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Shock

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https://www.readbyqxmd.com/read/28448400/comparison-of-the-performance-between-sepsis-1-and-sepsis-3-in-icus-in-china-a-retrospective-multicenter-study
#1
Baoli Cheng, Zhongwang Li, Jingya Wang, Guohao Xie, Xu Liu, Zhipeng Xu, Lihua Chu, Jialian Zhao, Yongming Yao, Xiangming Fang
The definition of sepsis was updated to sepsis-3 in February 2016. However, the performance of the previous and new definition of sepsis remains unclear in China. This was a retrospective multicenter study in 6 ICUs from 5 university-affiliated hospitals to compare the performance between sepsis-1 and sepsis-3 in China. From May 1, 2016 to June 1, 2016, 496 patients were enrolled consecutively. Data were extracted from the electronic clinical records. We evaluated the performance of sepsis-1 and sepsis-3 by measuring the area under the receiver operating characteristic curves (AUROC) to predict 28-day mortality rates...
April 26, 2017: Shock
https://www.readbyqxmd.com/read/28414691/mr-proadm-elevation-upon-icu-admission-predicts-the-outcome-of-septic-patients-and-is-correlated-with-upcoming-fluid-overload
#2
Pierre-Emmanuel Charles, Edwige Péju, Allyriane Dantec, Rémi Bruyère, Nicolas Meunier-Beillard, Auguste Dargent, Sébastien Prin, Darius Wilson, Jean-Pierre Quenot
BACKGROUND: Among septic patients admitted to the intensive care unit (ICU), early recognition of those with the highest risk of death is of paramount importance. We evaluated the prognostic value of Procalcitonin (PCT), mid regional-proadrenomedullin (MR-proADM), copeptine and CT-proendothelin 1 (CT-ProET 1) concentrations. METHODS: This was a prospective cohort study, which included 173 septic patient admitted to one ICU. Blood samples for biomarker measurements were obtained upon admission and on day 5...
April 26, 2017: Shock
https://www.readbyqxmd.com/read/28430717/multilateral-functional-alterations-of-human-neutrophils-in-sepsis-from-the-point-of-diagnosis-to-the-seventh-day
#3
Akira Endo, Miko Okamura, Shunsuke Yoshikawa, Yasuhiro Otomo, Tomohiro Morio
Neutrophil functional changes caused by sepsis itself and their time-course variation have not been fully elucidated because previous studies targeted patients who had received therapeutic interventions. We explored the multilateral functions of circulating neutrophils in patients with severe sepsis or septic shock who had not yet undergone interventions, and followed their changes. Patients were treated based on the Surviving Sepsis Campaign Guidelines 2012. Neutrophil functions were evaluated on days 0 (before therapeutic intervention), 3, and 7 in fifty-nine sepsis patients...
April 20, 2017: Shock
https://www.readbyqxmd.com/read/28422768/mechanisms-involved-in-secondary-cardiac-dysfunction-in-animal-models-of-trauma-and-haemorrhagic-shock
#4
Nick M Wilson, Johanna Wall, Veena Naganathar, Karim Brohi, Henry D De'Ath
Clinical evidence reveals the existence of a trauma induced secondary cardiac injury (TISCI) which is associated with poor patient outcomes. The mechanisms leading to TISCI in injured patients are uncertain. Conversely, animal models of trauma haemorrhage have repeatedly demonstrated significant cardiac dysfunction following injury, and highlighted mechanisms through which this might occur. The aim of this review was to provide an overview of the animal studies describing TISCI and its pathophysiology.Basic science models of trauma show evidence of innate immune system activation via Toll-Iike receptors (TLRs), the exact protagonists of which remain unclear...
April 18, 2017: Shock
https://www.readbyqxmd.com/read/28403067/protection-by-inhaled-hydrogen-therapy-in-a-rat-model-of-acute-lung-injury-can-be-tracked-in-vivo-using-molecular-imaging
#5
Said H Audi, Elizabeth R Jacobs, Xiao Zhang, Amadou K S Camara, Ming Zhao, Meetha M Medhora, Benjamin Rizzo, Anne V Clough
Inhaled hydrogen gas (H2) provides protection in rat models of human acute lung injury (ALI). We previously reported that biomarker imaging can detect oxidative stress and endothelial cell death in vivo in a rat model of ALI. Our objective was to evaluate the ability of Tc-hexamethylpropyleneamineoxime (HMPAO) and Tc-duramycin to track the effectiveness of H2 therapy in vivo in the hyperoxia rat model of ALI. Rats were exposed to room air (normoxia), 98% O2 + 2% N2 (hyperoxia) or 98% O2 + 2% H2 (hyperoxia+H2) for up to 60 hrs...
April 11, 2017: Shock
https://www.readbyqxmd.com/read/28403066/non-hemodynamic-effects-of-catecholamines
#6
Clair Hartmann, Peter Radermacher, Martin Wepler, Benedikt Nubaum
Circulatory shock is defined as an imbalance between tissue oxygen supply and demand, and mostly results from a loss of blood volume, cardiac pump failure and/or reduction of vasomotor tone. The clinical hallmarks of circulatory shock are arterial hypotension and lactate acidosis. Since the degree and duration of hypotension are major determinants of outcome, vasopressor administration represents a cornerstone therapy to treat these patients. Current guidelines recommend the use of catecholamines as the drug of first choice...
April 11, 2017: Shock
https://www.readbyqxmd.com/read/28394786/usefulness-of-the-delta-neutrophil-index-to-predict-30-day-mortality-in-patients-with-upper-gastrointestinal-bleeding
#7
Taeyoung Kong, Sangkook In, Yoo Seok Park, Hye Sun Lee, Jong Wook Lee, Je Sung You, Hyun Soo Chung, Incheol Park, Sung Phil Chung
PURPOSE: The delta neutrophil index (DNI), reflecting the fraction of circulating immature granulocytes, is associated with increased mortality in patients with systemic inflammation. It is rapidly and easily measured while performing a complete blood count. This study aimed to determine whether the DNI can predict short-term mortality in patients presenting to the emergency department (ED) with upper gastrointestinal hemorrhage (UGIH). METHODS: We retrospectively identified consecutive patients (>18 years old) with UGIH admitted to the ED from January 1, 2015 to February 28, 2016...
April 7, 2017: Shock
https://www.readbyqxmd.com/read/28383322/endotoxemia-results-in-trapping-of-transfused-red-blood-cells-in-lungs-with-associated-lung-injury
#8
Marleen Straat, Anita Tuip, Thomas R L Klei, Boukje M Beuger, Joris J T H Roelofs, Robin van Bruggen, Nicole P Juffermans
BACKGROUND: Red blood cell (RBC) transfusion is associated with organ failure, in particular in the critically ill. We hypothesized that endotoxemia contributes to increased trapping of RBCs in organs. Furthermore, we hypothesized that this effect is more pronounced following transfusion of stored RBCs compared to fresh RBCs. METHODS: Adult male Sprague-Dawley rats were randomized to receive injection with lipopolysaccharide from E. coli or vehicle and transfusion with fresh or stored biotinylated RBCs...
April 5, 2017: Shock
https://www.readbyqxmd.com/read/28379920/acute-kidney-injury-in-mechanically-ventilated-patients-the-risk-factor-profile-depends-on-the-timing-of-aki-onset
#9
Raúl Lombardi, Nicolás Nin, Oscar Peñuelas, Alejandro Ferreiro, Fernando Rios, Maria Carmen Marin, Konstantinos Raymondos, Jose A Lorente, Younsuck Koh, Javier Hurtado, Marco Gonzalez, Fekri Abroug, Manuel Jibaja, Yaseen Arabi, Rui Moreno, Dimitros Matamis, Antonio Anzueto, Andres Esteban
BACKGROUND.: Acute kidney injury (AKI) is a frequent complication in patients under mechanical ventilation (MV). We aimed to assess the risk factors for AKI with particular emphasis on those potentially preventable. STUDY DESIGN, SETTING AND PARTICIPANTS.: Retrospective analysis of a large, multinational database of MV patients with >24 hours of MV and normal renal function at admission. AKI was defined according to creatinine-based KDIGO criteria. Risk factors were analyzed according to the time point at which AKI occurred: early (≤48 hours after ICU admission, AKIE) and late (day 3 to day 7 of ICU stay, AKIL)...
April 4, 2017: Shock
https://www.readbyqxmd.com/read/28368977/cutaneous-burn-injury-promotes-shifts-in-the-bacterial-microbiome-in-autologous-donor-skin-implications-for-skin-grafting-outcomes
#10
Jennifer K Plichta, Xiang Gao, Huaiying Lin, Qunfeng Dong, Evelyn Toh, David E Nelson, Richard L Gamelli, Elizabeth A Grice, Katherine A Radek
INTRODUCTION: The cutaneous microbiome maintains skin barrier function, regulates inflammation, and stimulates wound healing responses. Burn injury promotes an excessive activation of the cutaneous and systemic immune response directed against commensal and invading pathogens. Skin grafting is the primary method of reconstructing full-thickness burns, and wound infection continues to be a significant complication. METHODS: In this study, the cutaneous bacterial microbiome was evaluated and subsequently compared to patient outcomes...
March 31, 2017: Shock
https://www.readbyqxmd.com/read/28362715/phenotypic-changes-and-impaired-function-of-peripheral-%C3%AE-%C3%AE-t-cells-in-patients-with-sepsis
#11
Xue-Lian Liao, Ting Feng, Jiang-Qian Zhang, Xing Cao, Qi-Hong Wu, Zhi-Chao Xie, Yan Kang, Hong Li
INTRODUCTION: Recent studies demonstrated the significant loss of gamma delta T (γδ T) cells in patients with sepsis. Given the distinct functions of γδ T cells in human anti-infection immunity, we are interested in evaluating the phenotype and function of peripheral γδ T cells in septic patients and determining their prognostic implication. METHOD: This prospective study has been conducted in three intensive care units (ICUs) of a university hospital. During the period from October 2014 to June 2015, we enrolled 107 patients who were consecutively admitted and diagnosed with severe sepsis or septic shock (excluding previous immunosuppression) and 45 healthy controls...
March 30, 2017: Shock
https://www.readbyqxmd.com/read/28362714/iloprost-prostaglandin-e1-and-papaverine-relax-human-mesenteric-arteries-with-similar-potency
#12
Christoph Mahlke, Jens-Peter Kühn, Birger Mensel, André Schreiber, Annett Juretzko, Antje Steinbach, Olaf Grisk
OBJECTIVE: Non-occlusive mesenteric ischemia (NOMI) is accompanied by mesenteric artery spasms that are at least in part due to endothelin system activation. Acute treatment includes intra-arterial infusion of vasodilators such as iloprost, prostaglandin E1 (PGE1) and papaverine. Their effectiveness is not well characterized in human mesenteric arteries. We directly compared their potency to relax isolated human mesenteric arteries. To explore the potential of Rock inhibition to treat mesenteric artery spasms, we tested if endothelin-1 (ET-1)-induced mesenteric artery constrictions depend rho kinase (Rock)...
March 30, 2017: Shock
https://www.readbyqxmd.com/read/28362713/relative-adrenal-insufficiency-in-cardiogenic-shock-is-there-a-need-for-action
#13
Josef Briegel, Patrick Möhnle, M Vogeser, Christoph Thiemermann, Peter Radermacher
No abstract text is available yet for this article.
March 30, 2017: Shock
https://www.readbyqxmd.com/read/28358728/estradiol-modulates-local-gut-injury-induced-by-intestinal-ischemia-reperfusion-in-male-rats
#14
Fernanda Yamamoto Ricardo-da-Silva, Evelyn Thaís Fantozzi, Sara Rodrigues-Garbin, Ricardo Martins Oliveira-Filho, Bernardo Boris Vargaftig, Ana Cristina Breithaupt-Faloppa, Wothan Tavares de Lima
Intestinal ischemia and reperfusion (I/R) triggers a systemic inflammatory response characterized by leukocyte mobilization from the bone marrow, release of cytokines to the circulation, and increased microvascular permeability, leading to high mortality. Females have shown attenuated inflammatory response to trauma when compared to males, indicating a role for female sex hormones in this process. Here we have evaluated the effect of estradiol on the local gut injury induced by I/R in male rats. I/R was induced by the clamping of the superior mesenteric artery for 45 min, followed by 2 h of reperfusion...
March 29, 2017: Shock
https://www.readbyqxmd.com/read/28333715/noninvasive-imaging-of-stored-red-blood-cell-transfusion-aggravating-sepsis-induced-liver-injury-associated-with-increased-activation-of-m1-polarized-kupffer-cells
#15
Tao Wu, Lei Wang, Jie An, Chao Y Wu, Yue Wang, Lu Qian, Jun Zhou, Yu L Zhang, Qian Q Zhou, Xiao H Wang, Hua F Wang, Qiu X Fu, Lin S Zhan
Liver injury has a critical effect on the severity and outcome of sepsis. The impact of stored RBCs on the pathogenesis of sepsis-associated hepatic injury is not well understood. Therefore, to investigate the effects of stored-RBC transfusion on sepsis-induced liver damage as well as the associated mechanism, we constructed a sepsis mouse model enabling non-invasive imaging of bacterial infection caused by Pseudomonas aeruginosa, a common gram-negative respiratory pathogen. We showed that transfusions with stored RBCs enhanced sepsis-induced liver injury in vivo, and liver injury exacerbated the severity of sepsis and decreased survival in P...
March 22, 2017: Shock
https://www.readbyqxmd.com/read/28328711/management-of-atrial-fibrillation-with-rapid-ventricular-response-in-the-intensive-care-unit-a-secondary-analysis-of-electronic-health-record-data
#16
Ari Moskowitz, Kenneth P Chen, Avraham Z Cooper, Abdullah Chahin, Mohammad M Ghassemi, Leo Anthony Celi
PURPOSE: Atrial fibrillation with rapid ventricular response (RVR) is common during critical illness. In this study, we explore the comparative effectiveness of three commonly used drugs (metoprolol, diltiazem, and amiodarone) in the management of atrial fibrillation with RVR in the intensive care unit (ICU). METHODS: Data pertaining to the first ICU admission were extracted from the Medical Information Mart for Intensive Care (MIMIC) III database. Patients who received one of the above pharmacologic agents while their heart rate was > 110bpm and had atrial fibrillation documented in the clinical chart were included...
March 21, 2017: Shock
https://www.readbyqxmd.com/read/28328710/fatty-acid-saturation-of-albumin-used-in-resuscitation-fluids-modulates-cell-damage-in-shock-in-vitro-results-using-a-novel-technique-to-measure-fatty-acid-binding-capacity
#17
Alexander H Penn, Michael A Dubick, Ivo P Torres Filho
The use of albumin for resuscitation has not proven as beneficial in human trials as expected from numerous animal studies. One explanation could be the practice of adding fatty acid (FA) during manufacture of pharmaceutical albumin. During ischemia, unbound free FAs (FFA) in the circulation could potentially induce cellular damage. We hypothesized that albumins with higher available binding capacities (ABC) for FFAs may prevent that damage. Therefore, we developed a technique to measure ABC, determined if pharmaceutical human serum albumin (HSA) has decreased ABC compared to FA-free bovine serum albumin (BSA), and if binding capacity would affect hemolysis when blood is mixed with exogenous FFA at levels similar to those observed in shock...
March 21, 2017: Shock
https://www.readbyqxmd.com/read/28319494/heparin-binding-protein-hbp-a-causative-marker-and-potential-target-for-heparin-treatment-of-human-sepsis-induced-acute-kidney-injury
#18
Jane Fisher, James A Russell, Peter Bentzer, Devyn Parsons, Stefano Secchia, Matthias Mörgelin, Keith R Walley, John H Boyd, Adam Linder
RATIONALE: Sepsis-induced acute kidney injury (AKI) is a common condition with high morbidity and mortality. Neutrophil-derived heparin-binding protein (HBP) induces vascular leakage and is a promising biomarker of sepsis-induced organ dysfunction. It remains unknown if HBP is prognostic of AKI in septic shock and if HBP could play a role in the pathophysiology of sepsis-induced AKI. OBJECTIVES: To determine the association of plasma HBP levels with development of AKI, investigate the role of HBP in the pathophysiology of sepsis-induced AKI, and test the effect of blocking HBP using heparin derivatives...
March 17, 2017: Shock
https://www.readbyqxmd.com/read/28296657/neuroendocrine-derangements-in-early-septic-shock-pharmacotherapy-for-relative-adrenal-and-vasopressin-insufficiency
#19
James W Schurr, Paul M Szumita, Jeremy R DeGrado
Septic shock is a leading cause of mortality in intensive care units throughout the world. While this disease state represents a highly complex pathophysiology involving numerous organ systems, the early approach to care includes adequate hemodynamic support traditionally achieved via infusions of vasoactive medications after adequate fluid resuscitation. Relative adrenal and vasopressin deficiencies are a common feature of septic shock that contribute to impaired hemodynamics. Hydrocortisone and vasopressin are endocrine system hormone analogues that target the acute neuroendocrine imbalance associated with septic shock...
March 14, 2017: Shock
https://www.readbyqxmd.com/read/28282360/an-alpha7-nicotinic-acetylcholine-receptor-agonist-gts-21-promotes-c2c12-myonuclear-accretion-in-association-with-release-of-interleukin-6-il-6-and-improves-survival-in-burned-mice
#20
Mohammed A S Khan, Mohammed F Khan, Shizuka Kashiwagi, William R Kem, Shingo Yasuhara, Masao Kaneki, Ronald G Tompkins, J A Jeevendra Martyn
The role of interleukin-6 (IL-6) in physiological processes and disease is poorly understood. The hypothesis tested in this study was that selective alpha7 acetylcholine receptor (α7AChR) agonist, GTS-21, releases of IL-6 in association with myonuclear accretion and enhances insulin signaling in muscle cells, and improves survival of burn injured (BI) mice. The in vitro effects of GTS-21 were determined in C2C12 myoblasts and 7-day differentiated myotubes (myotubes). The in vivo effects of GTS-21 were tested in BI wild type (WT) and IL-6 knockout (IL6KO) mice...
March 9, 2017: Shock
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