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https://www.readbyqxmd.com/read/28231305/effects-of-vasoactive-drugs-on-crystalloid-fluid-kinetics-in-septic-sheep
#1
Yuhong Li, Zheng Xiaozhu, Ru Guomei, Ding Qiannan, Robert G Hahn
PURPOSE: Crystalloid fluid and vasoactive drugs are used in the early treatment of sepsis. The purpose of the present study was to examine how these drugs alter plasma volume expansion, peripheral edema, and urinary excretion. METHODS: Twenty-five anesthetized sheep were made septic by cecal puncture and a short infusion of lipopolysaccharide. After 50 min, a slow infusion of isotonic saline was initiated: the saline either contained no drug, norepinephrine (1 μg/kg/min), phenylephrine (3 μg/kg/min), dopamine (50 μg/kg/min), or esmolol (50 μg/kg/min)...
2017: PloS One
https://www.readbyqxmd.com/read/28230708/cell-derived-nanoparticles-are-endogenous-modulators-of-sepsis-with-therapeutic-potential
#2
Natalia Kunz, Brent T Xia, Kai-Uwe Kalies, Matthias Klinger, Timo Gemoll, Jens K Habermann, Brynne E Whitacre, Aaron P Seitz, Kathrin Kalies, Charles C Caldwell
Cell-derived nanoparticles (CDNPs) containing cytosolic proteins and RNAs/DNAs can be isolated from stressed eukaryotic cells. Previously, CDNPs isolated from cultured cells exerted immunomodulatory activities in different infections. Here, we sought to elucidate the role of CDNPs using a murine model of cecal ligation and puncture (CLP). We hypothesized that CDNPs influence the immune response at the site of infection, where severe cellular stress occurs. We observed early CDNP accumulation in the peritoneum after 4 h and continued CDNP presence 24 h after CLP...
February 22, 2017: Shock
https://www.readbyqxmd.com/read/28230556/comparison-of-automated-methods-versus-the-american-burn-association-sepsis-definition-to-identify-sepsis-and-sepsis-with-organ-dysfunction-septic-shock-in-burn-injured-adults
#3
Megan A Rech, Michael J Mosier, Susan Zelisko, Giora Netzer, Elizabeth J Kovacs, Majid Afshar
To develop an algorithm to identify sepsis and sepsis with organ dysfunction/septic shock in burn-injured patients incorporating criteria from the American Burn Association sepsis definition that possesses good test characteristics compared with International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9) codes and an algorithm previously validated in nonburn-injured septic patients (Martin et al method). This was a retrospective cohort study of consecutive patients admitted to the burn intensive care unit between January 2008 and March 2015...
February 22, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28224121/immunological-defects-in-neonatal-sepsis-and-potential-therapeutic-approaches
#4
REVIEW
Steven L Raymond, Julie A Stortz, Juan C Mira, Shawn D Larson, James L Wynn, Lyle L Moldawer
Despite advances in critical care medicine, neonatal sepsis remains a major cause of morbidity and mortality worldwide, with the greatest risk affecting very low birth weight, preterm neonates. The presentation of neonatal sepsis varies markedly from its presentation in adults, and there is no clear consensus definition of neonatal sepsis. Previous work has demonstrated that when neonates become septic, death can occur rapidly over a matter of hours or days and is generally associated with inflammation, organ injury, and respiratory failure...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#5
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28221185/antipyretic-therapy-in-critically-ill-septic-patients-a-systematic-review-and-meta-analysis
#6
Anne M Drewry, Enyo A Ablordeppey, Ellen T Murray, Carolyn R T Stoll, Sonya R Izadi, Catherine M Dalton, Angela C Hardi, Susan A Fowler, Brian M Fuller, Graham A Colditz
OBJECTIVE: This meta-analysis aimed to examine the impact of antipyretic therapy on mortality in critically ill septic adults. DATA SOURCES: Literature searches were implemented in Ovid Medline, Embase, Scopus, Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, and ClinicalTrials.gov through February 2016. STUDY SELECTION: Inclusion criteria were observational or randomized studies of septic patients, evaluation of antipyretic treatment, mortality reported, and English-language version available...
February 17, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#7
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28218355/mechanisms-of-endothelial-activation-in-sepsis-and-cell-culture-models-to-study-the-heterogeneous-host-response
#8
Tanja Eichhorn, Michael B Fischer, Viktoria Weber
Sepsis is currently viewed as a fundamental disintegration of control functions from intracellular signalling to immunoregulatory and neuroendocrine mechanisms. The immediate threat in sepsis is invasive infection, and the need to activate immune defense mechanisms to clear the pathogen before irreparable damage occurs. In the process of pathogen elimination, however, the systemic host response to infection may cause collateral damage to the endothelium and may lead to the destruction of host tissues.A number of experimental models have been developed to monitor endothelial activation and to study endothelial dysfunction under septic conditions...
February 13, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28218011/asymmetric-dimethylarginine-in-the-assessment-of-febrile-neutropenia-in-hematological-patients
#9
Marika Lappalainen, Sari Hämäläinen, Auni Juutilainen, Irma Koivula, Kari Pulkki, Esa Jantunen
Asymmetric dimethylarginine (ADMA) has been recognized as an independent prognostic factor for sepsis mortality in intensive care units. No data are available on kinetics or prognostic value of ADMA in hematological patients. We evaluated the ability of ADMA to act as a predictor for complicated course of febrile neutropenia, defined as bacteremia and/or septic shock in adult hematological patients receiving intensive chemotherapy. This prospective study included 87 adult hematological patients with febrile neutropenia after an intensive chemotherapy for acute myeloid leukemia (AML) or after an autologous stem cell transplantation (ASCT)...
April 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28213737/associations-among-left-ventricular-systolic-function-tachycardia-and-cardiac-preload-in-septic-patients
#10
Michael J Lanspa, Sajid Shahul, Andrew Hersh, Emily L Wilson, Troy D Olsen, Eliotte L Hirshberg, Colin K Grissom, Samuel M Brown
BACKGROUND: In sepsis, tachycardia may indicate low preload, adrenergic stimulation, or both. Adrenergic overstimulation is associated with septic cardiomyopathy. We sought to determine whether tachycardia was associated with left ventricular longitudinal strain, a measure of cardiac dysfunction. We hypothesized an association would primarily exist in patients with high preload. METHODS: We prospectively observed septic patients admitted to three study ICUs, who underwent early transthoracic echocardiography...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28211096/monocyte-and-lymphocyte-surface-molecules-in-severe-sepsis-and-non-septic-critically-ill-patients
#11
Joel Jämsä, Hannu Syrjälä, Virva Huotari, Eeva-Riitta Savolainen, Tero Ala-Kokko
The aim of the present study was to investigate whether expression of monocyte and lymphocyte surface molecules differs between patients with severe sepsis and non-septic patients treated in the intensive care unit (ICU). The expression of monocyte CD14, CD40, CD80 and HLA-DR, and lymphocyte CD69 were analyzed using quantitative flow cytometry on three consecutive days in 27 patients with severe sepsis and in 15 non-septic patients. Receiver operating characteristic analyses were performed and each corresponding area under the curve (AUC) was determined...
February 17, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28210888/double-carbapenem-combination-as-salvage-therapy-for-untreatable-infections-by-kpc-2-producing-klebsiella-pneumoniae
#12
M Souli, I Karaiskos, A Masgala, L Galani, E Barmpouti, H Giamarellou
We report our experience using the double-carbapenem combination as salvage therapy for patients with untreatable infections caused by KPC-2- producing Klebsiella pneumoniae. A total of 27 patients in two institutions in Athens, Greece suffering from complicated urinary tract infections (16) with or without secondary bacteraemia (four and 12 respectively), primary (six) or catheter-related bloodstream infections (two), HAP or VAP (two) and external ventricular drainage infection (one) were treated exclusively with ertapenem and high-dose prolonged infusion meropenem because in-vitro active antimicrobials were unavailable (19) or failed (four) or were contraindicated (six)...
February 16, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28210072/the-parenteral-vitamin-c-improves-sepsis-and-sepsis-induced-multiple-organ-dysfunction-syndrome-via-preventing-cellular-immunosuppression
#13
Yu-Lei Gao, Bin Lu, Jian-Hua Zhai, Yan-Cun Liu, Hai-Xia Qi, Ying Yao, Yan-Fen Chai, Song-Tao Shou
Cellular immunosuppression appears to be involved in sepsis and sepsis-induced multiple organ dysfunction syndrome (MODS). Recent evidence showed that parenteral vitamin C (Vit C) had the ability to attenuate sepsis and sepsis-induced MODS. Herein, we investigated the impact of parenteral Vit C on cellular immunosuppression and the therapeutic value in sepsis. Using cecal ligation and puncture (CLP), sepsis was induced in WT and Gulo(-/-) mice followed with 200 mg/Kg parenteral Vit C administration. The immunologic functions of CD4(+)CD25(+) regulatory T cells (Tregs) and CD4(+)CD25(-) T cells, as well as the organ functions, were determined...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28207922/mass-spectrometry-for-the-discovery-of-biomarkers-of-sepsis
#14
REVIEW
Katelyn R Ludwig, Amanda B Hummon
Sepsis is a serious medical condition that occurs in 30% of patients in intensive care units (ICUs). Early detection of sepsis is key to prevent its progression to severe sepsis and septic shock, which can cause organ failure and death. Diagnostic criteria for sepsis are nonspecific and hinder a timely diagnosis in patients. Therefore, there is currently a large effort to detect biomarkers that can aid physicians in the diagnosis and prognosis of sepsis. Mass spectrometry is often the method of choice to detect metabolomic and proteomic changes that occur during sepsis progression...
February 16, 2017: Molecular BioSystems
https://www.readbyqxmd.com/read/28207795/organ-dysfunction-during-continuous-veno-venous-high-cut-off-hemodialysis-in-patients-with-septic-acute-kidney-injury-a-prospective-observational-study
#15
Gianluca Villa, Cosimo Chelazzi, Elena Morettini, Lucia Zamidei, Serafina Valente, A Lucia Caldini, Giovanni Zagli, A Raffaele De Gaudio, Stefano Romagnoli
BACKGROUND: Continuous veno-venous hemodialysis with high cut-off membranes (HCO-CVVHD) removes inflammatory mediators involved in organ dysfunction during sepsis. The aim of the present study was to assess the variations in SOFA score and identify early predictors of short-term mortality in a cohort of patients with septic shock, treated with HCO-CVVHD for acute kidney injury (AKI). METHODS: An observational prospective multicenter cohort study was conducted in four mixed medical-surgical ICUs...
2017: PloS One
https://www.readbyqxmd.com/read/28207566/the-new-sepsis-definition-limitations-and-contribution-to-research-and-diagnosis-of-sepsis
#16
Franck Verdonk, Alice Blet, Alexandre Mebazaa
PURPOSE OF REVIEW: Based on recent clinical, epidemiological, and pathophysiological data, a third international consensus conference was carried out to define new criteria of sepsis in February 2016. This review presents the different items of this new definition, their limitations and their contribution to research and diagnosis of sepsis, in comparison with the previous definitions. RECENT FINDINGS: Incidence, management, and pathophysiological knowledge of sepsis have improved over the past 20 years...
February 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28207287/thiamine-as-a-renal-protective-agent-in-septic-shock-a-secondary-analysis-of-a-randomized-double-blind-placebo-controlled-trial
#17
Ari Moskowitz, Lars W Andersen, Michael N Cocchi, Mathias Karlsson, Parth V Patel, Michael W Donnino
RATIONALE: Acute kidney injury (AKI) is common in patients with sepsis and has been associated with high mortality rates. The provision of thiamine to septic patients may reduce the incidence and severity of sepsis-related AKI and thereby prevent renal failure requiring renal replacement therapy (RRT). OBJECTIVES: To test the hypothesis that thiamine supplementation mitigates kidney injury in septic shock. METHODS: This was a secondary analysis of a single-center, randomized, double-blind trial comparing thiamine to placebo in patients with septic shock...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28205241/septic-transfusion-case-caused-by-a-platelet-pool-with-visible-clotting-due-to-contamination-with-staphylococcus-aureus
#18
Maria Loza-Correa, Yuntong Kou, Mariam Taha, Miloslav Kalab, Jennifer Ronholm, Patrick M Schlievert, Michael P Cahill, Robert Skeate, Christine Cserti-Gazdewich, Sandra Ramirez-Arcos
BACKGROUND: Contamination of platelet concentrates (PCs) with Staphylococcus aureus is one of the most significant ongoing transfusion safety risks in developed countries. CASE REPORT: This report describes a transfusion reaction in an elderly patient diagnosed with acute myeloid leukemia, transfused with a 4-day-old buffy coat PC through a central venous catheter. The transfusion was interrupted when a large fibrous clot in the PC obstructed infusion pump flow...
February 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28205051/impact-of-preoperative-steroid-or-immunosuppressant-use-on-short-term-outcomes-following-colectomy-in-crohn-s-disease-patients
#19
N Valizadeh, A C A Murray, K Suradkar, A Al-Mazrou, R P Kiran
BACKGROUND: Evaluating the impact of steroid or immunosuppressants (SI) therapy prior to colectomy in Crohn's disease (CD) patients on postoperative septic and colectomy-specific outcomes using the American College of Surgeons (ACS)-National Surgical Quality Improvement Program (NSQIP)-targeted colectomy database. METHODS: All CD patients undergoing colectomy were retrieved from the 2012-2013 NSQIP-targeted database. Thirty-day postoperative outcomes were compared for patients who were on steroids or immunosuppressants (SI) within the 30 days prior to colectomy to the others using univariable and multivariable analyses...
February 15, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28203100/from-amino-acids-polymers-antimicrobial-peptides-and-histones-to-their-possible-role-in-the-pathogenesis-of-septic-shock-a-historical-perspective
#20
Isaac Ginsburg, Peter Vernon van Heerden, Erez Koren
This paper describes the evolution of our understanding of the biological role played by synthetic and natural antimicrobial cationic peptides and by the highly basic nuclear histones as modulators of infection, postinfectious sequelae, trauma, and coagulation phenomena. The authors discuss the effects of the synthetic polymers of basic poly α amino acids, poly l-lysine, and poly l-arginine on blood coagulation, fibrinolysis, bacterial killing, and blood vessels; the properties of natural and synthetic antimicrobial cationic peptides as potential replacements or adjuncts to antibiotics; polycations as opsonizing agents promoting endocytosis/phagocytosis; polycations and muramidases as activators of autolytic wall enzymes in bacteria, causing bacteriolysis and tissue damage; and polycations and nuclear histones as potential virulence factors and as markers of sepsis, septic shock, disseminated intravasclar coagulopathy, acute lung injury, pancreatitis, trauma, and other additional clinical disorders...
2017: Journal of Inflammation Research
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