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surviving sepsis

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https://www.readbyqxmd.com/read/28448952/sepsis-and-septic-shock-pathogenesis-and-treatment-perspectives
#1
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/28447715/correlation-of-the-expression-of-yy1-and-fas-cell-surface-death-receptor-with-apoptosis-of-peripheral-blood-mononuclear-cells-and-the-development-of-multiple-organ-dysfunction-in-children-with-sepsis
#2
Judith Reséndiz-Martínez, Juan Asbun-Bojalil, Sara Huerta-Yepez, Mario Vega
Multiple organ dysfunction (MOD) is a lethal complication in children with sepsis. Apoptosis of several cell types is involved in this process, and it is associated with increased Fas cell surface death receptor (Fas) expression. As YY1 transcription factor (YY1) negatively regulates the expression of Fas in cancer models, and is associated with the clinical outcome, it may be important in MOD. The present study aimed to determine the association between the expression of Fas, YY1 and apoptosis in children with sepsis, and its association with MOD, these factors were analyzed in 30 pediatric patients that had been diagnosed with sepsis...
March 9, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28446249/adipose-derived-mesenchymal-stem-cells-modulate-cd14-cd16-expression-on-monocytes-from-sepsis-patients-in-vitro-via-prostaglandin-e2
#3
Guanguan Qiu, Guoping Zheng, Menghua Ge, Lanfang Huang, Haijiang Tong, Ping Chen, Dengming Lai, Yaoqin Hu, Baoli Cheng, Qiang Shu, Jianguo Xu
BACKGROUND: Mesenchymal stem cells (MSCs) have been shown to reduce sepsis-induced inflammation and improve survival in mouse models of sepsis. CD16(+) monocytes are proinflammatory and abundant in inflammatory conditions such as sepsis. The primary objective in this exploratory study was to determine the effects of adipose-derived MSCs (ASCs) on three subsets of monocytes from sepsis patients in vitro and to delineate the underlying mechanism. METHODS: This is a prospective cohort study of patients admitted to the medical intensive care unit (ICU) at an academic medical center...
April 26, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28445239/aldosterone-and-vascular-mineralocorticoid-receptors-in-murine-endotoxic-and-human-septic-shock
#4
Fouad Fadel, Gwennan André-Grégoire, Basile Gravez, Brigitte Bauvois, Sandrine Bouchet, Catalina Sierra-Ramos, Andrea Polito, Arnaud Mansart, Diego Alvarez de la Rosa, Djillali Annane, Frédéric Jaisser
OBJECTIVES: Vascular mineralocorticoid receptors play a role in vascular tone and blood pressure regulation, might participate in the pathophysiology of circulatory failure during sepsis, and represent a potential therapeutic target in this disease. We aimed to study the effects of mineralocorticoids and the involvement of vascular mineralocorticoid receptors in murine endotoxic and human septic shock. DESIGN: Experimental study. SETTING: Translational investigation including animal research and in vitro experiments using human vascular cells and plasma from septic patients...
April 25, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28445237/effects-of-polymyxin-b-hemoperfusion-on-mortality-in-patients-with-severe-sepsis-and-septic-shock-a-systemic-review-meta-analysis-update-and-disease-severity-subgroup-meta-analysis
#5
Tzu Chang, Yu-Kang Tu, Chen-Tse Lee, Anne Chao, Chi-Hsiang Huang, Ming-Jiuh Wang, Yu-Chang Yeh
OBJECTIVE: Several studies have reported a survival benefit for polymyxin B hemoperfusion treatment in patients with severe sepsis and septic shock. However, recently, a propensity-matched analysis and a randomized controlled trial reported no survival benefit for polymyxin B hemoperfusion treatment. We performed an up-to-date meta-analysis to determine the effect of polymyxin B hemoperfusion treatment on mortality in patients with severe sepsis and septic shock. DATA SOURCES: PubMed, Embase, and Cochrane Library were searched from inception to May 2016...
April 25, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28444069/predictors-and-pattern-of-weaning-and-long-term-outcome-of-patients-with-prolonged-mechanical-ventilation-at-an-acute-intensive-care-unit-in-north-india
#6
Syed Nabeel Muzaffar, Mohan Gurjar, Arvind K Baronia, Afzal Azim, Prabhakar Mishra, Banani Poddar, Ratender K Singh
Objective: This study aimed to examine the clinical characteristics, weaning pattern, and outcome of patients requiring prolonged mechanical ventilation in acute intensive care unit settings in a resource-limited country. Methods: This was a prospective single-center observational study in India, where all adult patients requiring prolonged ventilation were followed for weaning duration and pattern and for survival at both intensive care unit discharge and at 12 months...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28442605/the-toll-like-receptor-4-antagonist-eritoran-protects-mice-from-lethal-filovirus-challenge
#7
Patrick Younan, Palaniappan Ramanathan, Jessica Graber, Fabian Gusovsky, Alexander Bukreyev
The 2013-2016 outbreak of Ebola virus (EBOV) in West Africa, which has seen intermittent reemergence since it was officially declared over in February of 2016, has demonstrated the need for the rapid development of therapeutic intervention strategies. Indirect evidence has suggested that the EBOV infection shares several commonalities associated with the onset of bacterial sepsis, including the development of a "cytokine storm." Eritoran, a Toll-like receptor 4 (TLR4) antagonist, was previously shown to result in protection of mice against lethal influenza virus infection...
April 25, 2017: MBio
https://www.readbyqxmd.com/read/28439133/importance-of-pharmacy-involvement-in-the-treatment-of-sepsis
#8
Joseph B Cavanaugh, Jesse B Sullivan, Nicole East, Jessica N Nodzon
Purpose: A review of the impact of pharmacists on appropriate medication selection, timing of administration, and as members of a multidisciplinary sepsis response team. Summary: Early goal-directed therapy (EGDT), currently recommended by the 2013 Surviving Sepsis Campaign guidelines for the management of patients with sepsis, includes the administration of appropriate antibiotics in patients with septic shock within the first hour. Multidisciplinary teams containing pharmacists have been shown to decrease time to antibiotic delivery, time to antibiotic administration, and patient mortality...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28439131/compliance-with-updated-sepsis-bundles-to-meet-new-sepsis-core-measure-in-a-tertiary-care-hospital
#9
Taylor H Ramsdell, April N Smith, Eric Kerkhove
Background: The updated Surviving Sepsis Campaign care bundles are associated with improved outcomes in patients with sepsis, yet adherence to the bundles remains inconsistent. The Centers for Medicare & Medicaid Services has adopted similar care bundles as a core measure that went into effect with October 1, 2015 discharges. Objective: The aim of this study was to assess bundle compliance, length of stay (LOS), and in-hospital mortality before and after introduction of the new sepsis core measure. Methods: A retrospective cohort study was conducted in 158 patients with a diagnosis of severe sepsis or septic shock from April 2015 to February 2016...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28437804/-prognostic-factors-of-open-abdomen-treatment-in-visceral-surgery
#10
Martin W von Websky, Agnes Jedig, Arnulf Willms, Azin Jafari, Hanno Matthaei, Jörg C Kalff, Steffen Manekeller
Introduction In general surgery, open abdomen treatment (OAT) is used to treat abdominal compartment syndrome (ACS) and sepsis, often after a primary surgical procedure associated with complications. The results achieved in this patient population may depend on factors that are yet unknown. This study evaluates independent patient-related prognostic factors after OAT. Methods 38 clinical parameters and survival data of 165 consecutive general surgery patients after OAT were entered into a prospective database according to a defined algorithm in order to analyse the underlying surgical pathology, predictors of survival and important aspects of OAT-related morbidity...
April 24, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28437459/management-and-outcomes-of-severe-dengue-patients-presenting-with-sepsis-in-a-tropical-country
#11
Prapit Teparrukkul, Viriya Hantrakun, Nicholas P J Day, T Eoin West, Direk Limmathurotsakul
BACKGROUND: Dengue is a common cause of infection in adults in tropical countries. Sepsis is a syndrome of systemic manifestations induced by infection of any organisms; including bacterial, fungal and viral agents. Here, we investigated the diagnosis, management and outcomes of dengue patients presenting with sepsis in a prospective study of community-acquired sepsis in Thailand. METHODS: From June to December 2015, 874 adult patients (age≥18 years) with suspected or documented community-acquired infection, with ≥3 diagnostic criteria for sepsis according to the Surviving Sepsis Campaign 2012, and within 24 hours of admission were evaluated...
2017: PloS One
https://www.readbyqxmd.com/read/28437373/resuscitation-with-balanced-fluids-is-associated-with-improved-survival-in-pediatric-severe-sepsis
#12
Elizabeth T Emrath, James D Fortenberry, Curtis Travers, Courtney E McCracken, Kiran B Hebbar
OBJECTIVE: To evaluate outcomes in patients receiving balanced fluids for resuscitation in pediatric severe sepsis. DESIGN: Observational cohort review of prospectively collected data from a large administrative database. SETTING: PICUs from 43 children's hospitals. PATIENTS: PICU patients diagnosed with severe sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We reviewed data from the Pediatric Health Information System database from 2004 to 2012...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28433610/paraoxonases-and-infectious-diseases
#13
REVIEW
Jordi Camps, Simona Iftimie, Anabel García-Heredia, Antoni Castro, Jorge Joven
The paraoxonases (PON1, PON2 and PON3) are an enzyme family with a high structural homology. All of them have lactonase activity and degrade lipid peroxides in lipoproteins and cells. As such, they play a role in protection against oxidation and inflammation. Infectious diseases are often associated with oxidative stress and an inflammatory response. Infection and inflammation trigger a cascade of reactions in the host, known as the acute-phase response. This response is associated with dramatic changes in serum proteins and lipoproteins, including a decrease in serum PON1 activity...
April 19, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28430717/multilateral-functional-alterations-of-human-neutrophils-in-sepsis-from-the-point-of-diagnosis-to-the-seventh-day
#14
Akira Endo, Miko Okamura, Shunsuke Yoshikawa, Yasuhiro Otomo, Tomohiro Morio
Neutrophil functional changes caused by sepsis itself and their time-course variation have not been fully elucidated because previous studies targeted patients who had received therapeutic interventions. We explored the multilateral functions of circulating neutrophils in patients with severe sepsis or septic shock who had not yet undergone interventions, and followed their changes. Patients were treated based on the Surviving Sepsis Campaign Guidelines 2012. Neutrophil functions were evaluated on days 0 (before therapeutic intervention), 3, and 7 in fifty-nine sepsis patients...
April 20, 2017: Shock
https://www.readbyqxmd.com/read/28430592/resveratrol-protects-against-early-polymicrobial-sepsis-induced-acute-kidney-injury-through-inhibiting-endoplasmic-reticulum-stress-activated-nf-%C3%AE%C2%BAb-pathway
#15
Nian Wang, Li Mao, Liu Yang, Jiang Zou, Ke Liu, Meidong Liu, Huali Zhang, Xianzhong Xiao, Kangkai Wang
Resveratrol, a polyphenol compound derived from various edible plants, protects against sepsis-induced acute kidney injury (AKI) via its anti-inflammatory activity, but the underlying mechanisms remain largely unknown. In this study, a rat model of sepsis was established by cecal ligation and puncture (CLP), 30 mg/kg resveratrol was intraperitoneally administrated immediately after the CLP operation. HK-2 cells treated by 1 μg/ml lipopolysaccharide, 0.2 μM tunicamycin, 2.5 mM irestatin 9389 and 20 μM resveratrol were used for in vitro study...
April 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28429310/the-protective-association-of-endogenous-immunoglobulins-against-sepsis-mortality-is-restricted-to-patients-with-moderate-organ-failure
#16
Ignacio Martin-Loeches, Arturo Muriel-Bombín, Ricard Ferrer, Antonio Artigas, Jordi Sole-Violan, Leonardo Lorente, David Andaluz-Ojeda, Adriele Prina-Mello, Ruben Herrán-Monge, Borja Suberviola, Ana Rodriguez-Fernandez, Pedro Merino, Ana M Loza, Pablo Garcia-Olivares, Eduardo Anton, Eduardo Tamayo, Wysali Trapiello, Jesús Blanco, Jesús F Bermejo-Martin
BACKGROUND: Pre-evaluation of endogenous immunoglobulin levels is a potential strategy to improve the results of intravenous immunoglobulins in sepsis, but more work has to be done to identify those patients who could benefit the most from this treatment. The objective of this study was to evaluate the impact of endogenous immunoglobulins on the mortality risk in sepsis depending on disease severity. METHODS: This was a retrospective observational study including 278 patients admitted to the ICU with sepsis fulfilling the SEPSIS-3 criteria, coming from the Spanish GRECIA and ABISS-EDUSEPSIS cohorts...
December 2017: Annals of Intensive Care
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
#17
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/28427574/acute-noncardiovascular-illness-in-the-cardiac-intensive-care-unit
#18
Eric M Holland, Travis J Moss
BACKGROUND: Fifty years after the inception of the cardiac intensive care unit (CICU), noncardiovascular illnesses have become more prevalent and may contribute to morbidity and mortality. OBJECTIVES: The authors performed multivariate statistical analyses to determine the association of acute noncardiovascular illnesses with outcomes, including length of stay (LOS), mortality, and hospital readmission. METHODS: We studied 1,042 admissions between October 12, 2013 and November 28, 2014 to the CICU at the University of Virginia Health System, a tertiary-care academic medical center...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28427496/mortality-risk-factors-in-intensive-care-unit-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-a-retrospective-cohort-study%C3%A2
#19
Michael Schmitz, Frank P Tillmann, Ausra Paluckaite, Erich A Laufer, Brian Rayner, Lars C Rump, Peter J Heering
BACKGROUND: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. METHODS: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved...
April 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#20
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
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