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lactate in sepsis

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https://www.readbyqxmd.com/read/28422977/defining-the-complex-phenotype-of-severe-systemic-loxoscelism-using-a-large-electronic-health-record-cohort
#1
Jamie R Robinson, Vanessa E Kennedy, Youssef Doss, Lisa Bastarache, Joshua Denny, Jeremy L Warner
OBJECTIVE: Systemic loxoscelism is a rare illness resulting from the bite of the recluse spider and, in its most severe form, can lead to widespread hemolysis, coagulopathy, and death. We aim to describe the clinical features and outcomes of the largest known cohort of individuals with moderate to severe loxoscelism. METHODS: We performed a retrospective, cross sectional study from January 1, 1995, to December 31, 2015, at a tertiary-care academic medical center, to determine individuals with clinical records consistent with moderate to severe loxoscelism...
2017: PloS One
https://www.readbyqxmd.com/read/28414569/elevated-levels-of-plasma-mitochondrial-dna-are-associated-with-clinical-outcome-in-intra-abdominal-infections-caused-by-severe-trauma
#2
Qiongyuan Hu, Jianan Ren, Jie Wu, Guanwei Li, Xiuwen Wu, Song Liu, Gefei Wang, Guosheng Gu, Jieshou Li
BACKGROUND: The purpose of our study was to determine prospectively relationships between plasma mitochondrial deoxyribonucleic acid (mtDNA) concentration and clinical outcome in patients with intra-abdominal infections (IAIs) induced by severe abdominal trauma. PATIENTS AND METHODS: The DNA was isolated from serum samples taken from patients with IAIs at hospital days zero, one, and two. Plasma mtDNA concentration was assessed by real-time polymerase chain reaction (PCR)...
April 17, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28411114/circulating-biologically-active-adrenomedullin-bio-adm-predicts-hemodynamic-support-requirement-and-mortality-during-sepsis
#3
Pietro Caironi, Roberto Latini, Joachim Struck, Oliver Hartmann, Andreas Bergmann, Giuseppe Maggio, Marco Cavana, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Serge Masson
BACKGROUND: The biological role of adrenomedullin, a hormone involved in hemodynamic homeostasis, is controversial in sepsis, since administration of either the peptide or an antibody against it may be beneficial. METHODS: Plasma bio-ADM was assessed on days 1, 2 and 7 after randomization of 956 patients with sepsis or septic shock to albumin or crystalloids for fluid resuscitation in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. We tested the association of bio-ADM and its time-dependent variation with fluid therapy, vasopressor administration, organ failures and mortality...
April 11, 2017: Chest
https://www.readbyqxmd.com/read/28409028/impact-of-delayed-admission-to-the-intensive-care-unit-from-the-emergency-department-upon-sepsis-outcomes-and-sepsis-protocol-compliance
#4
Michael Agustin, Lori Lyn Price, Augustine Andoh-Duku, Peter LaCamera
Rationale. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. Methods. We performed a retrospective observational study of septic patients admitted to the ICU from the ED between January 2012 and December 2015 in a single tertiary care teaching hospital. 287 patients with severe sepsis and septic shock were included. Study population was divided into patients with EDLOS < 6 hrs (early admission) versus ≥6 hours (delayed admission)...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28391994/usefulness-and-prognostic-value-of-biomarkers-in-patients-with-community-acquired-pneumonia-in-the-emergency-department
#5
REVIEW
Agustín Julián-Jiménez, Juan González Del Castillo, Francisco Javier Candel
Between all patients treated in the Emergency Department (ED), 1.35% are diagnosed with community-acquired pneumonia (CAP). CAP is the main cause of death due to infectious disease (10-14%) and the most frequent reason of sepsis-septic shock in the ED. In the last decade, the search for objective tools to help establishing an early diagnosis, bacterial aetiology, severity, suspicion of bacteremia and the prognosis of mortality has increased. Biomarkers have shown their usefulness in this matter. Procalcitonin (obtains the highest accuracy for CAP diagnosis, bacterial aetiology and the presence of bacteremia), lactate (biomarker of hypoxia and tissue hypoperfusion) and proadrenomedullin (which has the greatest accuracy to predict mortality which in combination with the prognostic severity scales obtains even better results)...
April 6, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28383617/plasma-amino-acids-of-the-transsulfuration-pathway-and-plasma-lactate-in-septic-patients
#6
C Chiarla, I Giovannini, G Miggiano
OBJECTIVES: In sepsis increasing plasma lactate, even if unrelated to hypoperfusion and hypoxia, is a cause of concern. Among the patterns associated with increasing lactate, several plasma amino acid (AA) abnormalities, more in particular those of sulfur AAs, have remained unexplored, and their assessment has been the purpose of our study. MATERIALS AND METHODS: A systematic and detailed analysis of 183 simultaneous determinations of plasma AA-grams and lactate, from 12 trauma surgery patients who had developed sepsis, was performed...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28368517/enhanced-glycolytic-metabolism-contributes-to-cardiac-dysfunction-in-polymicrobial-sepsis
#7
Zhibo Zheng, He Ma, Xia Zhang, Fei Tu, Xiaohui Wang, Tuanzhu Ha, Min Fan, Li Liu, Jingjing Xu, Kaiking Yu, Ruitao Wang, John Kalbfleisch, Race Kao, David Williams, Chuanfu Li
Background: Cardiac dysfunction is present in >40% of sepsis patients and is associated with mortality rates of up to 70%. Recent evidence suggests that glycolytic metabolism plays a critical role in host defense and inflammation. Activation of Toll-like receptors on immune cells can enhance glycolytic metabolism. This study investigated whether modulation of glycolysis by inhibition of hexokinase will be beneficial to septic cardiomyopathy. Methods: Male C57B6/J mice were treated with a hexokinase inhibitor (2-deoxy-D-glucose, 2-DG, 0...
March 22, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28356059/association-between-acute-gastrointestinal-injury-and-biomarkers-of-intestinal-barrier-function-in-critically-ill-patients
#8
Hongxiang Li, Ying Chen, Feifei Huo, Yushan Wang, Dong Zhang
BACKGROUND: To assess the associations of biomarkers of intestinal barrier function and other clinical variables with acute gastrointestinal injury (AGI) grade, and of these clinical variables with mortality in critically ill patients. METHODS: This was a single-center, observational, prospective study. Patients were included if they were diagnosed with AGI and underwent tests for the measurement of plasma levels of intestinal fatty acid-binding protein (i-FABP), D-lactate (D-la), and lipopolysaccharide...
March 29, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28350646/association-between-hospital-case-volume-of-sepsis-adherence-to-evidence-based-processes-of-care-and-patient-outcomes
#9
Ashraf Fawzy, Allan J Walkey
OBJECTIVES: We sought to explore potential mechanisms underlying hospital sepsis case volume-mortality associations by investigating implementation of evidence-based processes of care. DESIGN: Retrospective cohort study. We determined associations of sepsis case volume with three evidence-based processes of care (lactate measurement during first hospital day, norepinephrine as first vasopressor, and avoidance of starch-based colloids) and assessed their role in mediation of case volume-mortality associations...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28345070/are-scoring-systems-sufficient-for-predicting-mortality-due-to-sepsis-in-the-emergency-department
#10
Merve Gunes Ozaydin, Ozlem Guneysel, Fatma Saridogan, Vehbi Ozaydin
OBJECTIVES: Scoring systems have been used to risk stratify in intensive care units (ICU), but not routinely used in emergency departments. The aim of this study was to determine accuracy for predicting mortality in emergency medicine with Sequential Organ Failure Assessment (SOFA), Mortality in ED Sepsis (MEDS) score and Simplified Acute Physiology Score (SAPSII). METHODS: This is a prospective observational study. Patients presenting with evidence of sepsis were all included...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343695/treatment-with-milk-fat-globule-epidermal-growth-factor-factor-8-mfg-e8-reduces-inflammation-and-lung-injury-in-neonatal-sepsis
#11
Laura W Hansen, Weng Lang Yang, Alexandra C Bolognese, Asha Jacob, Tracy Chen, Jose M Prince, Jeffrey M Nicastro, Gene F Coppa, Ping Wang
BACKGROUND: Sepsis remains one of the leading causes of infant death worldwide. It is characterized by uncontrolled inflammatory responses due to proven bacterial infection. Despite improvement in supportive care and the availability of effective antibiotics, no specific therapy targeting the dysregulated inflammatory response is available for neonatal sepsis. Milk fat globule epidermal growth factor-factor 8 (MFG-E8) is a secretory glycoprotein abundantly present in human milk. MFG-E8 suppresses the systemic inflammatory responses in adult murine injury models by improving the clearance of dying cells...
March 23, 2017: Surgery
https://www.readbyqxmd.com/read/28343448/hemoadsorption-by-cytosorb-in-septic-patients-a-case-series
#12
Klaus Kogelmann, Dominik Jarczak, Morten Scheller, Matthias Drüner
BACKGROUND: Septic shock, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, is a highly lethal condition that causes substantial morbidity and mortality among critically ill patients. One of the hallmarks of sepsis is the excessive release of cytokines and other inflammatory mediators causing refractory hypotension, tissue damage, metabolic acidosis and ultimately multiple organ failure. In this context, cytokine reduction by hemoadsorption represents a new concept for blood purification, developed to attenuate the overwhelming systemic levels of pro-inflammatory and anti-inflammatory mediators released in the early phase of sepsis...
March 27, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28338650/risk-factors-associated-to-hospital-mortality-in-patients-with-acute-kidney-injury-on-hemodialysis
#13
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/28288667/dual-inhibition-of-thrombin-and-activated-factor-x-attenuates-disseminated-intravascular-coagulation-and-protects-organ-function-in-a-baboon-model-of-severe-gram-negative-sepsis
#14
Herbert Schöchl, Martijn van Griensven, Stefan Heitmeier, Volker Laux, Ulrike Kipman, Jan Roodt, Soheyl Bahrami, Heinz Redl
BACKGROUND: Inhibition of procoagulant pathways may improve outcome in sepsis. We examined whether a dual short-acting thrombin (factor II) and factor X (FX)a inhibitor (SATI) ameliorates sepsis-induced disseminated intravascular coagulation (DIC) and is organ-protective. METHODS: Escherichia coli were infused for 2 h in 22 anesthetized baboons. The control (CO) group (n = 8) received sterile isotonic solution only. In the treatment groups, SATI was administered starting 15 minutes after the end of the bacterial exposure...
March 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28281216/a-hypoperfusion-context-may-aid-to-interpret-hyperlactatemia-in-sepsis-3-septic-shock-patients-a-proof-of-concept-study
#15
Leyla Alegría, Magdalena Vera, Jorge Dreyse, Ricardo Castro, David Carpio, Carolina Henriquez, Daniela Gajardo, Sebastian Bravo, Felipe Araneda, Eduardo Kattan, Pedro Torres, Gustavo Ospina-Tascón, Jean-Louis Teboul, Jan Bakker, Glenn Hernández
BACKGROUND: Persistent hyperlactatemia is particularly difficult to interpret in septic shock. Besides hypoperfusion, adrenergic-driven lactate production and impaired lactate clearance are important contributors. However, clinical recognition of different sources of hyperlactatemia is unfortunately not a common practice and patients are treated with the same strategy despite the risk of over-resuscitation in some. Indeed, pursuing additional resuscitation in non-hypoperfusion-related cases might lead to the toxicity of fluid overload and vasoactive drugs...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28277320/subcellular-energetics-and-metabolism-potential-therapeutic-applications
#16
Robert H Thiele
Part I of this review discussed the similarities between embryogenesis, mammalian adaptions to hypoxia (primarily driven by hypoxia-inducible factor-1 [HIF-1]), ischemia-reperfusion injury (and its relationship with reactive oxygen species), hibernation, diving animals, cancer, and sepsis, and it focused on the common characteristics that allow cells and organisms to survive in these states. Part II of this review describes techniques by which researchers gain insight into subcellular energetics and identify potential future tools for clinicians...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28267667/smartphone-based-enzymatic-biosensor-for-oral-fluid-l-lactate-detection-in-one-minute-using-confined-multilayer-paper-reflectometry
#17
Donato Calabria, Cristiana Caliceti, Martina Zangheri, Mara Mirasoli, Patrizia Simoni, Aldo Roda
The development of smartphone-based biosensors for point-of-care testing (POCT) applications allows realizing "all in one" instruments, with large potential distribution among the general population. With this respect, paper color-based detection performed by reflectance measurement is the most popular, simple, inexpensive and straightforward method. Despite the large number of scientific publications related to these biosensors, they still suffer from a poor detectability and reproducibility related to inhomogeneity of color development, which leads to low assay reproducibility...
March 1, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28262318/an-emergency-department-validation-of-the-sep-3-sepsis-and-septic-shock-definitions-and-comparison-with-1992-consensus-definitions
#18
Daniel J Henning, Michael A Puskarich, Wesley H Self, Michael D Howell, Michael W Donnino, Donald M Yealy, Alan E Jones, Nathan I Shapiro
STUDY OBJECTIVE: The Third International Consensus Definitions Task Force (SEP-3) proposed revised criteria defining sepsis and septic shock. We seek to evaluate the performance of the SEP-3 definitions for prediction of inhospital mortality in an emergency department (ED) population and compare the performance of the SEP-3 definitions to that of the previous definitions. METHODS: This was a secondary analysis of 3 prospectively collected, observational cohorts of infected ED subjects aged 18 years or older...
March 2, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28261297/comparison-of-prognostic-value-of-n-terminal-pro-brain-natriuretic-peptide-in-septic-and-non-septic-intensive-care-patients
#19
Namik Ozcan, Ayse Ozcan, Cetin Kaymak, Hulya Basar, Mustafa Kotanoglu, Bektas Kose
INTRODUCTION: The aim of this study is to compare the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in septic and non-septic intensive care patients. MATERIAL AND METHODS: Fifty consecutive patients admitted to the intensive care unit (ICU) were enrolled in either the septic or non-septic group according to the criteria in the International Sepsis Definitions Conference in 2001. Demographic and clinical data, procalcitonin and lactate levels at admission, and death within 28 days were registered...
March 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28250600/a-comparison-of-residents-knowledge-regarding-the-surviving-sepsis-campaign-2012-guideline
#20
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
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