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https://www.readbyqxmd.com/read/28625260/-predictive-value-of-four-different-scoring-systems-for-septic-patient-s-outcome-a-retrospective-analysis-with-311-patients
#1
Shengbiao Wang, Tao Li, Yunfeng Li, Jianwen Zhang, Xingui Dai
OBJECTIVE: To study the predicting value of four different scoring systems such as the acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, quick SOFA (qSOFA) score and systemic inflammatory response syndrome (SIRS) score for the prognosis of septic patients. METHODS: A retrospective analysis were conducted. Septic patients in intensive care unit (ICU) of the First People's Hospital of Chenzhou form July 1st, 2012 to June 30th, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28617696/should-hyperoxia-be-avoided-during-sepsis-an-experimental-study-in-ovine-peritonitis
#2
Xinrong He, Fuhong Su, Keliang Xie, Fabio Silvio Taccone, Katia Donadello, Jean-Louis Vincent
OBJECTIVES: Optimizing oxygen delivery is an important part of the hemodynamic resuscitation of septic shock, but concerns have been raised over the potentially deleterious effects of hyperoxia. We evaluated the impact of hyperoxia on hemodynamics, the microcirculation, and cerebral and renal metabolism in an ovine model of septic shock. DESIGN: Randomized animal study. SETTING: University hospital animal research laboratory. SUBJECTS: Fourteen adult female sheep...
June 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28616838/assessment-of-renal-hemodynamic-toxicity-of-fluid-challenge-with-0-9-nacl-compared-to-balanced-crystalloid-plasmalyte-%C3%A2-in-a-rat-model-with-severe-sepsis
#3
Pierre-Yves Olivier, François Beloncle, Valérie Seegers, Maher Tabka, Mathilde Renou de La Bourdonnaye, Alain Mercat, Paul Cales, Daniel Henrion, Peter Radermacher, Lise Piquilloud, Nicolas Lerolle, Pierre Asfar
BACKGROUND: According to international guidelines, volume expansion with crystalloids is the first-line treatment for hemodynamic management in patients with severe sepsis or septic shock. Compared to balanced crystalloids, 0.9% sodium chloride (0.9% NaCl) induces hyperchloremia and metabolic acidosis and may alter renal hemodynamics and function. We compared the effects of 0.9% NaCl to a less chloride-concentrated fluid, PlasmaLyte(®) (PL) in targeted fluid resuscitation in a randomized, double-blind controlled study in an experimental model of severe sepsis in rats...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28577069/prevention-of-acute-kidney-injury-and-protection-of-renal-function-in-the-intensive-care-unit-update-2017-expert-opinion-of-the-working-group-on-prevention-aki-section-european-society-of-intensive-care-medicine
#4
M Joannidis, W Druml, L G Forni, A B J Groeneveld, P M Honore, E Hoste, M Ostermann, H M Oudemans-van Straaten, M Schetz
BACKGROUND: Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. OBJECTIVES: To determine and update previous recommendations for the prevention of AKI, specifically the role of fluids, diuretics, inotropes, vasopressors/vasodilators, hormonal and nutritional interventions, sedatives, statins, remote ischaemic preconditioning and care bundles. METHOD: A systematic search of the literature was performed for studies published between 1966 and March 2017 using these potential protective strategies in adult patients at risk of AKI...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28520696/an-ovine-model-of-hyperdynamic-endotoxemia-and-vital-organ-metabolism
#5
Liam Byrne, Nchafatso G Obonyo, Sara Diab, Kimble Dunster, Margaret Passmore, Ai Ching Boon, Louise See Hoe, Karen Hay, Frank Van Haren, John-Paul Tung, Louise Cullen, Kiran Shekar, Kathryn Maitland, John F Fraser
BACKGROUND: Animal models of endotoxemia are frequently used to understand the pathophysiology of sepsis and test new therapies. However, important differences exist between commonly used experimental models of endotoxemia and clinical sepsis. Animal models of endotoxemia frequently produce hypodynamic shock in contrast to clinical hyperdynamic shock. This difference may exaggerate the importance of hypoperfusion as a causative factor in organ dysfunction. This study sought to develop an ovine model of hyperdynamic endotoxemia and assess if there is evidence of impaired oxidative metabolism in the vital organs...
May 17, 2017: Shock
https://www.readbyqxmd.com/read/28509668/norepinephrine-in-septic-shock-when-and-how-much
#6
Olfa Hamzaoui, Thomas W L Scheeren, Jean-Louis Teboul
PURPOSE OF REVIEW: Norepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension because of depressed vascular tone. Important clinical issues are the best timing to start norepinephrine, the optimal blood pressure target, and the best therapeutic options to face refractory hypotension of when high doses of norepinephrine are required to reach the target. RECENT FINDINGS: Recent literature has reported benefits of early administration of norepinephrine because of the following reasons: profound and durable hypotension is an independent factor of increased mortality, early administration of norepinephrine increases cardiac output, improves microcirculation and avoid fluid overload...
May 13, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28505021/use-of-a-short-acting-%C3%AE-1-blocker-during-endotoxemia-may-reduce-cerebral-tissue-oxygenation-if-hemodynamics-are-depressed-by-a-decrease-in-heart-rate
#7
Tadayoshi Kurita, Shingo Kawashima, Koji Morita, Yoshiki Nakajima
BACKGROUND: A decrease in heart rate (HR) using a short-acting β blocker has potential benefits in sepsis; however, depression of hemodynamics and reduction of cerebral oxygenation may also occur in endotoxemia. METHODS: Seventeen swine were allocated to landiolol or control groups. In the landiolol group, the dose was sequentially changed from 0 to 40 to 200 μg kg min, and stopped. Hemodynamics, blood variables, and the cerebral tissue oxygenation index (TOI) were recorded by near infrared spectroscopy at each dose...
June 2017: Shock
https://www.readbyqxmd.com/read/28496179/microfluidic-system-for-monitoring-temporal-variations-of-hemorheological-properties-and-platelet-adhesion-in-lps-injected-rats
#8
Eunseop Yeom, Hye Mi Kim, Jun Hong Park, Woorak Choi, Junsang Doh, Sang Joon Lee
Sepsis causes multiple organs failures and eventually death. Changes in blood constituents due to sepsis lead to alterations in hemorheological properties, and cell adhesiveness. In this study, a new microfluidic system is proposed to measure temporal variations in biophysical properties of blood after injecting lipopolysaccharide (LPS) into a rat extracorporeal model under ex vivo condition. To measure blood viscosity, the interfacial line between blood and a reference fluid is formed in a Y-shaped channel...
May 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28485391/magnetic-resonance-imaging-targeted-transperineal-prostate-biopsy-a-local-anaesthetic-approach
#9
E J Bass, I A Donaldson, A Freeman, C Jameson, S Punwani, C Moore, M Arya, M Emberton, H U Ahmed
BACKGROUND: Despite high rates of disease misclassification and sepsis, the use of transrectal biopsy remains commonplace. Transperineal mapping biopsies mitigate these problems but carry increased cost and patient burden. Local anaesthetic, multiparametric magnetic resonance imaging (MRI)-targeted transperineal biopsy may offer an alternative. Here, we aim to determine the feasibility, tolerability and detection rates of clinically significant prostate cancer using a local anaesthetic, transperineal, MRI-targeted biopsy technique...
May 9, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28461486/brd4-modulates-the-innate-immune-response-through-mnk2-eif4e-pathway-dependent-translational-control-of-i%C3%AE%C2%BAb%C3%AE
#10
Yan Bao, Xuewei Wu, Jinjing Chen, Xiangming Hu, Fuxing Zeng, Jianjun Cheng, Hong Jin, Xin Lin, Lin-Feng Chen
Bromodomain-containing factor Brd4 has emerged as an important transcriptional regulator of NF-κB-dependent inflammatory gene expression. However, the in vivo physiological function of Brd4 in the inflammatory response remains poorly defined. We now demonstrate that mice deficient for Brd4 in myeloid-lineage cells are resistant to LPS-induced sepsis but are more susceptible to bacterial infection. Gene-expression microarray analysis of bone marrow-derived macrophages (BMDMs) reveals that deletion of Brd4 decreases the expression of a significant amount of LPS-induced inflammatory genes while reversing the expression of a small subset of LPS-suppressed genes, including MAP kinase-interacting serine/threonine-protein kinase 2 (Mknk2)...
May 16, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28429311/improving-animal-welfare-using-continuous-nalbuphine-infusion-in-a-long-term-rat-model-of-sepsis
#11
Victor Jeger, Mattia Arrigo, Florian F Hildenbrand, Daniel Müller, Paulin Jirkof, Till Hauffe, Burkhardt Seifert, Margarete Arras, Donat R Spahn, Dominique Bettex, Alain Rudiger
BACKGROUND: Sepsis research relies on animal models to investigate the mechanisms of the dysregulated host response to infection. Animal welfare concerns request the use of potent analgesics for the Refinement of existing sepsis models, according to the 3Rs principle. Nevertheless, adequate analgesia is often missing, partly because the effects of analgesics in this particular condition are unknown. We evaluated the use of nalbuphine, an opioid with kappa agonistic and mu antagonistic effects, in rats with and without experimental sepsis...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28400680/changes-in-b-type-natriuretic-peptide-and-related-hemodynamic-parameters-following-a-fluid-challenge-in-critically-ill-patients-with-severe-sepsis-or-septic-shock
#12
Shahed Omar, Ahmad Ali, Yahya Atiya, Rudo Lufuno Mathivha, Joel M Dulhunty
CONTEXT: Severe sepsis or septic shock. AIMS: The aim of this study is to examine the effect of a fluid challenge on the B-type natriuretic peptide (BNP) and the hemodynamic state. SETTINGS AND DESIGN: This observational study was conducted in an intensivist-led academic, mixed medical-surgical Intensive Care Unit. SUBJECTS AND METHODS: Focused transthoracic echocardiogram, plasma BNP, and hemodynamic measurements were recorded at baseline and following a 500 ml fluid challenge in thirty patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28385575/intersecting-worlds-of-transfusion-and-transplantation-medicine-an-international-symposium-organized-by-the-canadian-blood-services-centre-for-innovation
#13
REVIEW
Kendra M Hodgkinson, Jeffrey Kiernan, Andrew W Shih, Ziad Solh, William P Sheffield, Nicolas Pineault
The principal theme of the symposium was centered on how the world of regenerative medicine intersects with that of transfusion medicine, with a particular focus on hematopoietic stem cells (HSCs) and stem cell therapies. The symposium highlighted several exciting developments and identified areas where additional research is needed. A revised map of human hematopoietic hierarchy was presented based on the functional and phenotypic analysis of thousands of single stem and progenitor cells from adult bone marrow and fetal liver...
July 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28373035/mung-bean-vigna-radiata-l-coat-extract-modulates-macrophage-functions-to-enhance-antigen-presentation-a-proteomic-study
#14
Akiko Hashiguchi, Keisuke Hitachi, Wei Zhu, Jingkui Tian, Kunihiro Tsuchida, Setsuko Komatsu
The immunomodulatory effect of mung bean is mainly attributed to antioxidant properties of flavonoids; however, the precise machinery for biological effect on animal cells remains uncertain. To understand the physiological change produced by mung bean consumption, proteomic and metabolomic techniques were used. In vitro assay confirmed the importance of synergistic interaction among multiple flavonoids by IL-6 expression. Proteomic analysis detected that the abundance of 190 proteins was changed in lipopolysaccharide-stimulated RAW264...
March 31, 2017: Journal of Proteomics
https://www.readbyqxmd.com/read/28338650/risk-factors-associated-to-hospital-mortality-in-patients-with-acute-kidney-injury-on-hemodialysis
#15
Mariela Alejandra Linares-Linares, Jorge Arturo Figueroa-Tarrillo, Renato Cerna Viacava, Nilton Yhuri Carreazo, Renzo P Valdivia-Vega
INTRODUCTION: The worldwide incidence of acute kidney injury is 18% and the overall hospital mortality can rise above 50%. In Peru, there are few series about mortality of acute kidney injury in hemodialysis patients. OBJECTIVES: To identify risk factors associated to hospital mortality of acute kidney injury in hemodialysis patients. METHODS: This is a retrospective cohort of patients with acute kidney injury in hemodialysis of Hospital Nacional Edgardo Rebagliati Martins gathered between January 2013 and December 2015...
March 6, 2017: Medwave
https://www.readbyqxmd.com/read/28333320/cross-resistance-to-lincosamides-streptogramins-a-and-pleuromutilins-in-streptococcus-agalactiae-isolates-from-the-usa
#16
Paulina A Hawkins, Caitlin S Law, Benjamin J Metcalf, Sopio Chochua, Delois M Jackson, Lars F Westblade, Robert Jerris, Bernard W Beall, Lesley McGee
Background: Streptococcus agalactiae (Group B Streptococcus, GBS) is a leading cause of meningitis, sepsis and pneumonia in neonates in the United States. GBS also causes invasive disease in older infants, pregnant women, children and young adults with underlying medical conditions, and older adults. Resistance to lincosamides in the absence of erythromycin resistance is rare in GBS, but has been previously reported in clinical isolates, both on its own or in combination with resistance to streptogramins A and pleuromutilins (L/LSA/LSAP phenotypes)...
March 13, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28328498/a-framework-for-patient-state-tracking-by-classifying-multiscalar-physiologic-waveform-features
#17
Benjamin Vandendriessche, Mustafa Abas, Thomas Dick, Kenneth Loparo, Frank Jacono
OBJECTIVE: State-of-the-art algorithms that quantify nonlinear dynamics in physiologic waveforms are underutilized clinically due to their esoteric nature. We present a generalizable framework for classifying multiscalar waveform features, designed for patient-state tracking directly at the bedside. METHODS: An artificial neural network classifier was designed to evaluate multiscale waveform features against a fingerprint database of multifractal synthetic time series...
March 17, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28272257/suspected-infection-in-afebrile-patients-are-they-septic
#18
Fernanda de Souza Martins, Gisele Giuliane Guedes, Thiago Martins Santos, Marco A de Carvalho-Filho
We prospectively evaluated afebrile patients admitted to an emergency department (ED), with suspected infection and only tachycardia or tachypnea.The white blood cell count (WBC) was obtained, and patients were considered septic if leukocyte count was >12,000 μL-1 or <4000 μL-1 or with >10% of band forms. Clinical data were collected to examine whether sepsis could be predicted.Seventy patients were included and 37 (52.86%) met sepsis criteria. Self-measured fever showed an odds ratio (OR) of 5...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28250600/a-comparison-of-residents-knowledge-regarding-the-surviving-sepsis-campaign-2012-guideline
#19
Onnicha Suntornlohanakul, Bodin Khwannimit
BACKGROUND: Recently, Surviving Sepsis Campaign (SSC) guideline was updated. Our objective was to evaluate the knowledge of residents in different departments regarding the SSC 2012. METHODS: A cross-sectional, descriptive self-questionnaire was distributed to interns and residents in the Departments of Internal Medicine, Surgery, and Emergency Medicine. RESULTS: The response rate was 136 (89%) from 153 residents. The residents included 46 (33%) interns, 42 (31%) internal medicine residents, 41 (30%) surgical residents, and 7 (5%) emergency residents...
February 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28231305/effects-of-vasoactive-drugs-on-crystalloid-fluid-kinetics-in-septic-sheep
#20
Yuhong Li, Zheng Xiaozhu, Ru Guomei, Ding Qiannan, Robert G Hahn
PURPOSE: Crystalloid fluid and vasoactive drugs are used in the early treatment of sepsis. The purpose of the present study was to examine how these drugs alter plasma volume expansion, peripheral edema, and urinary excretion. METHODS: Twenty-five anesthetized sheep were made septic by cecal puncture and a short infusion of lipopolysaccharide. After 50 min, a slow infusion of isotonic saline was initiated: the saline either contained no drug, norepinephrine (1 μg/kg/min), phenylephrine (3 μg/kg/min), dopamine (50 μg/kg/min), or esmolol (50 μg/kg/min)...
2017: PloS One
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