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Sepsis and coagulation

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https://www.readbyqxmd.com/read/28514870/biomarker-profile-of-sepsis-associated-coagulopathy-using-biochip-assay-for-inflammatory-cytokines
#1
Amanda Walborn, Debra Hoppensteadt, Daneyal Syed, Michael Mosier, Jawed Fareed
Disseminated intravascular coagulation (DIC) is a major pathophysiological mechanism of sepsis and greatly increases the risk of death in septic patients. Disseminated intravascular coagulation is a complex physiological phenomenon that involves inappropriate activation of coagulation, inflammation, and endothelial processes. The purpose of this study was to analyze the levels of inflammatory cytokines in the plasma of patients with DIC in order to compare the measured levels with those from healthy individuals, draw correlations, and provide a basis for further biomarker panel development...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28492702/low-plasma-fvii-c-and-activated-fvii-as-predictive-markers-for-overt-disseminated-intravascular-coagulation
#2
Surapong Lertthammakiat, Nattachai Anantasit, Usanarat Anurathapan, Nongnuch Sirachainan, Praguywan Kadegasem, Ampaiwan Chuansumrit
In sepsis, binding of factor VII (FVII:C) and activated factor VII (FVIIa) with tissue factor is the key step of coagulation resulting in disseminated intravascular coagulation (DIC). We conducted a prospective cohort study among 47 septic patients, aged 8 months to 18.8 years. They were initially divided into three groups of no DIC (n=27), non-overt DIC (n=14) and overt DIC (n=6). Blood samples were collected at 0, 24 and 48 hours (h) after the onset of sepsis. At the onset of sepsis, FVII:C tended to be lower in the non-overt DIC [median 57 % (interquartile range [IQR] 41-80)] and overt DIC groups [33 % (23-52)] than that in the no DIC group [65 % (44-87)]...
May 11, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28492700/coagulation-factor-xi-improves-host-defence-during-murine-pneumonia-derived-sepsis-independent-of-factor-xii-activation
#3
Ingrid Stroo, Sacha Zeerleder, Chao Ding, Brenda M Luken, Joris J T H Roelofs, Onno J de Boer, Joost C M Meijers, Francis J Castellino, Cornelis van 't Veer, Tom van der Poll
Bacterial pneumonia, the most common cause of sepsis, is associated with activation of coagulation. Factor XI (FXI), the key component of the intrinsic pathway, can be activated via factor XII (FXII), part of the contact system, or via thrombin. To determine whether intrinsic coagulation is involved in host defence during pneumonia and whether this is dependent on FXII activation, we infected in parallel wild-type (WT), FXI knockout (KO) and FXII KO mice with two different clinically relevant pathogens, the Gram-positive bacterium Streptococcus pneumoniae and the Gram-negative bacterium Klebsiella pneumoniae, via the airways...
May 11, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28479018/levosimendan-mitigates-coagulopathy-and-organ-dysfunction-in-rats-with-endotoxemia
#4
Hsieh-Chou Huang, Hsin-Jung Tsai, Chao-Chun Wang, Cheng-Ming Tsao, Shuk-Man Ka, Wen-Jinn Liaw, Chin-Chen Wu
BACKGROUND: In patients with severe sepsis, pro-inflammatory cytokines and subsequent activation of tissue factors trigger a cascade of events that lead to coagulation dysfunction and multiple organ failure. It has been shown that levosimendan has protective effects against tissue injury caused by endotoxin. The purpose of this study was to evaluate the effects of levosimendan on consumptive coagulopathy and organ dysfunction in an endotoxemic animal model induced by lipopolysaccharide (LPS)...
May 3, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28476929/the-case-of-the-mysterious-vanishing-spleen-autosplenectomy-complicating-pneumococcal-sepsis
#5
Georgina Moritz, Megan Jenkins, Dushyant Shetty, Julie Blundell
A 57-year-old previously healthy fisherman was admitted in fulminant pneumococcal septic shock, with disseminated intravascular coagulation, requiring aggressive management including bilateral below-knee amputations for ischaemic necrosis. He began to recover and was discharged for rehabilitation, however during his convalescence was found to be hypercalcaemic. No malignancy was found on CT scan, but it was noted that his spleen was absent, replaced by a 4 cm smooth-walled, fluid-filled lesion. This was unexpected as an ultrasound in intensive care 10 weeks previously had demonstrated a normal spleen...
May 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28465231/rac1-regulates-sepsis-induced-formation-of-platelet-derived-microparticles-and-thrombin-generation
#6
Yongzhi Wang, Lingtao Luo, Matthias Mörgelin, Henrik Thorlacius
Dysfunctional coagulation aggravates clinical outcome in patients with sepsis. The aim of this study was to define the role of Rac-1 in the formation of platelet-derived microparticles (PMPs) and thrombin generation (TG) in abdominal sepsis. Male C57BL/6 mice underwent cecal ligation and puncture (CLP). Scanning electron microscopy and flow cytometry were used to quantify PMPs. TG was determined by use of a fluorimetric assay. It was found that CLP increased Rac1 activity in platelets, which was abolished by administration of the Rac1 inhibitor NSC23766...
June 10, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28458067/effect-of-liberal-blood-transfusion-on-clinical-outcomes-and-cost-in-spine-surgery-patients
#7
Taylor E Purvis, C Rory Goodwin, Rafael De la Garza-Ramos, A Karim Ahmed, Virginie Lafage, Brian J Neuman, Peter G Passias, Khaled M Kebaish, Steven M Frank, Daniel M Sciubba
BACKGROUND CONTEXT: Blood transfusions in spine surgery are shown to be associated with increased patient morbidity. The association between transfusion performed using a liberal hemoglobin (Hb) trigger-defined as an intraoperative Hb level of ≥10 g/dL, a postoperative level of ≥8 g/dL, or a whole hospital nadir between 8 and 10 g/dL-and perioperative morbidity and cost in spine surgery patients is unknown and thus was investigated in this study. PURPOSE: This study aimed to describe the perioperative outcomes and economic cost associated with liberal Hb trigger transfusion among spine surgery patients...
April 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28457334/plasma-dna-and-rna-differentially-impact-coagulation-during-abdominal-sepsis-an-explorative-study
#8
Emmanuel Schneck, Omar Samara, Christian Koch, Andreas Hecker, Winfried Padberg, Christoph Lichtenstern, Markus Alexander Weigand, Florian Uhle
BACKGROUND: Cell-free DNA (cfDNA) and extracellular RNA (exRNA) are both suspected to activate coagulation cascades in sepsis. Therefore, our study investigated the influence of plasmatic nucleic acids on coagulation in septic patients in comparison to patients after major abdominal surgery. MATERIALS AND METHODS: A total of 15 patients with sepsis, 10 postoperative patients, and 10 healthy volunteers were included in this longitudinal study. Blood was collected at sepsis onset and after surgery respectively, as well as after 24, 72 and 168 h...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28448952/sepsis-and-septic-shock-pathogenesis-and-treatment-perspectives
#9
REVIEW
Hayk Minasyan
The majority of bacteremias do not develop to sepsis: bacteria are cleared from the bloodstream. Oxygen released from erythrocytes and humoral immunity kill bacteria in the bloodstream. Sepsis develops if bacteria are resistant to oxidation and proliferate in erythrocytes. Bacteria provoke oxygen release from erythrocytes to arterial blood. Abundant release of oxygen to the plasma triggers a cascade of events that cause: 1. oxygen delivery failure to cells; 2. oxidation of plasma components that impairs humoral regulation and inactivates immune complexes; 3...
April 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28447577/prognostic-value-of-adamts13-in-patients-with-severe-sepsis-and-septic-shock
#10
M Feroz Azfar, M Faisal Khan, S Shahid Habib, Z Al Aseri, A Mohammad Zubaidi, D Ocampo Aguila, M Owais Suriya, Hameed Ullah
PURPOSE: ADAMTS13 level was evaluated as a predictor of mortality in patients with severe sepsis and septic shock, and compared with Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. METHODS: This prospective observational study was conducted in the Medical and Surgical Intensive Care Units of King Khalid University Hospital. Detailed clinical evaluations were performed on 84 patients (56.08±18.18 years of age) with severe sepsis and septic shock...
April 26, 2017: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/28444588/unveiling-differentially-expressed-genes-upon-regulation-of-transcription-factors-in-sepsis
#11
Junli Zhang, Yuelei Cheng, Minmin Duan, Nannan Qi, Jian Liu
In this study, we integrated the gene expression data of sepsis to reveal more precise genome-wide expression signature to shed light on the pathological mechanism of sepsis. Differentially expressed genes via integrating five microarray datasets from the Gene Expression Omnibus database were obtained. The gene function and involved pathways of differentially expressed genes (DEGs) were detected by GeneCodis3. Transcription factors (TFs) targeting top 20 dysregulated DEGs (including up- and downregulated genes) were found based on the TRANSFAC...
May 2017: 3 Biotech
https://www.readbyqxmd.com/read/28430304/pre-ecmo-coagulopathy-does-not-increase-the-occurrence-of-hemorrhage-during-extracorporeal-support
#12
Pilar Anton-Martin, Lakshmi Raman, Nikhil Thatte, Jefferson Tweed, Vinai Modem, Janna Journeycake
INTRODUCTION AND METHODS: Observational retrospective cohort study to evaluate the association between precannulation coagulopathy and the occurrence of hemorrhage during extracorporeal membrane oxygenation (ECMO) in neonatal and pediatric patients at a tertiary children's hospital. RESULTS: Of 241 patients supported with ECMO between January 2009 and December 2014, 175 (72.6%) had precannulation coagulation laboratory data and were included in the study. Of the eligible patients, 84 (48%) were identified as coagulopathic and 91 (52%) were noncoagulopathic...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28428949/p2x1-p2x4-and-p2x7-receptor-knock-out-mice-expose-differential-outcome-of-sepsis-induced-by-%C3%AE-haemolysin-producing-escherichia-coli
#13
Anne-Sofie Greve, Marianne Skals, Steen K Fagerberg, Wulf Tonnus, Svend Ellermann-Eriksen, Richard J Evans, Andreas Linkermann, Helle A Praetorius
α-haemolysin (HlyA)-producing Escherichia coli commonly inflict severe urinary tract infections, including pyelonephritis, which comprises substantial risk for sepsis. In vitro, the cytolytic effect of HlyA is mainly mediated by ATP release through the HlyA pore and subsequent P2X1/P2X7 receptor activation. This amplification of the lytic process is not unique to HlyA but is observed by many other pore-forming proteins including complement-induced haemolysis. Since free hemoglobin in the blood is known to be associated with a worse outcome in sepsis one could speculate that inhibition of P2X receptors would ameliorate the course of sepsis...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28425162/a-small-lick-will-sink-a-great-ship-fulminant-septicaemia-after-dog-saliva-wound-treatment-in-an-asplenic-patient
#14
Evi M Morandi, Reinhard Pauzenberger, Christoph Tasch, Ulrich M Rieger, Gerhard Pierer, Gabriel Djedovic
Capnocytophaga canimorsus is a bacterium transmitted through the saliva of dogs. An infection can cause severe sepsis with acral necrosis and is potentially fatal. Here, we report the case of a 41-year-old man who was infected through a wound that was licked by his dog. He went into septic shock with disseminated intravascular coagulation and subsequently lost both lower legs, his nose and all the fingers on both hands.
April 19, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28416934/sepsis-and-septic-shock-current-treatment-strategies-and-new-approaches
#15
REVIEW
Gizem Polat, Rustem Anil Ugan, Elif Cadirci, Zekai Halici
Sepsis is a complex condition characterized by the simultaneous activation of inflammation and coagulation in response to microbial insult. These events manifest as systemic inflammatory response syndrome or sepsis symptoms through the release of proinflammatory cytokines, procoagulants, and adhesion molecules from immune cells and/or damaged endothelium. Today, sepsis is a severe multisystem disease with difficult treatments for its manifestations and high mortality rates. In the last two decades in particular, many studies have been conducted on sepsis that cause shock, multiorgan dysfunction, and organ failure by especially leading to hemodynamic changes...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28412927/widespread-subcutaneous-necrosis-in-spotted-fever-group-rickettsioses-from-the-coastal-belt-of-sri-lanka-a-case-report
#16
Nathasha Luke, Hasini Munasinghe, Lakshmi Balasooriya, Ranjan Premaratna
BACKGROUND: Spotted fever group rickettsioses (SFGR) transmitted mostly by ticks are increasingly discovered around the World and some of them are either re-emerging or emerging in Sri Lanka. Accidental human infections caused by these vector borne zoonotic diseases generally give rise to nonspecific acute febrile illnesses which can be complicated by multi organ involvement carrying high morbidity and mortality. Nonspecific clinical features and non-availability of early diagnostic facilities are known to result in delay in the diagnosis of rickettsial infections...
April 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28409836/platelet-derived-microparticles-regulates-thrombin-generation-via-phophatidylserine-in-abdominal-sepsis
#17
Yongzhi Wang, Su Zhang, Lingtao Luo, Eva Norström, Oscar Ö Braun, Matthias Mörgelin, Henrik Thorlacius
Sepsis is associated with dysfunctional coagulation. Recent data suggest that platelets play a role in sepsis by promoting neutrophil accumulation. Herein, we show that cecal ligation and puncture (CLP) triggered systemic inflammation, which is characterized by formation of IL-6 and CXC chemokines as well as neutrophil accumulation in the lung. Platelet depletion decreased neutrophil accumulation, IL-6 and CXC chemokines formation in septic lungs. Depletion of platelets increased peak thrombin formation and total thrombin generation (TG) in plasma from septic animals...
April 14, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/28408302/pharmacokinetics-of-linezolid-during-continuous-hemodiafiltration-a-case-report
#18
Takuya Yamashina, Moeko Tsuruyama, Miki Odawara, Minako Tsuruta, Hirochika Miyata, Aki Kozono, Yasuhiro Tsuji, Takanori Miyoshi, Yosei Kawamata, Yoichi Hiraki
The pharmacokinetics of linezolid clearance (CLLZD) during continuous hemodiafiltration (CHDF) has not been comprehensively analyzed. Here, we examined CLLZD by CHDF in a patient with septic shock and disseminated intravascular coagulation due to methicillin-resistant Staphylococcus aureus. The extraction ratio of LZD by CHDF was 22.6%, and the protein-binding rate was 17.9% ± 7.7%. In addition, it was determined that the calculated total body clearance of LZD was 30.2 mL/min, plasma elimination half-life was 8...
April 10, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28397655/-liver-failure-in-neonatal-children-is-a-diagnostic-challenge
#19
Heidi Smedegaard, Vibeke Brix Christensen, Morten Hanefeld Dziegiel, Marianne Hørby Jørgensen
This case report presents a newborn boy with hypoglycaemia, anaemia, jaundice and severe coagulopathy during the first day of his life, imitating sepsis and disseminated intravascular coagulation. One week after the birth he was diagnosed with acute liver failure due to gestational alloimmune liver disease (GALD). Despite the fact that GALD is rare, it must be suspected in all unexplained stillborn children and infants with severe liver disease. If diagnosed, it is possible to prevent death and severe liver failure in future newborns by treating the affected women with immunoglobulin during pregnancy...
March 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28355654/experience-of-point-of-care-devices-in-obstetrical-care
#20
Ove Karlsson
During pregnancy and puerperium, there are pronounced hemostatic changes characterized by increased coagulability and decreased fibrinolysis. In addition, hemostasis can change dramatically during obstetric complications. Several reports have described substandard management of hemostatic defects in this setting and state the need for guidelines and better care. Point-of-care devices can assess hemostatic status and are especially suitable in perioperative settings. Using point-of-care devices, no time is required for transportation, allowing faster availability of results and providing potential for better care of the patient...
March 29, 2017: Seminars in Thrombosis and Hemostasis
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