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myocardial sepsis

Pramod Theetha Kariyanna, Apoorva Jayarangaiah, Abdullah Mahmood, Mitchell Hare, Nicholas Taklalsingh, Isabel M McFarlane
Idiopathic inflammatory myopathy (IIM) is a rare autoimmune myopathy that includes polymyositis, dermatomyositis, inclusion body myositis and autoimmune necrotizing myositis. Cardiac involvement was considered a rare occurrence in IIM however, recent reports suggests that cardiac involvement is a common feature and portends poor prognosis as it is usually encountered in advanced disease. IIM leads to myocarditis with subsequent development of myocardial fibrosis, cardiac conduction system disease and cardiomyopathy resulting in both systolic and diastolic heart failure...
2018: American journal of medical case reports
Caitlin Wilson, Clare Harley, Stephanie Steels
INTRODUCTION: Paramedics are involved in examining, treating and diagnosing patients. The accuracy of these diagnoses is evaluated using diagnostic accuracy studies. We undertook a systematic review of published literature to provide an overview of how accurately paramedics diagnose patients compared with hospital doctors. A bivariate meta-analysis was incorporated to examine the range of diagnostic sensitivity and specificity. METHODS: We searched MEDLINE, CINAHL, Embase, AMED and the Cochrane Database from 1946 to 7 May 2016 for studies where patients had been given a diagnosis by paramedics and hospital doctors...
September 14, 2018: Emergency Medicine Journal: EMJ
Maria Micaela Lopez Alarcón, Julieta Fernández Ruocco, Fabiano Ferreira, Heitor A Paula-Neto, Marisa Sepúlveda, Martín Vila Petroff, Adriana Bastos Carvalho, Isalira Peroba Ramos, Hugo Justino Branda, Claudia N Paiva, Emiliano Medei
Hemodynamic collapse and myocardial dysfunction are among the major causes of death in severe sepsis. The purpose of this study was to assess the role played by toll-like receptor 4 and by the NLRP3 inflammasome in the cardiac dysfunction that occurs after high-grade polymicrobial sepsis. We performed the colon ascendens stent peritonitis (CASP) surgery in Tlr4, Nlrp3, and caspase-1 mice. We also assessed for the first time the electrical heart function in the colon ascendens stent peritonitis (CASP) model...
October 2018: Shock
Robert Munashe Maweni, Shahram Shirazi, Dimitrios Chatzoudis, Sudip Das
We present the case of a 76-year-old patient who attended our emergency department with signs of sepsis and severe respiratory distress. She had stridor, type 1 respiratory failure and a left-sided neck swelling. On CT, it was initially misdiagnosed as parapharyngeal abscess. When the imaging was reviewed, it was found to be a left-sided mixed laryngopyocoele obstructing the larynx with an asymptomatic contralateral laryngocoele. The internal component of the left laryngopyocoele was excised through a microlaryngoscopy approach while the external component was approached through a transcervical incision...
September 4, 2018: BMJ Case Reports
Jill M Cholette, Ariane Willems, Stacey L Valentine, Scot T Bateman, Steven M Schwartz
OBJECTIVES: To present the recommendations and supporting literature for RBC transfusions in critically ill children with acquired and congenital heart disease developed by the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. DESIGN: Consensus conference series of 38 international, multidisciplinary experts in RBC transfusion management of critically ill children. METHODS: Experts developed evidence-based and, when evidence was lacking, expert-based clinical recommendations and research priorities for RBC transfusions in critically ill children...
September 2018: Pediatric Critical Care Medicine
Fahad Syed Naseerullah, Avinash Murthy
Hypothermia is often a sign of serious illness. Commonly reported aetiologies include but are not limited to sepsis, exposure to cold and endocrine disorders. Hypoglycaemia, a common occurrence, is rarely associated with hypothermia. We present a case of prolonged, severe hypothermia due to hypoglycaemia. A 58-year-old man with diabetes who presented with chest pain and was diagnosed with Non-ST elevation myocardial infarction. He was given nothing per mouth in preparation for a left heart catheterisation but received his reported insulin glargine dosage at bedtime...
August 29, 2018: BMJ Case Reports
Andreja Sinkovic, Barbara Kit, Andrej Markota
BACKGROUND: Septic cardiomyopathy represents cardiac impairment in sepsis and is a part of systemic involvement in sepsis. Cytokine storm is responsible for septic shock and for myocardial dysfunction of potentially reversible septic cardiomyopathy. Several case reports and case series demonstrated successful removal of circulating cytokines by combined blood purification techniques. In this way, septic shock and survival of septic patients improved. However, the evidences for reversal of myocardial dysfunction are rare...
August 29, 2018: BMC Infectious Diseases
Timothy H Pohlman, Alison M Fecher, Cecivon Arreola-Garcia
From clinical and laboratory studies of specific coagulation defects induced by injury, damage control resuscitation (DCR) emerged as the most effective management strategy for hemorrhagic shock. DCR of the trauma patient who has sustained massive blood loss consists of 1) hemorrhage control; 2) permissive hypotension; and 3) the prevention and correction of trauma-induced coagulopathies, referred to collectively here as acute coagulopathy of trauma (ACOT). Trauma patients with ACOT have higher transfusion requirements, may eventually require massive transfusion, and are at higher risk of exsanguinating...
2018: Journal of Blood Medicine
Muzaffer Tunç, Cengiz Şahutoğlu, Nursen Karaca, Seden Kocabaş, Fatma Zekiye Aşkar
Objective: Prolonged intensive care unit (ICU) stay prevents the use of ICU equipment by other patients and increases hospital cost. This retrospective study aimed to investigate the risk factors for prolonged ICU stay in patients undergoing open heart surgery. Methods: The medical records of 513 patients who underwent coronary artery bypass grafting and valvular heart surgery were retrospectively evaluated. Patients were divided into two groups based on their ICU stay: groups I (<48 h) and II (≥48 h)...
August 2018: Turkish Journal of Anaesthesiology and Reanimation
S Chiu Wong, Ilhwan Yeo, Geoffrey Bergman, Dmitriy N Feldman, Harsimran Singh, Robert Minutello, Luke K Kim
BACKGROUND: With the expected growth in the elderly segment of the U.S. population particularly in women, the prevalence of valvular heart disease is bound to increase in the coming years. We sought to delineate the impact of gender on in-hospital clinical outcomes in Medicare-age patients undergoing isolated left-side heart valve surgery. METHODS: Using the National Inpatient Sample files from 2003 to 2014, we compared the in-hospital major adverse cardiac and cerebral events (MACCE: all-cause mortality, stroke, or myocardial infarction) and composite complications (MACCE, permanent pacemaker implantation, bleeding requiring transfusion, iatrogenic vascular complications, acute respiratory failure, acute kidney injury requiring hemodialysis, sepsis and prolonged hospital stay) following isolated mitral or aortic surgery between genders with 1:1 propensity score analysis...
August 10, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Ivan Luptak, Dominique Croteau, Catherine Valentine, Fuzhong Qin, Deborah Siwik, Daniel Remick, Wilson S Colucci, Ion Hobai
Mice challenged with lipopolysaccharide (LPS) develop cardiomyopathy in a sex- and redox- dependent fashion. Here we extended these studies to the cecal ligation and puncture (CLP) model.We compared male and female FVB mice (wild type, WT) and transgenic littermates over-expressing myocardial catalase (CAT). CLP induced 100% mortality within 4 days, with similar mortality rates in male and female WT and CAT mice. 24 h after CLP, isolated (Langendorff) perfused hearts showed depressed contractility in WT male mice, but not in male CAT or female WT and CAT mice...
August 10, 2018: Shock
Todd Tartavoulle, Leanne Fowler
Sepsis-induced cardiogenic shock is a lethal condition and the management of it is challenging. Cardiogenic shock in the septic patient involves myocardial systolic and diastolic dysfunction. The limited ability of the ventricles to contract effectively results in a decrease in oxygen delivery to the organs and tissues. Supportive therapy is provided to patients with sepsis and no specific drug can reverse the myocardial dysfunction. Rapid diagnosis, prompt antibiotic therapy, cautious protocol-driven fluid resuscitation and vasoactive agents, control of infectious source, and expeditious coronary artery revascularization is recommended to achieve a positive outcome...
September 2018: Critical Care Nursing Clinics of North America
Carlos A Mestres, Eduard Quintana, Tomislav Kopjar, Juan Ambrosioni, Manuel Almela, David Fuster, Salvador Ninot, José M Miró
OBJECTIVES: The aim of this study was to analyse outcomes over 2 decades using cryopreserved vascular allografts to treat vascular infection. METHODS: We conducted a retrospective study of patients identified from our institutional database who were treated for primary or secondary vascular infection using implanted allografts. RESULTS: Between October 1992 and May 2014, 54 patients underwent surgery for vascular infection out of 118 patients implanted with cryopreserved vascular allografts...
August 1, 2018: European Journal of Cardio-thoracic Surgery
Alwin Chuan, Timothy G Short, Alexander Z Y Peng, Shelly Y B Wen, Alice X Sun, Timothy H Ting, Anthony S Wan, Linda Pope, Matthias Jaeger, Anders Aneman
BACKGROUND: Studies have identified multiple risk factors for development of cognitive decline after surgery. Impaired cerebrovascular autoregulation may be a contributor to postoperative cognitive decline. METHODS: One hundred and forty patients admitted for major elective noncardiac surgery were recruited. Near-infrared spectroscopy was used to calculate the tissue oxygenation index of dynamic autoregulation (TOx). The primary endpoint was Day 3 cognitive recovery as assessed using the Postoperative Quality of Recovery Scale...
August 5, 2018: Acta Anaesthesiologica Scandinavica
F Sanfilippo, C Corredor, N Fletcher, L Tritapepe, F L Lorini, A Arcadipane, A Vieillard-Baron, M Cecconi
BACKGROUND: Sepsis-induced myocardial dysfunction is associated with poor outcomes, but traditional measurements of systolic function such as left ventricular ejection fraction (LVEF) do not directly correlate with prognosis. Global longitudinal strain (GLS) utilizing speckle-tracking echocardiography (STE) could be a better marker of intrinsic left ventricular (LV) function, reflecting myocardial deformation rather than displacement and volume changes. We sought to investigate the prognostic value of GLS in patients with sepsis and/or septic shock...
August 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
Jihane Hajj, Natalie Blaine, Jola Salavaci, Douglas Jacoby
Sepsis is a serious and fatal medical condition that has overburdened the US healthcare system. The purpose of this paper is to provide a review of published literature on severe sepsis with a distinct focus on incidence, mortality, cost of hospital care, and postdischarge care. A review of the nature of postsepsis syndrome and its impact on septic patients is also included. The literature review was conducted utilizing the PubMed database, identifying 34 studies for inclusion. From the evaluation of these studies, it was determined that the incidence of sepsis continues to be on the rise according to three decades of epidemiological data...
July 30, 2018: Healthcare (Basel, Switzerland)
Christian Lopez Ramos, Michael G Brandel, Robert C Rennert, Arvin R Wali, Jeffrey A Steinberg, David R Santiago-Dieppa, Brittany N Burton, Jeffrey S Pannell, Scott E Olson, Alexander A Khalessi
BACKGROUND: Hospital readmission is a key surgical quality metric associated with financial penalties and greater healthcare costs. We examined the clinical risk factors and postoperative complications associated with 30-day unplanned hospital readmissions after cranial neurosurgery. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2016 for adult patients who had undergone a cranial neurosurgical procedure...
July 24, 2018: World Neurosurgery
Wen Han, Hao Wang, Longxiang Su, Yun Long, Na Cui, Dawei Liu
Background: Sepsis-induced myocardial dysfunction is a severe clinical problem. Recent studies have indicated that autophagy and myocardial energy depletion play a major role in myocardial dysfunction during sepsis, a mechanistic target of rapamycin (mTOR) as a master sensor of energy status and autophagy mediator; however, there are little data describing its role during sepsis in the heart. Methods: Cecal ligation and puncture (CLP) or sham operation (SHAM) was performed in rats...
2018: Mediators of Inflammation
Junhai Zhen, Li Li, Jing Yan
Sepsis is a common disease in critical patients, which may lead to myocardial damage, thereby aggravating the severity of the patients' condition, and causing adverse prognosis. How to detect sepsis with myocardial injury as early as possible, and use corresponding treatment measures on time are essential. Cardiac troponin I (cTnI), brain natriuretic peptide (BNP), myoglobin (Mb), MB isoenzyme of creatine kinase (CK-MB) and other traditional cardiac markers are easily affected by the complications of other critical diseases, thus the diagnostic value of those markers for myocardial injury of sepsis is reduced...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Yunpeng Lou, Sheng Zhang, Zhaofen Lin
OBJECTIVE: To investigate the effect of estrogen on expression of the cysteine-rich secretory protein containing LCCL domain 2 (CRISPLD2) in myocardium of lipopolysaccharide (LPS)-induced mice model of sepsis. METHODS: Totally 12 female and 12 male Balb/c mice of specific pathogen-free (SPF) level with 7 weeks were served as objectives. The female and male mice were randomly divided into model groups and control groups, respectively, with 6 mice in each group. The model of sepsis was reproduced by intraperitoneal injection of 10% LPS (5 mg/kg), and the mice in control groups were injected with the same volume of normal saline...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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