age. These data suggest an important role for cycle rather than gender itself. Our previous results indicate a crucial role for tumor necrosis factor alpha (TNFα) in inducing nososocomial infections. HYPOTHESIS: Cycle is important for TNF and other female hormone productions...
October 12, 2016: Shock
Hisatake Matsumoto, Kazuma Yamakawa, Hiroshi Ogura, Taichin Koh, Naoya Matsumoto, Takeshi Shimazu
Activated immune cells such as monocytes are key factors in systemic inflammatory response syndrome (SIRS) following trauma and sepsis. Activated monocytes induce almost all tissue factor (TF) expression contributing to inflammation and coagulation. TF and CD13 double-positive microparticles (TF/CD13MPs) are predominantly released from these activated monocytes. This study aimed to evaluate TF/CD13MPs and assess their usefulness as a biomarker of pathogenesis in early SIRS following trauma and sepsis. This prospective study comprising 24 trauma patients, 25 severe sepsis patients and 23 healthy controls was conducted from November 2012 to February 2015...
October 6, 2016: Shock
Pan Jiang, Qiurong Lv, Tianwen Lai, Feng Xu
Hypomagnesemia is commonly seen but frequently overlooked in critically ill patients in intensive care unit (ICU). However, the strength and consistency of the effect of hypomagnesemia on outcomes in critically ill patients remain controversial. In this report, we performed a systematic review and meta-analysis to evaluate the association of serum magnesium level with prognosis of critically ill patients upon admission to the ICU. A comprehensive search for clinical trials was performed, and ten studies comprising 1122 cases and 630 controls were finally selected for analysis...
October 6, 2016: Shock
Yong Zhou, Tian Liu, Jia-Xi Duan, Ping Li, Guo-Ying Sun, Yong-Ping Liu, Jun Zhang, Liang Dong, Kin Sing Stephen Lee, Bruce D Hammcok, Jian-Xin Jiang, Cha-Xiang Guan
Acute lung injury (ALI) is characterized by rapid alveolar injury, vascular leakage, lung inflammation, neutrophil accumulation, and induced cytokines production leading to lung edema. The mortality rate of patients suffering from ALI remains high. Epoxyeicosatrienoic acids (EETs) are cytochrome P450-dependent derivatives of polyunsaturated fatty acid (PUFA) with anti-hypertensive, profibrinolytic and anti-inflammatory functions. EETs are rapidly hydrated by soluble epoxide hydrolase (sEH) to their less potent diols...
October 6, 2016: Shock
Chuan-Xin Wu, Jing Cheng, Yun-Ying Wang, Jiao-Jiao Wang, Hui Guo, Hang Sun
INTRODUCTION: The aim of this study was to clarify the miRNA expression profiles of RAW264.7 macrophages infected by Candida albicans to elucidate the roles of differentially expressed miRNAs and to further explore the mechanisms underlying the immune response to C. albicans infection. METHODS: High-throughput miRNA microarray analysis was performed to detect differentially expressed miRNAs in control and C. albicans-infected RAW264.7 cells. Quantitative real-time PCR analysis was used to verify the microarray results...
October 5, 2016: Shock
Miriam Kalbitz, Christiane Waller, Markus Huber-Lang, Florian Gebhard, Chris Thiemermann, Peter Radermacher
No abstract text is available yet for this article.
October 5, 2016: Shock
Kristen T Crowell, David I Soybel, Charles H Lang
Muscle deconditioning is commonly observed in patients surviving sepsis. Little is known regarding the molecular mechanisms regulating muscle protein homeostasis during the recovery or convalescence phase. We adapted a sepsis-recovery mouse model that uses cecal ligation and puncture (CLP), followed 24 h later by cecal resection and antibiotic treatment, to identify putative cellular pathways regulating protein synthesis and breakdown in skeletal muscle. Ten days after CLP, body weight and food consumption did not differ between control and sepsis-recovery mice, but gastrocnemius weight was reduced...
October 5, 2016: Shock
Magnus von Seth, Miklós Lipcsey, Peter Engström, Anders Larsson, Lars Hillered, Enn Maripuu, Charles Widström, Jan Sjölin
Some experimental data suggest that rapid bolus administration of albumin causes less plasma-expanding effects than slow, continuous infusion. To determine whether rapid bolus administration, in comparison with slow infusion, results in greater extravasation of albumin in experimental septic shock we performed a randomized controlled trial with 32 endotoxemic pigs. The animals were monitored and ventilated with standard intensive care equipment and given 10 mL x kg 5% albumin labeled with Technetium-99m, either as a rapid 15-minute bolus (Bolus group, n = 16) or as a 2-hour (h) infusion (Infusion group, n = 16)...
October 5, 2016: Shock
Geber Pena, Christina Michalski, Yong Qin, Robert Donnelly, Ziad Sifri, Anne Mosenthal, David Livingston, Zoltan Spolarics
Sex-related outcome disparities following severe trauma have been demonstrated in human and animal studies however sex hormone status could not fully account for the differences. This study tested whether X-linked cellular mosaicism, which is unique to females, could represent a genetically based mechanism contributing to sex-related immuno-modulation following trauma. Serial blood samples collected for routine laboratory tests were analyzed for ChrX inactivation (XCI) ratios in white blood cells. 39 severely injured (mean ISS 19) female trauma patients on mixed racial and ethnic background were tested for initial (baseline) and trauma-induced changes in XCI-ratios and their associations with severity of injury and clinical outcome...
September 29, 2016: Shock
Mohammad Shaban, Nawal Salahuddin, Mohammad Raed Kolko, Moh'd Sharshir, Mohannad AbuRageila, Ahmed AlHussain
INTRODUCTION: Compromised tissue oxygenation leads to anaerobiosis, leading to organ failure and death. This study attempts to demonstrate the predictive abilities of the Pv-aCO2 gap and Pv-aCO2/Ca-vO2 ratio in shock patients undergoing resuscitation. METHODS: In a prospective study, consecutive patients with shock were included. Timed measurements of Pv-aCO2 gap, ScvO2, lactate and Pv-aCO2/ Ca-vO2 ratio were obtained. The association between the mortality and each variable at all intervals were analyzed...
September 29, 2016: Shock
Craig M Coopersmith, Clifford S Deutschman
New definitions of sepsis and septic shock were published in early 2016, updating old definitions that have not been revisited since 2001. These new definitions should profoundly affect sepsis research. In addition, these paper present clinical criteria for identifying infected patients who are highly likely to have or to develop sepsis or septic shock. In contrast to previous approaches, these new clinical criteria are evidence based. In this review, two of the authors of the new definitions detail the content of the papers and explore the implications for shock and sepsis researchers...
September 29, 2016: Shock
Jiri Parenica, Jiri Jarkovsky, Jan Malaska, Alexandre Mebazaa, Jana Gottwaldova, Katerina Helanova, Jiri Litzman, Milan Dastych, Josef Tomandl, Jindrich Spinar, Ludmila Dostalova, Petr Lokaj, Marie Tomandlova, Monika Goldergova Pavkova, Pavel Sevcik, Matthieu Legrand
INTRODUCTION: Cardiogenic shock (CS) patients are at a high risk of developing infectious complications; however, their early detection is difficult, mainly due to a frequently occurring non-infectious inflammatory response, which accompanies an extensive myocardial infarction or a post-cardiac arrest syndrome. The goal of our prospective study was to describe infectious complications in CS and the immune/inflammatory response based on a serial measurement of several blood-based inflammatory biomarkers...
September 29, 2016: Shock
Clair Hartmann, Sebastian Hafner, Angelika Scheuerle, Peter Möller, Markus Huber-Lang, Birgit Jung, Benedikt Nubaum, Oscar McCook, Michael Gröger, Florian Wagner, Sandra Weber, Bettina Stahl, Enrico Calzia, Michael Georgieff, Csaba Szabó, Rui Wang, Peter Radermacher, Katja Wagner
Pre-traumatic cigarette smoke (CS) exposure aggravates post-traumatic acute lung injury (ALI). Cystathionine-γ-lyase (CSE) protects against ALI and CS exposure-induced chronic obstructive lung disease (COPD). Therefore, we tested the hypothesis whether genetic CSE knockout (CSE) would aggravate post-traumatic ALI after CS exposure. After 3-4 weeks of CS exposure, anesthetized wild type (WT) and CSE mice underwent blunt chest trauma, surgical instrumentation and 4 hours of lung-protective mechanical ventilation...
September 28, 2016: Shock
Jiaxi Ge, Jie Tian, Hao Yang, Lei Hou, Zhankui Wang, Zhengyu He, Xiangrui Wang
OBJECTIVE: Cardiopulmonary bypass (CPB) carries a risk of lung ischemia- reperfusion, leading to acute lung injury (ALI). Alpha7 nicotinic acetylcholine receptor (alpha7nAChR) has been implicated in the release of high mobility group box1 (HMGB1), which promotes systemic inflammation in response to ischemia-reperfusion injury. However, the specific role of alpha7nAChR in CPB is poorly understood. This study employed the alpha7nAChR agonist PNU-282987 and a rat model of CPB to determine whether alpha7nAChR was associated with CPB-induced lung damage...
September 22, 2016: Shock
Tajia L Green, Stacey M Leventhal, Debora Lim, Kiho Cho, David G Greenhalgh
We previously identified a truncated human glucocorticoid receptor (hGR) isoform of 118 amino acids, hGR-S1(-349A), that despite lacking the major functional domains, was more hyperactive after glucocorticoid treatment than the full-length receptor. Furthermore, its 3' untranslated region (UTR) was required. To dissect the underlying mechanisms for hyperactivity, a series of hGR isoforms with consecutive deletions in the 3' UTR were created to test their transactivation potential using reporter assays. The hGR-S1(-349A) isoform retaining 1303 bp of 3' UTR displayed unusually high activity with or without glucocorticoid stimulation...
September 22, 2016: Shock
Bernardo Amisa Panka, Harm-Jan de Grooth, Angeliquè Spoelstra-de Man, Mark Looney, Pieter-Roel Tuinman
BACKGROUND: The acute respiratory distress syndrome (ARDS) is a life-threating disorder that contributes significantly to critical illness. No specific pharmacological interventions directed at lung injury itself, have proven effective in improving outcome of patients with ARDS. Platelet activation was identified as a key component in ARDS pathophysiology and may provide an opportunity for preventive and therapeutic strategies. We hypothesize that use of acetyl salicylic acid (ASA) may prevent and/ or attenuate lung injury...
September 19, 2016: Shock
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