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Intensive Care Medicine Experimental

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https://www.readbyqxmd.com/read/28168516/-in-a-dark-place-we-find-ourselves-light-intensity-in-critical-care-units
#1
LETTER
Hannah J Durrington, Richard Clark, Ruari Greer, Franck P Martial, John Blaikley, Paul Dark, Robert J Lucas, David W Ray
Intensive care units provide specialised care for critically ill patients around the clock. However, intensive care unit patients have disrupted circadian rhythms. Furthermore, disrupted circadian rhythms are associated with worse outcome. As light is the most powerful 're-setter' of circadian rhythm, we measured light intensity on intensive care unit. Light intensity was low compared to daylight during the 'day'; frequent bright light interruptions occurred over 'night'. These findings are predicted to disrupt circadian rhythms and impair entrainment to external time...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28150228/personalizing-mechanical-ventilation-according-to-physiologic-parameters-to-stabilize-alveoli-and-minimize-ventilator-induced-lung-injury-vili
#2
REVIEW
Gary F Nieman, Joshua Satalin, Penny Andrews, Hani Aiash, Nader M Habashi, Louis A Gatto
It has been shown that mechanical ventilation in patients with, or at high-risk for, the development of acute respiratory distress syndrome (ARDS) can be a double-edged sword. If the mechanical breath is improperly set, it can amplify the lung injury associated with ARDS, causing a secondary ventilator-induced lung injury (VILI). Conversely, the mechanical breath can be adjusted to minimize VILI, which can reduce ARDS mortality. The current standard of care ventilation strategy to minimize VILI attempts to reduce alveolar over-distension and recruitment-derecruitment (R/D) by lowering tidal volume (Vt) to 6 cc/kg combined with adjusting positive-end expiratory pressure (PEEP) based on a sliding scale directed by changes in oxygenation...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28124196/baseline-thrombospondin-1-concentrations-are-not-associated-with-mortality-in-septic-patients-a-single-center-cohort-study-on-the-intensive-care-unit
#3
Ruben J van der Wekken, Hans Kemperman, Mark Roest, Dylan W de Lange
BACKGROUND: The initial phase of sepsis is characterized by hyperinflammation. Levels of thrombospondin-1 (TSP-1) rise rapidly during acute inflammation. The purpose of this clinical study was to study the association between plasma TSP-1 levels and mortality in patients with sepsis on the intensive care unit. METHODS: Critically ill adult patients with sepsis, severe sepsis, or septic shock were included. They were further divided into tertiles based on their baseline plasma TSP-1 concentrations...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28108970/erratum-to-heparin-binding-protein-is-important-for-vascular-leak-in-sepsis
#4
Peter Bentzer, Jane Fisher, HyeJin Julia Kong, Mattias Mörgelin, John H Boyd, Keith R Walley, James A Russell, Adam Linder
No abstract text is available yet for this article.
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28105603/resuscitation-fluid-composition-affects-hepatic-inflammation-in-a-murine-model-of-early-sepsis
#5
Amanda L Patrick, Peter M Grin, Nicole Kraus, Michelle Gold, Matthew Berardocco, Patricia C Liaw, Alison E Fox-Robichaud
BACKGROUND: Fluid resuscitation is a crucial therapy for sepsis, and the use of balanced fluids and/or isotonic albumin may improve patient survival. We have previously demonstrated that resuscitation with normal saline results in increased hepatic leukocyte recruitment in a murine model of sepsis. Given that clinical formulations of albumin are in saline, our objectives were to develop a novel balanced electrolyte solution specifically for sepsis and to determine if supplementing this solution with albumin would improve the inflammatory response in sepsis...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28101752/the-impact-of-hydrocortisone-treatment-on-neutrophil-gelatinase-associated-lipocalin-release-in-porcine-endotoxemic-shock
#6
E Söderberg, M Eriksson, A Larsson, M Lipcsey
BACKGROUND: A key feature of sepsis is systemic inflammatory activation that could be counteracted by steroids. In this experimental model of systemic inflammation, we sought to investigate whether septic neutrophil activation, evaluated by the plasma levels of neutrophil gelatinase-associated protein (NGAL), is modulated by the timing of hydrocortisone treatment. METHODS: Sixteen anesthetized pigs were allocated to one of four equally sized groups. Three of these groups received endotoxin at 2 μg × kg(-1) × h(-1) for 6 h so as to induce endotoxemic shock...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28097512/deletion-of-nlrp3-protects-from-inflammation-induced-skeletal-muscle-atrophy
#7
Nora Huang, Melanie Kny, Fabian Riediger, Katharina Busch, Sibylle Schmidt, Friedrich C Luft, Hortense Slevogt, Jens Fielitz
BACKGROUND: Critically ill patients develop atrophic muscle failure, which increases morbidity and mortality. Interleukin-1β (IL-1β) is activated early in sepsis. Whether IL-1β acts directly on muscle cells and whether its inhibition prevents atrophy is unknown. We aimed to investigate if IL-1β activation via the Nlrp3 inflammasome is involved in inflammation-induced atrophy. METHODS: We performed an experimental study and prospective animal trial. The effect of IL-1β on differentiated C2C12 muscle cells was investigated by analyzing gene-and-protein expression, and atrophy response...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28092080/soluble-toll-like-receptor-2-is-a-biomarker-for-sepsis-in-critically-ill-patients-with-multi-organ-failure-within-12%C3%A2-h-of-icu-admission
#8
LETTER
Benjamin Holst, Tamas Szakmany, Anne-Catherine Raby, Vincent Hamlyn, Kimberley Durno, Judith E Hall, Mario O Labéta
Soluble TLR2 levels are elevated in infective and inflammatory conditions, but its diagnostic value with sepsis-induced multi-organ failure has not been evaluated. 37 patients with a diagnosis of severe sepsis/septic shock (sepsis) and 27 patients with organ failure without infection (SIRS) were studied. Median (IQR) plasma sTLR2 levels were 2.7 ng/ml (1.4-6.1) in sepsis and 0.6 ng/ml (0.4-0.9) in SIRS p < 0.001. sTLR2 showed good diagnostic value for sepsis at cut-off of 1.0 ng/ml, AUC:0.959. We report the ability of sTLR2 levels to discriminate between sepsis and SIRS within 12 h of ICU admission in patients with multi-organ failure...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28058672/neuroprotective-effects-of-intravenous-immunoglobulin-are-mediated-through-inhibition-of-complement-activation-and-apoptosis-in-a-rat-model-of-sepsis
#9
Figen Esen, Gunseli Orhun, Perihan Ergin Ozcan, Evren Senturk, Melike Kucukerden, Murat Giris, Ugur Akcan, Canan Ugur Yilmaz, Nurcan Orhan, Nadir Arican, Mehmet Kaya, Sema Bilgic Gazioglu, Erdem Tuzun
BACKGROUND: Intravenous (IV) immunoglobulin (Ig) treatment is known to alleviate behavioral deficits and increase survival in the experimentally induced model of sepsis. To delineate the mechanisms by which IVIg treatment prevents neuronal dysfunction, an array of immunological and apoptosis markers was investigated. METHODS: Sepsis was induced by cecal ligation perforation (CLP) in rats. The animals were divided into five groups: sham, control, CLP + saline, CLP + immunoglobulin G (IgG) (250 mg/kg, iv), and CLP + immunoglobulins enriched with immunoglobulin M (IgGAM) (250 mg/kg, iv)...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27943111/from-theory-to-bench-confirmation-or-from-bench-to-theory
#10
LETTER
Julien Demiselle, Frauke Tillmans, Andreas Koch, Peter Radermacher, Pierre Asfar
In this commentary, the authors discuss two possible approaches in experimental studies. The first approach is to replicate an experimentation in order to confirm or not previously published results. The second one is more theoretical and consists in estimating the expected effect of all the components of the problem. When theoretical calculations suggest a theoretical failure that contradicts previous published results, investigators are between a rock and a hard place. Indeed, how can already published data and theoretical likelihood of failure be reconciled?...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27873263/effects-of-volume-resuscitation-on-the-microcirculation-in-animal-models-of-lipopolysaccharide-sepsis-a-systematic-review
#11
REVIEW
Nchafatso G Obonyo, Jonathon P Fanning, Angela S Y Ng, Leticia P Pimenta, Kiran Shekar, David G Platts, Kathryn Maitland, John F Fraser
BACKGROUND: Recent research has identified an increased rate of mortality associated with fluid bolus therapy for severe sepsis and septic shock, but the mechanisms are still not well understood. Fluid resuscitation therapy administered for sepsis and septic shock targets restoration of the macro-circulation, but the pathogenesis of sepsis is complex and includes microcirculatory dysfunction. OBJECTIVE: The objective of the study is to systematically review data comparing the effects of different types of fluid resuscitation on the microcirculation in clinically relevant animal models of lipopolysaccharide-induced sepsis...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27864774/comparison-of-an-automatic-analysis-and-a-manual-analysis-of-conjunctival-microcirculation-in-a-sheep-model-of-haemorrhagic-shock
#12
Philip-Helge Arnemann, Michael Hessler, Tim Kampmeier, Andrea Morelli, Hugo Karel Van Aken, Martin Westphal, Sebastian Rehberg, Christian Ertmer
BACKGROUND: Life-threatening diseases of critically ill patients are known to derange microcirculation. Automatic analysis of microcirculation would provide a bedside diagnostic tool for microcirculatory disorders and allow immediate therapeutic decisions based upon microcirculation analysis. METHODS: After induction of general anaesthesia and instrumentation for haemodynamic monitoring, haemorrhagic shock was induced in ten female sheep by stepwise blood withdrawal of 3 × 10 mL per kilogram body weight...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27822777/critical-role-of-endogenous-histamine-in-promoting-end-organ-tissue-injury-in-sepsis
#13
Mizuki Hattori, Mitsuaki Yamazaki, Wakana Ohashi, Satoshi Tanaka, Kohshi Hattori, Kenichiro Todoroki, Toshio Fujimori, Hiroshi Ohtsu, Naoyuki Matsuda, Yuichi Hattori
BACKGROUND: Histamine assumes an important role as a major mediator in various pathologic disorders associated with inflammation and immune reactions. However, the involvement of histamine in the pathological conditions and symptoms of sepsis remains entirely unknown. In this study, we establish that histamine is identified as a contributory mediator to promoting the development of organ injury in sepsis. METHODS: Histidine decarboxylase (HDC) gene knockout (HDC(-/-)) mice, histamine H1-/H2-receptor gene-double knockout (H1R(-/-)/H2R(-/-)) mice, and their littermate wild-type (WT) C57BL/6J mice underwent cecal ligation and puncture (CLP) or sham operation...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27761886/comparison-between-effects-of-pressure-support-and-pressure-controlled-ventilation-on-lung-and-diaphragmatic-damage-in-experimental-emphysema
#14
Gisele de A Padilha, Lucas F B Horta, Lillian Moraes, Cassia L Braga, Milena V Oliveira, Cíntia L Santos, Isalira P Ramos, Marcelo M Morales, Vera Luiza Capelozzi, Regina C S Goldenberg, Marcelo Gama de Abreu, Paolo Pelosi, Pedro L Silva, Patricia R M Rocco
BACKGROUND: In patients with emphysema, invasive mechanical ventilation settings should be adjusted to minimize hyperinflation while reducing respiratory effort and providing adequate gas exchange. We evaluated the impact of pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) on pulmonary and diaphragmatic damage, as well as cardiac function, in experimental emphysema. METHODS: Emphysema was induced by intratracheal instillation of porcine pancreatic elastase in Wistar rats, once weekly for 4 weeks...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27726105/exploring-alternative-routes-for-oxygen-administration
#15
Elisa Damiani, Alex Dyson, Lucia Zacchetti, Abele Donati, Mervyn Singer
BACKGROUND: Hypoxemia may compromise cell metabolism and organ function. Supplemental oxygen (O2) at high concentrations may prove ineffective, and issues relating to hyperoxia, barotrauma, mechanical ventilation, and extracorporeal oxygenation are well documented. Old reports suggest the potential safety and efficacy of alternative routes for O2 administration, such as intravenous or intestinal. We re-explored these routes in rat models of hypoxemia. METHODS: Hypoxemia was induced in spontaneously breathing, anesthetized rats by breathing a hypoxic gas mix (FiO2 0...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27704481/heparin-binding-protein-is-important-for-vascular-leak-in-sepsis
#16
Peter Bentzer, Jane Fisher, HyeJin Julia Kong, Mattias Mörgelin, John H Boyd, Keith R Walley, James A Russell, Adam Linder
BACKGROUND: Elevated plasma levels of heparin-binding protein (HBP) are associated with risk of organ dysfunction and mortality in sepsis, but little is known about causality and mechanisms of action of HBP. The objective of the present study was to test the hypothesis that HBP is a key mediator of the increased endothelial permeability observed in sepsis and to test potential treatments that inhibit HBP-induced increases in permeability. METHODS: Association between HBP at admission with clinical signs of increased permeability was investigated in 341 patients with septic shock...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27686339/a-new-approach-to-selective-brain-cooling-by-a-ranque-hilsch-vortex-tube
#17
Mohammad Fazel Bakhsheshi, Yong Wang, Lynn Keenliside, Ting-Yim Lee
BACKGROUND: Target temperature management is the single most effective intervention and the gold standard in post-resuscitation care today. However, cooling the whole body below 33-34 °C can cause severe complications. Therefore, developing a selective brain cooling (SBC) approach which can be initiated early to induce rapid cooling and maintain the target temperature over 12-24 h before slowly rewarming brain temperature by itself alone would be advantageous. Vortex tubes are simple mechanical devices generating cold air from a stream of compressed air without applied chemical or energy...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27682607/plasmadiafiltration-ameliorating-gut-mucosal-barrier-dysfunction-and-improving-survival-in-porcine-sepsis-models
#18
Ming Xin Li, Jun Feng Liu, Jian Da Lu, Ying Zhu, Ding Wei Kuang, Jian Bing Xiang, Peng Sun, Wei Wang, Jun Xue, Yong Gu, Chuan Ming Hao
BACKGROUND: The object of this study is to explore whether the plasmadiafiltration (PDF) is more effective in improving the intestinal mucosal barrier function by removing more key large molecular inflammatory mediators and then prolonging the survival time. METHODS: Totally, 24 porcine sepsis models induced by cecal ligation and puncture (CLP) operation were randomly divided into three groups: PDF group, high-volume hemofiltration (HVHF) group, and control group, and received 8 h treatment, respectively...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27671340/effects-of-n-acetylcysteine-nac-supplementation-in-resuscitation-fluids-on-renal-microcirculatory-oxygenation-inflammation-and-function-in-a-rat-model-of-endotoxemia
#19
Bulent Ergin, Philippe Guerci, Lara Zafrani, Frank Nocken, Asli Kandil, Ebru Gurel-Gurevin, Cihan Demirci-Tansel, Can Ince
BACKGROUND: Modulation of inflammation and oxidative stress appears to limit sepsis-induced damage in experimental models. The kidney is one of the most sensitive organs to injury during septic shock. In this study, we evaluated the effect of N-acetylcysteine (NAC) administration in conjunction with fluid resuscitation on renal oxygenation and function. We hypothesized that reducing inflammation would improve the microcirculatory oxygenation in the kidney and limit the onset of acute kidney injury (AKI)...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27645151/transpulmonary-and-pleural-pressure-in-a-respiratory-system-model-with-an-elastic-recoiling-lung-and-an-expanding-chest-wall
#20
Per Persson, Stefan Lundin, Ola Stenqvist
BACKGROUND: We have shown in acute lung injury patients that lung elastance can be determined by a positive end-expiratory pressure (PEEP) step procedure and proposed that this is explained by the spring-out force of the rib cage off-loading the chest wall from the lung at end-expiration. The aim of this study was to investigate the effect of the expanding chest wall on pleural pressure during PEEP inflation by building a model with an elastic recoiling lung and an expanding chest wall complex...
December 2016: Intensive Care Medicine Experimental
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