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https://www.readbyqxmd.com/read/27908339/vasopressors-and-inotropes-in-sepsis
#1
REVIEW
Leeanne Stratton, David A Berlin, John E Arbo
Vasopressor and inotropes are beneficial in shock states. Norepinephrine is considered the first-line vasopressor for patients with sepsis-associated hypotension. Dobutamine is considered the first-line inotrope in sepsis, and should be considered for patients with evidence of myocardial dysfunction or ongoing signs of hypoperfusion. Vasopressor and inotrope therapy has complex effects that are often difficult to predict; emergency providers should consider the physiology and clinical trial data. It is essential to continually reevaluate the patient to determine if the selected treatment is having the intended result...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27880847/activation-of-both-the-calpain-and-ubiquitin-proteasome-systems-contributes-to-septic-cardiomyopathy-through-dystrophin-loss-disruption-and-mtor-inhibition
#2
Ana Caroline Silva Freitas, Maria Jose Figueiredo, Erica Carolina Campos, Danilo Figueiredo Soave, Simone Gusmao Ramos, Herbert B Tanowitz, Mara Rúbia N Celes
Cardiac dysfunction caused by the impairment of myocardial contractility has been recognized as an important factor contributing to the high mortality in sepsis. Calpain activation in the heart takes place in response to increased intracellular calcium influx resulting in proteolysis of structural and contractile proteins with subsequent myocardial dysfunction. The purpose of the present study was to test the hypothesis that increased levels of calpain in the septic heart leads to disruption of structural and contractile proteins and that administration of calpain inhibitor-1 (N-acetyl-leucinyl-leucinyl-norleucinal (ALLN)) after sepsis induced by cecal ligation and puncture prevents cardiac protein degradation...
2016: PloS One
https://www.readbyqxmd.com/read/27858884/layer-specific-quantification-of-myocardial-deformation-in-sepsis-induced-takotsubo-cardiomyopathy-three-case-reports-of-a-serial-2-dimensional-speckle-tracking-echocardiographic-study
#3
Ming-Jui Hung, Yu-Cheng Kao, Wei-Siang Chen, Chun-Tai Mao, Tien-Hsing Chen, Ning-I Yang, Ta Ko, Chung-Yu Liang
INTRODUCTION: Little is known about the time-course changes in left ventricular myocardial deformation in patients with Takotsubo cardiomyopathy (TC) using layer-specific quantification of myocardial deformation assessed by 2-dimensional speckle tracking echocardiography (2DSTE). CASE SUMMARY: In this retrospective 2DSTE follow-up study of 3 female patients with sepsis-induced TC, we examined changes in strain among the 3 myocardial layers, and examined the changes in left ventricular diastolic function and right ventricular systolic function...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27851285/1650-myocardial-calcification-in-pediatric-viral-sepsis
#4
Juan Gutierrez, Rao Andavolu, Philip Ursell
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27851098/1462-myocardial-injury-during-sepsis-incidence-and-association-with-mortality
#5
Jos Frencken, Dirk Donker, Janneke Horn, Tom Van Der Poll, Wilton Van Klei, Marc Bonten, Olaf Cremer
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850998/1362-long-term-new-onset-heart-failure-in-patients-with-myocardial-dysfunction-in-sepsis-and-septic-shock
#6
Saraschandra Vallabhajosyula, Jacob Jentzer, Jeffrey Geske, Kianoush Kashani, Ognjen Gajic, Rahul Kashyap
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850962/1326-aging-elevates-myocardial-tlr2-levels-to-augment-cardiac-dysfunction-and-mortality-during-sepsis
#7
Xianzhong Meng, Yufeng Zhai, Lihua Ao, Haipeng Hui, David Fullerton
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27836304/neutrophil-gelatinase-associated-lipocalin-predicts-myocardial-dysfunction-and-mortality-in-severe-sepsis-and-septic-shock
#8
Biao Wang, Gang Chen, Jia Li, Yuanying Zeng, Yunfu Wu, Xiaoye Yan
BACKGROUND: This study examines the clinical utility of plasma neutrophil gelatinase-associated lipocalin (NGAL) as an indicator of myocardial dysfunction and mortality in severe sepsis and septic shock. METHODS: We designed a prospective cohort study in an intensive care unit, and 53 patients with severe sepsis or septic shock were included. Data were used to determine a relationship between NGAL and the development of myocardial dysfunction and mortality. These associations were determined by the Mann-Whitney test, multiple logistic regression, plotting the receiver operating characteristic (ROC) curve, Kaplan-Meier curves and Spearman test...
November 3, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27807846/borderline-operability-in-hepatectomy-patients-is-associated-with-higher-rates-of-failure-to-rescue-after-severe-complications
#9
Bradford J Kim, Ching-Wei D Tzeng, Amanda B Cooper, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND/OBJECTIVE: To understand the influence of age and comorbidities, this study analyzed the incidence and risk factors for post-hepatectomy morbidity/mortality in patients with "borderline" (BL) operability, defined by the preoperative factors: age ≥75 years, dependent function, lung disease, ascites/varices, myocardial infarction, stroke, steroids, weight loss >10%, and/or sepsis. METHODS: All elective hepatectomies were identified in the 2005-2013 ACS-NSQIP database...
November 3, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27803955/open-repair-of-aaa-in-a-high-volume-center
#10
Lazar B Davidovic, Milanko Maksic, Igor Koncar, Nikola Ilic, Marko Dragas, Nikola Fatic, Miroslav Markovic, Igor Banzic, Perica Mutavdzic
OBJECTIVE: To assess results of open repair (OR) of AAA in a single high volume center. METHODS: We analyzed prospectively collected data of 450 patients who underwent elective OR of AAA at the Clinic for Vascular and Endovascular Surgery of the Serbian Clinical Centre in the period between January 2013 and September 2014. RESULTS: Postoperative death occurred in seven patients (1. 55%) during the first 30 postoperative days. The mortality was caused by: uncontrolled bleeding-1, acute myocardial infarction-1, ischemic colitis-2, MOFS-2, sepsis due to infection and dehiscence of laparotomy wound-1...
November 1, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27796503/spontaneous-pulmonary-hematoma-in-a%C3%A2-patient-with-sepsis-treated-with-dual-antiplatelet-therapy
#11
Janko Vlaović, Gorazd Voga
A 72-year-old patient was admitted to the medical intensive care unit due to a right-sided, hospital-acquired pneumonia and septic shock with respiratory failure and deterioration of chronic renal failure. During hospitalization the patient required hemodynamic support with norepinephrine and dobutamine, mechanical ventilation and hemodialysis. The patient suffered a non-ST segment elevation myocardial infarction (NSTEMI) and received dual antiplatelet therapy. After 14 days an acute intrapulmonary infiltrate of unknown origin developed, accompanied by fever and a significant increase of the C‑reactive protein (CRP) level...
October 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27788932/causes-and-predictors-of-death-in-patients-with-coronary-heart-disease-from-the-heart-and-soul-study
#12
Elizabeth Y Wang, Jeffrey Dixson, Nelson B Schiller, Mary A Whooley
Although the prevalence of coronary heart disease (CHD) in the United States has increased during the past 25 years, cardiovascular mortality has decreased due to advances in CHD therapy and prevention. We sought to determine the proportion of patients with CHD who die from cardiovascular versus noncardiovascular causes and the causes and predictors of death, in a cohort of patients with CHD. The Heart and Soul Study enrolled 1,024 participants with stable CHD from 2000 to 2002 and followed them for 10 years...
September 29, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27779675/resveratrol-alleviates-sepsis%C3%A2-induced-myocardial-injury-in-rats-by-suppressing-neutrophil-accumulation-the-induction-of-tnf%C3%A2-%C3%AE-and-myocardial-apoptosis-via-activation-of-sirt1
#13
Rui An, Lei Zhao, Jian Xu, Cong Xi, Haixun Li, Guohong Shen, Wei Zhang, Shumiao Zhang, Lijun Sun
Sepsis is a severe inflammatory response to systemic infection that frequently affects the myocardium. Previous studies have suggested that resveratrol (RESV) is protective in sepsis. The present study aimed to investigate the role of sirtuin 1 (Sirt1) signaling in the protective effect of intraperitoneally administered RESV against sepsis‑induced myocardial injury. Cecal ligation and puncture, or a sham operation, were performed in male Sprague‑Dawley rats, and the levels of tumor necrosis factor (TNF)‑α and myeloperoxidase (MPO) were assessed by ELISA and an MPO activity kit, respectively...
October 19, 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27765178/surgical-outcomes-and-failure-to-rescue-events-after-colectomy-in-teaching-hospitals-a-nationwide-analysis
#14
Ara Ko, Lia Aquino, Nicolas Melo, Rodrigo F Alban
BACKGROUND: The relationship between failure-to-rescue (FTR) after colectomy is not well understood, particularly in teaching institutions. We sought to examine this relationship using a large national database. METHODS: Patients undergoing colectomy from 2010 to 2012 were identified in the Nationwide Inpatient Sample database. FTR events were defined as deaths following deep vein thrombosis or pulmonary embolism, sepsis, gastrointestinal bleed, acute myocardial infarction, acute kidney injury, pneumonia, respiratory failure, shock...
September 30, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27758722/-ic-triage-in-patients-with-an-acutely-worsening-condition-challenges-considerations-and-decisions
#15
C Savelkoul, A F Klijnsma, E Balk, A Janse, D H T Tjan
Acute intensive care (IC) triage involves a challenging decision-making process. Physicians are required to make life or death decisions about an unfamiliar patient within a short time frame. An 84-year-old female was admitted to the stroke unit following an extensive cerebral infarction. The intensive care unit (ICU) physician was consulted because of a suspected severe abdominal sepsis even though ICU treatment had never previously been discussed. A 77-year-old female with a previous history of myocardial infarction and severe COPD developed acute respiratory failure on the ward, and was admitted to the ICU for support by a mechanical ventilator...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27727247/inhibition-of-mir-155-protects-against-lps-induced-cardiac-dysfunction-and-apoptosis-in-mice
#16
Hui Wang, Yihua Bei, Peipei Huang, Qiulian Zhou, Jing Shi, Qi Sun, Jiuchang Zhong, Xinli Li, Xiangqing Kong, Junjie Xiao
Sepsis-induced myocardial dysfunction represents a major cause of death in intensive care units. Dysregulated microRNAs (miR)-155 has been implicated in multiple cardiovascular diseases and miR-155 can be induced by lipopolysaccharide (LPS). However, the role of miR-155 in LPS-induced cardiac dysfunction is unclear. Septic cardiac dysfunction in mice was induced by intraperitoneal injection of LPS (5 mg/kg) and miR-155 was found to be significantly increased in heart challenged with LPS. Pharmacological inhibition of miR-155 using antagomiR improved cardiac function and suppressed cardiac apoptosis induced by LPS in mice as determined by echocardiography, terminal deoxynucleotidyl transferase nick-end labeling (TUNEL) assay, and Western blot for Bax and Bcl-2, while overexpression of miR-155 using agomiR had inverse effects...
October 11, 2016: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/27720136/ima901-a-multipeptide-cancer-vaccine-plus-sunitinib-versus-sunitinib-alone-as-first-line-therapy-for-advanced-or-metastatic-renal-cell-carcinoma-imprint-a-multicentre-open-label-randomised-controlled-phase-3-trial
#17
Brian I Rini, Arnulf Stenzl, Romauld Zdrojowy, Mikhail Kogan, Mikhail Shkolnik, Stephane Oudard, Steffen Weikert, Sergio Bracarda, Simon J Crabb, Jens Bedke, Joerg Ludwig, Dominik Maurer, Regina Mendrzyk, Claudia Wagner, Andrea Mahr, Jens Fritsche, Toni Weinschenk, Steffen Walter, Alexandra Kirner, Harpreet Singh-Jasuja, Carsten Reinhardt, Tim Eisen
BACKGROUND: In a phase 2 study in patients with metastatic renal cell carcinoma, overall survival was associated with T-cell responses against IMA901, a vaccine consisting of ten tumour-associated peptides. In this phase 3 trial, we aimed to determine the clinical effect of adding IMA901 to sunitinib, the standard first-line treatment in metastatic renal cell carcinoma with postulated favourable immunomodulatory effects. METHODS: The IMPRINT study is an open-label, randomised, controlled, phase 3 trial done at 124 clinical sites in 11 countries...
October 3, 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27716530/naringin-protects-against-lipopolysaccharide-induced-cardiac-injury-in-mice
#18
Liu Xianchu, Professor Zheng Lan, Li Qiufang, Liu Yi, Ruan Xiangcheng, Hou Wenqi, Ding Yang
Previous research has demonstrated that lipopolysaccharide (LPS) can induce sepsis and lead to myocardial dysfunction. Naringin has various biological activities in LPS-induced sepsis. In this study, our aim was to investigate the effects of Naringin on LPS-induced cardiac injury and clarify its potential mechanism. We found that in vivo treatment with Naringin significantly ameliorated body weight loss, and attenuated cardiac histopathological changes after LPS challenge. Furthermore, Naringin inhibited LPS-induced increase of TNF-α, IL-1β and IL-6 activities to alleviate inflammatory response in heart...
December 2016: Environmental Toxicology and Pharmacology
https://www.readbyqxmd.com/read/27709263/refractory-septic-shock-in-children-a-european-society-of-paediatric-and-neonatal-intensive-care-definition
#19
Luc Morin, Samiran Ray, Clare Wilson, Solenn Remy, Mohamed Rida Benissa, Nicolaas J G Jansen, Etienne Javouhey, Mark J Peters, Martin Kneyber, Daniele De Luca, Simon Nadel, Luregn Jan Schlapbach, Graeme Maclaren, Pierre Tissieres
PURPOSE: Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and neonatal intensive care (ESPNIC) experts' definition of paediatric RSS. METHODS: We conducted a two-round Delphi study followed by an observational multicentre retrospective study...
December 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27708836/pathophysiology-of-sepsis-induced-myocardial-dysfunction
#20
Xiuxiu Lv, Huadong Wang
Sepsis-induced myocardial dysfunction is a common complication in septic patients and is associated with increased mortality. In the clinical setting, it was once believed that myocardial dysfunction was not a major pathological process in the septic patients, at least in part, due to the unavailability of suitable clinical markers to assess intrinsic myocardial function during sepsis. Although sepsis-induced myocardial dysfunction has been studied in clinical and basic research for more than 30 years, its pathophysiology is not completely understood, and no specific therapies for this disorder exist...
2016: Military Medical Research
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