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Sepsis and coagulation

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https://www.readbyqxmd.com/read/28213648/-state-of-the-art-in-fluid-and-volume-therapy-a%C3%A2-user-friendly-staged-concept
#1
M Rehm, N Hulde, T Kammerer, A S Meidert, K Hofmann-Kiefer
Adequate fluid therapy is highly important for the perioperative outcome of our patients. Both, hypovolemia and hypervolemia can lead to an increase in perioperative complications and can impair the outcome. Therefore, perioperative infusion therapy should be target-oriented. The main target is to maintain the patient's preoperative normovolemia by using a sophisticated, rational infusion strategy.Perioperative fluid losses should be discriminated from volume losses (surgical blood loss or interstitial volume losses containing protein)...
February 17, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28203580/unusual-presentation-of-diffuse-large-b-cell-lymphoma-with-splenic-infarcts
#2
Vivek Kumar, Parita Soni, Vishangi Dave, Jonathan Harris
A 67-year-old man presented with a 3-day history of abdominal pain, fever, and significant weight loss over 2 months. Physical examination revealed left upper quadrant tenderness, hepatomegaly, splenomegaly, and bilateral pitting edema but peripheral lymphadenopathy was absent. Laboratory tests showed anemia, thrombocytopenia, elevated prothrombin time (PT), partial thromboplastin time (PTT), and increased lactate dehydrogenase (LDH). PTT was corrected completely in mixing study. Further workup for the cause of coagulopathy revealed decreased levels of all clotting factors except factor VIII and increase fibrinogen levels, which ruled out disseminated intravascular coagulation (DIC)...
January 2017: Journal of Investigative Medicine High Impact Case Reports
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
#3
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
https://www.readbyqxmd.com/read/28202126/-effect-of-ulinastatin-on-serum-levels-of-tumor-necrosis-factor-%C3%AE-p-selectin-and-thrombin-antithrombin-complex-in-young-rats-with-sepsis
#4
Yun Liu, Xing-Heng Wu
OBJECTIVE: To investigate the effect of ulinastatin (UTI) for early drug intervention on the serum levels of tumor necrosis factor-α (TNF-α), P-selectin, and thrombin-antithrombin complex (TAT) in young rats with sepsis. METHODS: A total of 120 male rats aged 4 weeks were randomly divided into normal control group, sham-operation group, sepsis group, low-dose UTI group (50 000 U/kg), and high-dose UTI group (200 000 U/kg), with 24 rats in each group. Modified cecal ligation and puncture was performed to establish a rat model of sepsis, and the rats in the low- and high-dose UTI groups were given caudal vein injection of UTI after model establishment...
February 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28191382/inadvertent-skipping-of-steroids-in-septic-shock-leads-to-a-diagnosis-of-adult-onset-still-s-disease
#5
Vinoth K Sethuraman, Kavitha Balasubramanian, Stalin Viswanathan, Rajeswari Aghoram
Adult onset Still's disease is uncommon in middle-aged and elderly individuals and can rarely present with shock; shock is usually associated with disseminated intravascular coagulation, multiorgan dysfunction syndrome or acute respiratory distress syndrome. We report a post-menopausal woman with arthritis, fever, pneumonitis and hypotension which was managed as septic shock. Steroids were inadvertently missed during the second day of hospitalization in the intensive care unit. Persistence of hypotension on inotropes, with normal renal, hepatic and neurological function and recurrence of fever when steroids were skipped, led to suspicion of an inflammatory disorder...
January 14, 2017: Curēus
https://www.readbyqxmd.com/read/28178155/complement-mediated-thrombotic-microangiopathy-secondary-to-sepsis-induced-disseminated-intravascular-coagulation-successfully-treated-with-eculizumab-a-case-report
#6
Tomohiro Abe, Akira Sasaki, Taichiro Ueda, Yoshitaka Miyakawa, Hidenobu Ochiai
Secondary thrombotic microangiopathies (TMAs) are induced by several underlying conditions; most are resolved by treating background disease. Eculizumab is a human monoclonal antibody that blocks the final stage of the complement system and effectively treats atypical hemolytic uremic syndrome (aHUS). In this report, we present a patient with TMA secondary to sepsis- induced coagulopathy, who was successfully treated with eculizumab.A 44-year-old woman, who had no special medical history or familial history of TMAs, was admitted on suspicion of septic shock...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28166112/endogenous-thrombin-potential-as-marker-of-procoagulant-response-that-can-be-useful-in-early-stage-of-sepsis
#7
Dunja Mihajlovic, Snezana Brkic, Dajana Lendak, Aleksandra Novakov Mikic, Biljana Draskovic, Gorana Mitic
Sepsis is associated with complex procoagulant and anticoagulant changes that modify inflammatory response. Identification of coagulation markers that can differentiate useful procoagulant response from adverse alteration of clotting mechanism in patient with sepsis. In total, 150 patients who fulfilled criteria for diagnosis of sepsis were included in this study. Patients were categorized in two groups according to sepsis severity in the first 24 h from intensive care unit admission: sepsis and septic shock...
February 3, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28149244/monitoring-and-treatment-of-coagulation-abnormalities-in-burn-patients-an-international-survey-on-current-practices
#8
A Lavrentieva, N Depetris, E Kaimakamis, M Berardino, M Stella
The magnitude of coagulation abnormalities, and the definition and treatment of coagulopathy in burn patients are inadequately understood and continue to be discussed in the literature. We aimed to analyse physicians' views on monitoring and treating coagulation abnormalities in burn patients. A total of 350 questionnaires were distributed electronically to burn ICU physicians. Participation was voluntary and anonymous. Responses were analysed electronically and comparisons were made according to the region of the ICU or the specialty of the physician...
September 30, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28138127/sepsis-net-induced-coagulation-induces-organ-damage-in-sepsis
#9
Susan J Allison
No abstract text is available yet for this article.
January 31, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28130261/impact-of-thrombosis-on-pulmonary-endothelial-injury-and-repair-following-sepsis
#10
Colin Evans, You-Yang Zhao
The prevailing morbidity and mortality in sepsis are largely due to multiple organ dysfunction (MOD), most commonly lung injury, as well as renal and cardiac dysfunction. Despite recent advances in defining many aspects of the pathogenesis of sepsis-related MOD, including acute respiratory distress syndrome (ARDS), there are currently no effective pharmacological or cell-based treatments for the disease. Human and animal studies have shown that pulmonary thrombosis is common in sepsis-induced ARDS, and pre-clinical studies have shown that anti-coagulation may improve outcome following sepsis challenge...
January 27, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28122835/risk-of-disseminated-intravascular-coagulation-in-patients-with-type-2-diabetes-mellitus-retrospective-cohort-study
#11
Kenichiro Nogami, Isao Muraki, Hironori Imano, Hiroyasu Iso
OBJECTIVES: To determine quantitatively the association between type 2 diabetes mellitus (T2DM) and disseminated intravascular coagulation (DIC). DESIGN: Retrospective cohort study using a claims database. SETTING: Medical care institutions representing 9% of all secondary hospitals (acute care hospitals) in Japan. PARTICIPANTS: In total, 797 324 admissions, comprising 435 354 patients aged 18-79 years at the time of admission, were enrolled between January 2010 and September 2014...
January 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/28107024/the-host-response-in-sepsis-patients-developing-intensive-care-unit-acquired-secondary-infections
#12
Lonneke A van Vught, Maryse A Wiewel, Arie J Hoogendijk, Jos F Frencken, Brendon P Scicluna, Peter M C Klein Klouwenberg, Aeilko H Zwinderman, Rene Lutter, Janneke Horn, Marcus J Schultz, Marc M J Bonten, Olaf L Cremer, Tom van der Poll
RATIONALE: Sepsis can be complicated by secondary infections. We explored the possibility that sepsis patients developing a secondary infection while in the Intensive Care Unit (ICU) display sustained inflammatory, vascular and procoagulant responses. OBJECTIVE: To compare systemic proinflammatory host responses in patients with sepsis who acquire a new infection with those who do not. METHODS: Consecutive sepsis patients with a length of ICU stay >48 hours were prospectively analyzed for the development of ICU-acquired infections...
January 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28094478/fluid-management-in-cardiac-surgery-patients-pitfalls-challenges-and-solutions
#13
Elena Bignami, Marcello Guarnieri, Marco Gemma
Fluid administration is a powerful tool for hemodynamic stabilization as it increases preload and improves cardiac function in fluid-responsive patients. However, there are various types of fluid to choose from. The use of colloids and crystalloids in non-cardiac Intensive Care Units (ICU) has been reported, showing controversial results. Many trials on sepsis in a non-cardiac ICU setting show that colloids, in particular hydroxyethyl starches and gelatins, might have a detrimental effect on kidney function, and on major outcomes such as mortality...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28092405/thrombin-contributes-to-protective-immunity-in-pneumonia-derived-sepsis-via-fibrin-polymerization-and-platelet-neutrophil-interactions
#14
T A M Claushuis, S F de Stoppelaar, I Stroo, J J T H Roelofs, R Ottenhoff, T van der Poll, C Van't Veer
: Essentials Immunity and coagulation are linked during sepsis but the role of thrombin is not fully elucidated. We investigated the effect of thrombin inhibition on murine Klebsiella pneumosepsis outcome. Thrombin is crucial for survival and limiting bacterial growth in pneumonia derived sepsis. Thrombin improves host defense via fibrin and enhancement of platelet-neutrophil interactions. SUMMARY: Background Innate immunity and coagulation are closely linked during sepsis...
January 16, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28079606/relationship-between-alternative-resuscitation-strategies-host-response-and-injury-biomarkers-and-outcome-in-septic-shock-analysis-of-the-protocol-based-care-for-early-septic-shock-study
#15
John A Kellum, Francis Pike, Donald M Yealy, David T Huang, Nathan I Shapiro, Derek C Angus
OBJECTIVES: The Protocol-based Care for Early Septic Shock trial found no differences across alternative resuscitation strategies in all-cause mortality. A separate aim was to determine whether differences in resuscitation strategies affected trajectories of biomarkers of key pathways associated with downstream clinical outcomes of sepsis and whether there were differences in survival across treatment arms for patients with different baseline biomarker profiles. DESIGN: Secondary analysis of a large randomized clinical trial...
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28079604/prior-use-of-calcium-channel-blockers-is-associated-with-decreased-mortality-in-critically-ill-patients-with-sepsis-a-prospective-observational-study
#16
Maryse A Wiewel, Lonneke A van Vught, Brendon P Scicluna, Arie J Hoogendijk, Jos F Frencken, Aeilko H Zwinderman, Janneke Horn, Olaf L Cremer, Marc J Bonten, Marcus J Schultz, Tom van der Poll
OBJECTIVES: Experimental studies suggest that calcium channel blockers can improve sepsis outcome. The aim of this study was to determine the association between prior use of calcium channel blockers and the outcome of patients admitted to the ICU with sepsis. DESIGN: A prospective observational study. SETTING: The ICUs of two tertiary care hospitals in the Netherlands. PATIENTS: In total, 1,060 consecutive patients admitted with sepsis were analyzed, 18...
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28078348/the-fifth-epidermal-growth-factor-like-region-of-thrombomodulin-alleviates-lps-induced-sepsis-through-interacting-with-g-protein-coupled-receptor-15
#17
Bin Pan, Xiangmin Wang, Shinsuke Kojima, Chie Nishioka, Akihito Yokoyama, Goichi Honda, Kailin Xu, Takayuki Ikezoe
Thrombomodulin (TM) exerts cytoprotection via the fifth region of epidermal growth factor (EGF)-like domain of TM (TME5) by interacting with G-protein coupled receptor 15 (GPR15) expressed on cell surface of vascular endothelial cells. TM is also implied to mediate anti-inflammatory functions by unknown mechanism. By applying a lipopolysaccharide (LPS)-induced murine sepsis model, we assessed the role of TME5 in septic inflammation and coagulation. We found that TME5 treatment protected mice in association with ameliorating inflammation and coagulopathy in LPS-induced sepsis...
January 12, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28073784/platelets-and-neutrophil-extracellular-traps-collaborate-to-promote-intravascular-coagulation-during-sepsis-in-mice
#18
Braedon McDonald, Rachelle P Davis, Seok-Joo Kim, Mandy Tse, Charles T Esmon, Elzbieta Kolaczkowska, Craig N Jenne
Neutrophil extracellular traps (NETs; webs of DNA coated in anti-microbial proteins) are released into the vasculature during sepsis where they contribute to host defense, but also cause tissue damage and organ dysfunction. Various components of NETs have also been implicated as activators of coagulation. Using multi-color confocal intravital microscopy in mouse models of sepsis, we observed profound platelet aggregation, thrombin activation, and fibrin clot formation within (and downstream of) NETs in vivo...
January 10, 2017: Blood
https://www.readbyqxmd.com/read/28043040/rho-kinase-inhibitor-treatment-prevents-pulmonary-inflammation-and-coagulation-in-lipopolysaccharide-induced-lung-injury
#19
Renyu Ding, Dongmei Zhao, Xiaoxia Li, Baoyan Liu, Xiaochun Ma
INTRODUCTION: In the pathogenesis of sepsis-induced acute lung injury (ALI), the crosstalk between inflammation and coagulation plays a pivotal role. The aim of this study was to investigate the role of Rho kinase (ROCK) inhibitor in alleviating pulmonary inflammation and coagulation in lipopolysaccharide (LPS)-induced acute lung injury (ALI) models. METHODS: In the in vivo study, mice were randomized to four different groups: Control, Y-27632 (Y), LPS, and LPS+Y-27632 (LPS+Y)...
February 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28029716/inactivation-of-human-coagulation-factor-x-by-a-protease-of-the-pathogen-capnocytophaga-canimorsus
#20
K Hack, F Renzi, E Hess, F Lauber, J Douxfils, J M Dogné, G R Cornelis
BACKGROUND: Capnocytophaga canimorsus is a Gram-negative bacterium, which belongs to the oral flora of dogs and causes fulminant sepsis in humans who have been bitten, licked or scratched. In patients, bleeding abnormalities, such as petechiae, purpura fulminans or disseminated intravascular coagulation (DIC) occur frequently. OBJECTIVE: We investigated whether C. canimorsus could actively contribute to these bleeding abnormalities. METHODS: Calibrated automated thrombogram and clotting time assays were performed to assess the anticoagulant activity of C...
December 28, 2016: Journal of Thrombosis and Haemostasis: JTH
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