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map in sepsis

Donatella Nardiello, Clelia Prattichizzo, Maria Teresa Rocchetti, Loreto Gesualdo, Diego Centonze
A dedicated proteomic approach based on nano-Liquid Chromatography coupled with tandem mass spectrometry in ion trap is proposed for the analysis of proteins trapped in sorbent resin cartridges used to remove inflammatory mediators from blood by coupled plasma filtration adsorption (CPFA). The final purpose of the proposed proteomic approach was to obtain a reference map of plasma proteins trapped in CPFA sorbents used for the extracorporeal blood purification of healthy pigs, with the potential impact to design new bio-filters able to control the inflammatory imbalance under pathological conditions, such as severe sepsis...
October 12, 2016: Journal of Pharmaceutical and Biomedical Analysis
Esther Peters, Bülent Ergin, Asli Kandil, Ebru Gurel-Gurevin, Andrea van Elsas, Rosalinde Masereeuw, Peter Pickkers, Can Ince
Two small clinical trials indicated that administration of bovine intestinal alkaline phosphatase (AP) improves renal function in critically ill patients with sepsis-associated acute kidney injury (AKI), for which the mechanism of action is not completely understood. Here, we investigated the effects of a newly developed human recombinant AP (recAP) on renal oxygenation and hemodynamics and prevention of kidney damage and inflammation in two in vivo AKI models. To induce AKI, male Wistar rats (n=18) were subjected to renal ischemia (30min) and reperfusion (I/R), or sham-operated...
October 16, 2016: Toxicology and Applied Pharmacology
Jochen-Frederick Hernekamp, Florian Neubrech, Tomke Cordts, Volker J Schmidt, Ulrich Kneser, Thomas Kremer
PURPOSE: The clinical course after major burns is characterized by microcirculatory changes and consecutive capillary leakage. However, current clinical monitoring does not properly assess microcirculation, whereas macrohemodynamic changes are continuously evaluated. Here, we assess if macrohemodynamic and microhemodynamic parameters after burn trauma are correlated in a rat model. METHODS: Burn plasma harvested from donor rats 4 hours after thermal injury (30% total body surface area, 100 °C water, 12 seconds) was administered intravenously to healthy animals during 2 hours of intravital microscopy (burn group [BG])...
October 17, 2016: Annals of Plastic Surgery
Zhongheng Zhang, Kun Chen
The article describes some commonly used vasoactive agents in patients with septic shock. Depending on their distinct pharmacological properties, their effects on vascular bed and cardiac function are different. For example, dopamine has equivalent effect on heart and vasculature, which can result in increases in cardiac output, mean arterial pressure and heart rate. Dobutamine is considered as inodilator because it has potent effect on cardiac systole and vasculature. Patients with sepsis and septic shock sometimes have coexisting cardiac dysfunction that justifies the use of dobutamine...
September 2016: Annals of Translational Medicine
Hendry Robert Sawe, Cathryn Haeffele, Juma A Mfinanga, Victor G Mwafongo, Teri A Reynolds
BACKGROUND: Bedside inferior vena cava (IVC) ultrasound has been proposed as a non-invasive measure of volume status. We compared ultrasound measurements of the caval index (CI) and physician gestalt to predict blood pressure response in patients requiring intravenous fluid resuscitation. METHODS: This was a prospective study of adult emergency department patients requiring fluid resuscitation. A structured data sheet was used to record serial vital signs and the treating clinician's impression of patient volume status and cause of hypotension...
2016: PloS One
Ashok Choudhury, Chandan Kumar Kedarisetty, Chitranshu Vashishtha, Deepak Saini, Sachin Kumar, Rakhi Maiwall, Manoj Kumar Sharma, Ajeet Singh Bhadoria, Guresh Kumar, Yogendra Kumar Joshi, Shiv Kumar Sarin
BACKGROUND AND AIMS: The choice of vasopressor for treating cirrhosis with septic shock is unclear. While noradrenaline in general is the preferred vasopressor, terlipressin improves microcirculation in addition to vasopressor action in non-cirrhotics. We compared the efficacy and safety of noradrenaline and terlipressin in cirrhotics with septic shock. PATIENTS AND METHODS: Cirrhotics with septic shock underwent open label randomization to receive either terlipressin (n=42)or noradrenaline (n=42) infusion at a titrated dose...
September 16, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Arisa Miura, Hirofumi Hino, Kazuhide Uchida, Soichiro Inoue, Takeshi Tateda
PURPOSE: The pathological mechanisms of critical illness polyneuropathy (CIP), an acute neuromuscular disorder, remain unknown. In this study, we evaluated nerve and vascular properties that might account for electrophysiological abnormalities, including reduced nerve conduction amplitude, in the early phase of CIP. METHODS: Rats were administered intravenous saline (C-group; n = 31) or lipopolysaccharide (3 mg/kg/day; L-group; n = 30) for 48 h. Subsequently, tracheotomy was performed and sciatic nerves exposed bilaterally...
September 9, 2016: Journal of Anesthesia
Hyun Suk Yang, Mina Hur, Hanah Kim, Laura Magrini, Rossella Marino, Salvatore Di Somma
Soluble suppression of tumorigenicity 2 (sST2) has emerged as a biomarker of cardiac stretch or remodeling, and has demonstrated a role in acutely decompensated heart failure. However, its role in sepsis-induced cardiac dysfunction is still unknown. We explored whether sST2 serum concentration reflects either systolic or diastolic dysfunction as measured by Doppler echocardiography. In a total of 127 patients with sepsis, correlations between sST2 and blood pressure, left ventricular (LV) ejection fraction, LV diastolic filling (ratio of early transmitral flow velocity to early diastolic mitral annulus velocity), and resting pulmonary arterial pressure were evaluated...
November 2016: Annals of Laboratory Medicine
Somdatta Chatterjee, Saswati Datta, Subhasree Roy, Lavanya Ramanan, Anindya Saha, Rajlakshmi Viswanathan, Tapas Som, Sulagna Basu
Carbapenem-resistant determinants and their surrounding genetic structure were studied in Acinetobacter spp. from neonatal sepsis cases collected over 7 years at a tertiary care hospital. Acinetobacter spp. (n = 68) were identified by ARDRA followed by susceptibility tests. Oxacillinases, metallo-β-lactamases (MBLs), extended-spectrum β-lactamases and AmpCs, were detected phenotypically and/or by PCR followed by DNA sequencing. Transconjugants possessing the bla NDM-1(New Delhi metallo-β-lactamase) underwent further analysis for plasmids, integrons and associated genes...
2016: Frontiers in Microbiology
Claudia T Matthaeus-Kraemer, Daniel O Thomas-Rueddel, Daniel Schwarzkopf, Hendrik Rueddel, Bernhard Poidinger, Konrad Reinhart, Frank Bloos
PURPOSE: The purpose was to identify barriers to the early detection and timely management of severe sepsis throughout the emergency department (ED), general ward (GW), intermediate care unit (IMC), and the intensive care unit (ICU). MATERIALS AND METHODS: Five multicenter focus group discussions with 29 clinicians were conducted. Discussions were based on a moderation guide were recorded and transcribed. Qualitative analysis was performed according to the principles of the concept mapping method and the framework approach...
July 9, 2016: Journal of Critical Care
Jae Yoon Park, Jung Nam An, Jong Hyun Jhee, Dong Ki Kim, Hyung Jung Oh, Sejoong Kim, Kwon Wook Joo, Yun Kyu Oh, Chun-Soo Lim, Shin-Wook Kang, Yon Su Kim, Jung Tak Park, Jung Pyo Lee
BACKGROUND: Continuous renal replacement therapy (CRRT) is essential in the management of critically ill patients with acute kidney injury (AKI). However, the optimal timing for initiating CRRT remains controversial, especially in elderly patients. Therefore, we investigated the outcomes of early CRRT initiation in elderly patients with AKI. METHODS: A total of 607 patients ≥65 years of age who started CRRT due to AKI between August 2009 and December 2013 were prospectively enrolled...
August 16, 2016: Critical Care: the Official Journal of the Critical Care Forum
Djordje Gligorijevic, Jelena Stojanovic, Zoran Obradovic
Data-driven phenotype discoveries on Electronic Health Records (EHR) data have recently drawn benefits across many aspects of clinical practice. In the method described in this paper, we map a very large EHR database containing more than a million inpatient cases into a low dimensional space where diseases with similar phenotypes have similar representation. This embedding allows for an effective segmentation of diseases into more homogeneous categories, an important task of discovering disease types for precision medicine...
July 28, 2016: Methods: a Companion to Methods in Enzymology
Shinya Chihara, Yoshiki Masuda, Hiroomi Tatsumi, Kota Nakano, Tomokazu Shimada, Takao Murohashi, Michiaki Yamakage
This study was conducted to clarify the effectiveness of induction timing of direct hemoperfusion with a polymyxin-B immobilized column (PMX-DHP) for amelioration of hemodynamic derangement and outcome in patients with septic shock. Suspected Gram-negative septic shock patients who received PMX-DHP therapy from January 2010 to December 2014 in our ICU were enrolled in this study. The patients were divided into two groups that received PMX-DHP therapy within 8 h (early group) and more than 8 h (late group) from catecholamine administration...
July 28, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Sebastian Reith, Jan Rudolf Ortlepp
After recognition of the diagnosis sepsis early resuscitation of the patient is mandatory. Patients should have a mean arterial pressure (MAP) ≥65 mmHg. Patients with hypotension should receive initial fluid challenge with approximately 30 mL/kg of balanced electrolyte solutions. However, iatrogenic volume overload should be avoided. If MAP remains < 65mmHg despite adequate volume norepinephrine is the first choice catecholamine. Oxygen should be delivered when oxygen saturation is below 90% to avoid hypoxemia...
July 2016: Deutsche Medizinische Wochenschrift
Laena Pernomian, Alejandro F Prado, Bruno R Silva, Aline Azevedo, Lucas C Pinheiro, José E Tanus-Santos, Lusiane M Bendhack
AIMS: To evaluate the role of nitric oxide, reactive oxygen species (ROS), and natriuretic peptide receptor-B activation in C-type natriuretic peptide-anti-contractile effect on Phenylephrine-induced contraction in aorta isolated from septic rats. METHODS AND RESULTS: Cecal ligation and puncture (CLP) surgery was used to induce sepsis in male rats. Vascular reactivity was conducted in rat aorta and resistance mesenteric artery (RMA). Measurement of survival rate, mean arterial pressure (MAP), plasma nitric oxide, specific protein expression, and localization were evaluated...
2016: Frontiers in Physiology
Joshua Rolnick, N Lance Downing, John Shepard, Weihan Chu, Julia Tam, Alexander Wessels, Ron Li, Brian Dietrich, Michael Rudy, Leon Castaneda, Lisa Shieh
BACHGROUND: Increasing use of EHRs has generated interest in the potential of computerized clinical decision support to improve treatment of sepsis. Electronic sepsis alerts have had mixed results due to poor test characteristics, the inability to detect sepsis in a timely fashion and the use of outside software limiting widespread adoption. We describe the development, evaluation and validation of an accurate and timely severe sepsis alert with the potential to impact sepsis management...
2016: Applied Clinical Informatics
Martin Sauer, Jens Altrichter, Cristof Haubner, Annette Pertschy, Thomas Wild, Fanny Doß, Thomas Mencke, Maren Thomsen, Johannes Ehler, Jörg Henschel, Sandra Doß, Stephanie Koch, Georg Richter, Gabriele Nöldge-Schomburg, Steffen R Mitzner
Purpose. Granulocyte transfusions have been used to treat immune cell dysfunction in sepsis. A granulocyte bioreactor for the extracorporeal treatment of sepsis was tested in a prospective clinical study focusing on the dosage of norepinephrine in patients and influence on dynamic and cell based liver tests during extracorporeal therapies. Methods and Patients. Ten patients with severe sepsis were treated twice within 72 h with the system containing granulocytes from healthy donors. Survival, physiologic parameters, extended hemodynamic measurement, and the indocyanine green plasma disappearance rate (PDR) were monitored...
2016: BioMed Research International
Guofu Li, Jia Jia, Kaiqiang Ji, Xiaoying Gong, Rui Wang, Xiaoli Zhang, Haiyuan Wang, Bin Zang
Sepsis-induced acute kidney injury (AKI) represents a major cause of mortality in intensive care units. Sivelestat, a selective inhibitor of neutrophil elastase (NE), can attenuate sepsis-related acute lung injury. However, whether sivelestat can preserve kidney function during sepsis remains unclear. In this study, we thus examined the effects of sivelestat on sepsis-related AKI. Cecal ligation and puncture (CLP) was performed to induce multiple bacterial infection in male Sprague-Dawley rats, and subsequently, 50 or 100 mg/kg sivelestat were administered by intraperitoneal injection immediately after the surgical procedure...
September 2016: International Journal of Molecular Medicine
Huihui Li, Dapeng Qiu, Qin Gao, Huaxue Wang, Meiqun Sun
Objective To observe the effect of selective activation of melanocortin 4 receptor (MC4R) on the rats with sepsis-induced acute liver injury. Methods Sixty-four male SD rats were randomly grouped into sham operation group (PBS treatment after sham operation), cecal ligation and puncture (CLP) group (sepsis model was established by CLP), Ro27-3225 treatment group (Ro27-3225 treatment after CLP), and Ro27-3225 sham operation control group (Ro27-3225 treatment after sham operation), 16 rats for each group (ten rats were used to observe general condition and 72-hour survival after operation...
August 2016: Xi Bao Yu Fen Zi Mian Yi Xue za Zhi, Chinese Journal of Cellular and Molecular Immunology
Karthickeyan Chella Krishnan, Santhosh Mukundan, Jeyashree Alagarsamy, Junguk Hur, Suba Nookala, Nikolai Siemens, Mattias Svensson, Ole Hyldegaard, Anna Norrby-Teglund, Malak Kotb
Host genetic variations play an important role in several pathogenic diseases, and we have previously provided strong evidences that these genetic variations contribute significantly to differences in susceptibility and clinical outcomes of invasive Group A Streptococcus (GAS) infections, including sepsis and necrotizing soft tissue infections (NSTIs). Our initial studies with conventional mouse strains revealed that host genetic variations and sex differences play an important role in orchestrating the severity, susceptibility and outcomes of NSTIs...
July 2016: PLoS Pathogens
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