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Sepsis and coagulation

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https://www.readbyqxmd.com/read/29349709/the-host-response-in-critically-ill-sepsis-patients-on-statin-therapy-a-prospective-observational-study
#1
Maryse A Wiewel, Brendon P Scicluna, Lonneke A van Vught, Arie J Hoogendijk, Aeilko H Zwinderman, René Lutter, Janneke Horn, Olaf L Cremer, Marc J Bonten, Marcus J Schultz, Tom van der Poll
BACKGROUND: Statins can exert pleiotropic anti-inflammatory, vascular protective and anticoagulant effects, which in theory could improve the dysregulated host response during sepsis. We aimed to determine the association between prior statin use and host response characteristics in critically ill patients with sepsis. METHODS: We performed a prospective observational study in 1060 patients admitted with sepsis to the mixed intensive care units (ICUs) of two hospitals in the Netherlands between January 2011 and July 2013...
January 18, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29346034/coagulopathy-in-severe-sepsis-interconnectivity-of-coagulation-and-the-immune-system
#2
Jason M Samuels, Hunter B Moore, Ernest E Moore
BACKGROUND: Disseminated intravascular coagulation (DIC) remains a challenging complication of infection with inadequate treatment and significant morbidity and mortality rates. METHODS: Review of the English-language literature. RESULTS: Disseminated intravascular coagulation arises from the immune system's response to microbial invasion, as well as the byproducts of cell death that result from severe sepsis. This response triggers the coagulation system through an interconnected network of cellular and molecular signals, which developed originally as an evolutionary mechanism intended to isolate micro-organisms via fibrin mesh formation...
January 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29343993/management-of-disseminated-intravascular-coagulation-current-insights-on-antithrombin-and-thrombomodulin-treatments
#3
REVIEW
Mineji Hayakawa
Sepsis and septic shock are frequently complicated by disseminated intravascular coagulation (DIC), which decreases the survival rate of patients with sepsis. In the past, large international randomized controlled trials (RCTs) using physiological anticoagulants for sepsis-induced DIC were not performed; however, RCTs have been conducted for sepsis and/or septic shock. In these trials, physiological anticoagulants did not show any beneficial effects compared with placebo for the treatment of sepsis and/or septic shock...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29329022/impact-of-non-anticoagulant-therapy-on-patients-with-sepsis-induced-disseminated-intravascular-coagulation-a-multicenter-case-control-study
#4
Daisuke Kudo, Mineji Hayakawa, Kota Ono, Kazuma Yamakawa
INTRODUCTION: Anticoagulant therapy for patients with sepsis is not recommended in the latest Surviving Sepsis Campaign guidelines, and non-anticoagulant therapy is the global standard treatment approach at present. We aimed at elucidating the effect of non-anticoagulant therapy on patients with sepsis-induced disseminated intravascular coagulation (DIC), as evidence on this topic has remained inconclusive. MATERIALS AND METHODS: Data from 3195 consecutive adult patients admitted to 42 intensive care units for the treatment of severe sepsis were retrospectively analyzed via propensity score analyses with and without multiple imputation...
January 3, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29308942/bilateral-orbital-compartment-syndrome-in-a-patient-with-disseminated-intravascular-coagulation
#5
Sonia Huang, Michelle T Sun, Davis Garry, Fitzgerald Jude, Selva Dinesh, Tim Henderson
A 39-year-old male developed bilateral periorbital oedema and tense orbits in keeping with orbital compartment syndrome (OCS) shortly after presenting to the emergency department for uncontrollable epistaxis. Bilateral lateral canthotomy and inferior cantholysis was performed within 30 minutes of onset, with the left side further decompressed via superior cantholysis. Computed tomography demonstrated bilateral proptosis and optic nerve stretch, but no intraorbital haemorrhage or haematoma. Laboratory findings were consistent with disseminated intravascular coagulation (DIC) and sepsis of unknown origin...
January 8, 2018: Orbit
https://www.readbyqxmd.com/read/29308782/septic-miscarriage-with-toxic-shock-syndrome-and-disseminated-intravascular-coagulation-dic-the-role-of-surgery-recombinant-activated-factor-vii-and-intravenous-immunoglobulin-ivig
#6
L N Tan, G Mariappa, H Y Voon, H Suharjono
Severe sepsis with multi-organ failure is associated with a high mortality rate. This case report highlights the challenges and modalities available in the management of a lady with refractory shock and disseminated intravascular coagulation (DIC) due to toxic shock syndrome (TSS) from genital tract sepsis. Early surgical intervention to remove the source of infection, the use of recombinant activated factor VII to treat intractable disseminated intravascular coagulation and intravenous immunoglobulin to neutralise the circulating exotoxins, have been employed and shown to drastically improve outcomes...
December 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/29307969/thrombocytopenia-in-critically-ill-patients-clinical-and-laboratorial-behavior-and-its-correlation-with-short-term-outcome-during-hospitalization
#7
Divya Khurana, Shilpa A Deoke
Background: Thrombocytopenia, being among the most common laboratory abnormality, found in Intensive Care Unit (ICU) patients is commonly associated with sepsis and disseminated intravascular coagulation. Declining platelet counts are associated with higher mortality rates. Thus, thrombocytopenia can be used as a prognostic marker in critically ill patients. Methodology: A prospective observational study was conducted on patients fulfilling the inclusion criteria and were evaluated for complete medical history, clinical, and laboratorial examination...
December 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29306986/d-dimer-as-a-marker-of-acute-pyelonephritis-in-infants-younger-than-24%C3%A2-months-with-urinary-tract-infection
#8
Jung Won Lee, Sun Mi Her, Ji Hong Kim, Keum Hwa Lee, Michael Eisenhut, Se Jin Park, Jae Il Shin
BACKGROUND: D-dimer, as well as other biomarkers related to coagulation, is significantly increased during severe bacterial infection and sepsis. The aim of this study was to evaluate the usefulness of serum D-dimer as a biological marker in diagnosing acute pyelonephritis (APN) and in predicting vesicoureteric reflux (VUR) in infants with urinary tract infection (UTI). METHODS: We retrospectively analyzed the data of 177 young infants (<2 years) with febrile UTI between 2005 and 2014, grouped as APN and lower UTI groups...
January 6, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29302904/acute-kidney-injury-in-pregnancy-with-special-reference-to-pregnancy-specific-disorders-a-hospital-based-study-2014-2016
#9
Jai Prakash, Vivek C Ganiger, Suraj Prakash, Mohammad Iqbal, Deba Prasad Kar, Usha Singh, Ashish Verma
INTRODUCTION: There are numerous reports in the literature describing acute kidney injury in pregnancy (P-AKI) due to various obstetric complications. However, there is a dearth of studies on AKI related to pregnancy-specific disorders from India. We aimed to analyze clinical features and outcome of P-AKI related to pregnancy-specific disorders compared to total pregnancy, in India. METHOD: All pregnant women attending the department of Obstetrics and Gynecology from November 2014 to July 2016 were screened for AKI based on: (1) sudden elevation of serum creatinine ≥ 1 mg/dl; (2) oligoanuria for > 12 h; and (3) need for dialysis...
January 4, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29297814/coagulation-assessment-underutilized-diagnostic-tools-in-zoo-and-aquatic-animal-medicine
#10
Trevor J Gerlach, Ashley Barratclough, Bobbi Conner
Veterinarians specializing in nondomestic species are faced with unique challenges regarding research and diagnostic capabilities given the wild and frequently dangerous nature of their patients. Standard diagnostic techniques used in small or large animal practice are not always possible due to anatomical constraints, size, tractability, or the inherent risk of anesthesia in highly valued, rare species. Diagnostic modalities that utilize simple, relatively noninvasive techniques show promise in evaluating nondomestic species and elucidating the pathophysiology behind poorly characterized disease processes in both wild and captive populations...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29285085/unfractionated-heparin-protects-the-protein-c-system-against-lipopolysaccharide-induced-damage-in-vivo-and-in-vitro
#11
Dongmei Zhao, Renyu Ding, Yina Liu, Xiaohan Yin, Zhidan Zhang, Xiaochun Ma
Activation of protein C is greatly enhanced by the presence of thrombomodulin (TM) and endothelial protein C receptor (EPCR) on the endothelial surface. Impairment of the anticoagulant protein C system occurs during endotoxemia and contributes to sepsis-associated hypercoagulability. Previous studies have demonstrated that unfractionated heparin (UFH) can attenuate coagulation in endotoxemic mice. However, whether UFH has an effect on the protein C system remains to be elucidated. The current study evaluated the therapeutic effect of UFH on the protein C system in a mouse model of lipopolysaccharide (LPS)-induced sepsis, and further investigated the effect of UFH on the expression of TM and EPCR in vitro using human umbilical vein endothelial cells (HUVECs)...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29273917/recent-advances-in-the-pathogenetic-mechanisms-of-sepsis-associated-acute-kidney-injury
#12
REVIEW
Filippo Fani, Giuseppe Regolisti, Marco Delsante, Vincenzo Cantaluppi, Giuseppe Castellano, Loreto Gesualdo, Gianluca Villa, Enrico Fiaccadori
Sepsis is a serious medical condition that can lead to multi-organ failure and shock, and it is associated with increased mortality. Acute kidney injury (AKI) is a frequent complication of sepsis in critically ill patients, and often requires renal replacement therapy. The pathophysiology of AKI in sepsis has not yet been fully defined. In the past, classic theories were mainly focused on systemic hemodynamic derangements, underscoring the key role of whole kidney hypoperfusion due to reduced renal blood flow...
December 23, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/29251820/staphylococcus-aureus-master-manipulator-of-the-human-hemostatic-system
#13
REVIEW
Laurens Liesenborghs, Peter Verhamme, Thomas Vanassche
The coagulation system does not only offer protection against bleeding, but also aids in our defense against invading microorganisms. The hemostatic system and innate immunity are strongly entangled, which explains why so many infections are complicated by either bleeding or thrombosis. Staphylococcus aureus (S. aureus), currently the most deadly infectious agent in the developed world, causes devastating intravascular infections like sepsis and infective endocarditis. During these infections S. aureus comes in close contact with host hemostatic system and proves to be a master in manipulating coagulation...
December 18, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29246581/combined-therapy-with-gas-gangrene-antitoxin-and-recombinant-human-soluble-thrombomodulin-for-clostridium-perfringens-sepsis-in-a-rat-model
#14
Toru Hifumi, Daisuke Nakano, Joe Chiba, Motohide Takahashi, Akihiko Yamamoto, Yoshihide Fujisawa, Kenya Kawakita, Yasuhiro Kuroda, Akira Nishiyama
Cases of Clostridium perfringens septicemia, such as liver abscess, often develop a rapidly progressive intravascular hemolysis and coagulation; the mortality rate with current standard care including antibiotics and surgery is high. Herein, we firstly investigated the effects of gas gangrene antitoxin (GGA) (antitoxin against C. perfringens) and recombinant human soluble thrombomodulin (rTM) on the hemolysis, coagulation status, inflammatory process, and mortality in α-toxin-treated rats. Male 11-week-old Sprague Dawley rats were randomly divided into five groups: control group, α-toxin group, GGA group, rTM group, and combined GGA and rTM (combination group)...
December 12, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29245350/a-case-report-of-patient-with-severe-acute-cholangitis-with-tigecycline-treatment-causing-coagulopathy-and-hypofibrinogenemia
#15
Xiaoqin Wu, Ping Zhao, Liang Dong, Xiuhong Zhang
RATIONALE: Tigecycline is the first member of the glycylcycline family. There are rarely reports of tigecycline causing coagulopathy and hypofibrinogenemia until now. We report a case on tigecycline-associated coagulopathy and hypofibrinogenemia and discuss the characteristics of the adverse reaction. PATIENT CONCERNS: A 47-year-old male patient with severe acute cholangitis who developed sepsis was treated with a high dosage (100 mg twice daily) of tigecycline...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29242228/bmscs-ameliorate-septic-coagulopathy-through-suppressing-inflammation-in-cecal-ligation-and-puncture-induced-sepsis
#16
Shunyao Xu, Zhen Zhou, Hao Li, Ziying Liu, Xiaojun Pan, Fen Wang, Yueyue Huang, Xiaogang Li, Yunbei Xiao, Jingye Pan, Cong Wang, Dequan Li
Sepsis is an aggressive and life-threatening systemic inflammatory response with a high mortality. Inflammation and coagulation play crucial roles in the pathogenesis of sepsis in a mutually promoting manner. Unlike other single-target molecular therapies that have no obvious effects on clinical sepsis, the bone marrow stromal cell (BMSC) therapy offers a broader spectrum of activities ranging from immune and inflammation suppression to tissue regeneration. In this report, we demonstrated that BMSC injection attenuated the septic coagulopathy...
December 14, 2017: Journal of Cell Science
https://www.readbyqxmd.com/read/29220594/modification-of-immunological-features-in-human-platelets-during-sepsis
#17
Valle-Jiménez Xareni Raque, Sánchez-García Juan Carlos, Revilla-Rodríguez Eduardo, Baltierrez-Hoyos Rafael, Romero-Tlalolini María de Los Ángeles, Ramírez-Cosmes Adriana, Torres-Aguilar Honorio, Bustos-Arriaga José, Aguilar-Ruiz Sergio Roberto
Sepsis is an organic dysfunction that puts at risk the life of patients suffering this disorder due to an exacerbated immunological response to the infection mediated by the host. Platelets have been largely researched on sepsis owing to its role in Disseminated Intracellular Coagulation (DIC) and because thrombocytopenia is an important clinical feature of these patients. Nevertheless, a great number of evidence shows that platelets have also an important role in immunological response since they have pattern recognition receptors, chemokine receptors and granules with stored soluble mediators...
December 8, 2017: Immunological Investigations
https://www.readbyqxmd.com/read/29216953/-significance-of-heparin-in-the-treatment-of-patients-with-sepsis
#18
Qinlong Sun, Erzhen Chen
The latest definition of sepsis (Sepsis-3) is the life-threatening organ dysfunction due to overreaction of immune system caused by infection. The situation can develop into multiple organ dysfunction syndromes (MODS). In the pathological process of pathogen invasion, a large number of inflammatory factors directly damage organ function, while dysfunction of coagulation system is also involved in this process. With the overreaction of inflammation, disseminated intravascular coagulation (DIC) occurred, which further exacerbated organ damage...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29216936/-experimental-basis-and-clinical-practice-of-bacterial-poison-and-cure-sepsis
#19
Zhijun Li, Yinping Li
Since the 20th century, research team of Professor Wang Jinda in the Tianjin First Central Hospital has been using blood circulation drugs to rescue critically ill patients for 70 years. With the deepening of the understanding of sepsis, put forward the "bacteria and inflammation and governance" theory, and the use of blood circulation drugs Xuebijing injection with anti-endotoxin and inflammatory mediators effect in the treatment of sepsis, some clinical efficacy has been found. However, in recent years, the progress of treatment of sepsis at home and abroad is slow, we review a series of animal experiments since the late of 1980s, and found that small thrombosis in the microcirculation and coagulation disorders play a more important role in the development of local infection to sepsis transition...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29215847/-pathogenic-peculiarities-of-disseminated-intravascular-coagulation-of-various-ethiology
#20
E V Guzovskaya, S N Serebrennikova
DIC is a severe complication, often resulting in multi-organ failure and fatal outcome. As any syndrome, it is polyethiologic, while a big number of its causes logically leads to various mechanisms of its forming. Main manifestations of the disseminated intravascular blood coagulation syndrome are clottage and haemorrhage. A result of a massive clottage in microcirculatory bed of internal organs is development of dystrophic changes in them and organ failure. Haemorrhage in its turn, results in decreased volume of circulating blood, arterial hypotension and hemic hypoxia, in most severe cases leading to the fatal outcome...
April 2017: Patologicheskaia Fiziologiia i èksperimental'naia Terapiia
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