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lactate in sepsis

Miry Shim, Sara Yang, Catherine R Messina, Jonathan P Mintzer
PURPOSE: To compare discharge breastmilk feeding rates among asymptomatic term newborns receiving 48-hour versus >48-hour antibiotics in the neonatal intensive care unit (NICU) and a cohort of well-baby nursery (WBN) newborns. MATERIALS AND METHODS: This retrospective review included asymptomatic term neonates admitted to the NICU due to maternal chorioamnionitis and a comparison group of WBN neonates between January 2012 and December 2015. Demographic, birth, feeding, and lactation consultant visit data were analyzed in univariate and multivariate models...
March 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
Jiangquan Fu, Qing Lan, Difen Wang, Ying Wang, Ying Liu
OBJECTIVE: To approach the value of red cell distribution width (RDW) on the prognostic assessment of patients with abdominal sepsis. METHODS: The clinical data of adult patients with abdominal sepsis admitted to intensive care unit (ICU) of Affiliated Hospital of Guizhou Medical University from January 2015 to September 2017 were retrospectively analyzed. The patients were divided into survival group and death group according to ICU prognosis. The levels of serum lactate (Lac), procalcitonin (PCT), RDW, and acute physiology and chronic health evaluation II (APACHE II) score within 24 hours were recorded...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
A Aramburo, Jim Todd, Elizabeth C George, Sarah Kiguli, Peter Olupot-Olupot, Robert O Opoka, Charles Engoru, Samuel O Akech, Richard Nyeko, George Mtove, Diana M Gibb, Abdel G Babiker, Kathryn Maitland
BACKGROUND: Hyperlactataemia (HL) is a biomarker of disease severity that predicts mortality in patients with sepsis and malaria. Lactate clearance (LC) during resuscitation has been shown to be a prognostic factor of survival in critically ill adults, but little data exist for African children living in malaria-endemic areas. METHODS: In a secondary data analysis of severely ill febrile children included in the Fluid Expansion as Supportive Therapy (FEAST) resuscitation trial, we assessed the association between lactate levels at admission and LC at 8 h with all-cause mortality at 72 h (d72)...
March 9, 2018: BMC Medicine
Ding Wu, Shen Yuehong, Li Qiang, Jiang Shouyin, Shen Huahao
AIMS: Therapeutic hypothermia has shown beneficial effects in sepsis. This study focused on its mechanism. MAIN METHODS: Sixteen male Sprague-Dawley rats underwent cecal ligation and perforation and subsequently were treated with either hypothermia (HT; body temperature cooled and maintained at 34 °C by ice pad for 10 h; n = 8) or normothermia (NT; n = 8). Three additional rats underwent sham surgery. The body temperatures of the sham-operated and NT groups were maintained at 38 °C with a thermal pad...
March 2, 2018: Life Sciences
Hitoshi Yamamura, Yu Kawazoe, Kyohei Miyamoto, Tomonori Yamamoto, Yoshinori Ohta, Takeshi Morimoto
Background: Use of high-dose norepinephrine is thought to have an immunosuppressive action that increases mortality. This study aimed to evaluate the correlation between norepinephrine dosage and prognosis of patients with septic shock. Methods: This study was a nested cohort of the DExmedetomidine for Sepsis in Intensive Care Unit Randomized Evaluation (DESIRE) trial. We evaluated 112 patients with septic shock and an initial Sequential Organ Failure Assessment Cardiovascular (SOFA-C) category score > 2 and initial lactate level > 2 mmol/L...
2018: Journal of Intensive Care
Nishkantha Arulkumaran, Marije L Sixma, Sean Pollen, Elias Ceravola, Elisa Jentho, Maria Prendecki, Paul S Bass, Frederick W K Tam, Robert J Unwin, Mervyn Singer
Sepsis is a major clinical problem associated with significant organ dysfunction and high mortality. The ATP-sensitive P2X7 receptor activates the NLRP3 inflammasome and is a key component of the innate immune system. We used a fluid-resuscitated rat model of fecal peritonitis and acute kidney injury (AKI) to investigate the contribution of this purinergic receptor to renal dysfunction in sepsis. Six and 24 h time-points were chosen to represent early and established sepsis, respectively. A selective P2X7 receptor antagonist (A-438079) dissolved in dimethyl sulfoxide (DMSO) was infused 2 h following induction of sepsis...
March 2018: Physiological Reports
Helge Røsjø, Serge Masson, Pietro Caironi, Mats Stridsberg, Michela Magnoli, Geir Christensen, Gabriella Moise, Maria Cristina Urbano, Luciano Gattinoni, Antonio Pesenti, Roberto Latini, Torbjørn Omland
OBJECTIVES: Secretoneurin directly influences cardiomyocyte calcium handling, and circulating secretoneurin levels seem to improve risk prediction in patients with myocardial dysfunction by integrating information on systemic stress, myocardial function, and renal function. Accordingly, in this study, we hypothesized that secretoneurin would improve risk prediction in patients with sepsis and especially in patients with septic shock as these patients are more hemodynamically unstable...
February 23, 2018: Critical Care Medicine
Byuk Sung Ko, Kyuseok Kim, Sung-Hyuk Choi, Gu Hyun Kang, Tae Gun Shin, You Hwan Jo, Seung Mok Ryoo, Jin Ho Beom, Woon Yong Kwon, Kap Su Han, Han Sung Choi, Sung Phil Chung, Gil Joon Suh, Tae Ho Lim, Won Young Kim
BACKGROUND: Septic shock can be defined both by the presence of hyperlactatemia and need of vasopressors. Lactate levels should be measured after volume resuscitation (as per the Sepsis-3 definition). However, currently, no studies have evaluated patients who have been excluded by the new criteria for septic shock. The aim of this study was to determine the clinical characteristics and prognosis of these patients, based on their lactate levels after initial fluid resuscitation. METHODS: This observational study was performed using a prospective, multi-center registry of septic shock, with the participation of 10 hospitals in the Korean Shock Society, between October 2015 and February 2017...
February 24, 2018: Critical Care: the Official Journal of the Critical Care Forum
Anders Brunse, Päivi Worsøe, Susanne Elisabeth Pors, Kerstin Skovgaard, Per Torp Sangild
Preterm infants have increased risk of neonatal sepsis, potentially inducing brain injury, and they may benefit from early initiation of enteral milk feeding. Using preterm pigs as models, we hypothesized that early provision of bovine colostrum to parentally nourished newborns protects against sepsis and neuroinflammation during bloodstream infection. Preterm newborn pigs were administered 10 CFU/kg of intra-arterial Staphylococcus epidermidis (SE, an opportunistic pathogen often causing sepsis in preterm infants), followed by administration of total parenteral nutrition (TPN, SE + TPN, n = 15) or oral provision of bovine colostrum with supplementary parenteral nutrition (SE + COL, n = 14), and compared with uninfected, TPN-nourished controls (CON + TPN, n = 11)...
February 21, 2018: Shock
Khie Chen Lie, Chuen-Yen Lau, Nguyen Van Vinh Chau, T Eoin West, Direk Limmathurotsakul
Background: Sepsis is a global threat but insufficiently studied in Southeast Asia. The objective was to evaluate management, outcomes, adherence to sepsis bundles, and mortality prediction of maximum Sequential Organ Failure Assessment (SOFA) scores in patients with community-acquired sepsis in Southeast Asia. Methods: We prospectively recruited hospitalized adults within 24 h of admission with community-acquired infection at nine public hospitals in Indonesia ( n  = 3), Thailand ( n  = 3), and Vietnam ( n  = 3)...
2018: Journal of Intensive Care
Jikyoung Shin, Sung Yeon Hwang, Ik Joon Jo, Won Young Kim, Seung Mok Ryoo, Gu Hyun Kang, Kyuseok Kim, You Hwan Jo, Sung Phil Chung, Young Seon Joo, Jin Ho Beom, Young Hoon Yoon, Kap Su Han, Tae Ho Lim, Han Sung Choi, Woon Yong Kwon, Gil Joon Suh, Sung-Hyuk Choi, Tae Gun Shin
AIM: The aim of this study was to evaluate the clinical utility of the lactate/albumin (L/A) ratio as a predictive factor of 28-day mortality in critically ill sepsis patients. METHODS: This is a retrospective observational study from a prospectively-collected multi-center registry of 10 emergency departments (EDs) in teaching hospitals that participated in the Korean Shock Society (KoSS). It enrolled patients who were 19 years of age or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion...
February 14, 2018: Shock
Dominique J Pepper, Dharmvir Jaswal, Junfeng Sun, Judith Welsh, Charles Natanson, Peter Q Eichacker
Background: The Severe Sepsis and Septic Shock Early Management Bundle (SEP-1), the sepsis performance measure introduced by the Centers for Medicare & Medicaid Services (CMS), requires up to 5 hemodynamic interventions, as many as 141 tasks, and 3 hours to document for a single patient. Purpose: To evaluate whether moderate- or high-level evidence shows that use of SEP-1 or its hemodynamic interventions improves survival in adults with sepsis. Data Sources: PubMed, Embase, Scopus, Web of Science, and ClinicalTrials...
February 20, 2018: Annals of Internal Medicine
Timothy E Sweeney, Thanneer M Perumal, Ricardo Henao, Marshall Nichols, Judith A Howrylak, Augustine M Choi, Jesús F Bermejo-Martin, Raquel Almansa, Eduardo Tamayo, Emma E Davenport, Katie L Burnham, Charles J Hinds, Julian C Knight, Christopher W Woods, Stephen F Kingsmore, Geoffrey S Ginsburg, Hector R Wong, Grant P Parnell, Benjamin Tang, Lyle L Moldawer, Frederick E Moore, Larsson Omberg, Purvesh Khatri, Ephraim L Tsalik, Lara M Mangravite, Raymond J Langley
Improved risk stratification and prognosis prediction in sepsis is a critical unmet need. Clinical severity scores and available assays such as blood lactate reflect global illness severity with suboptimal performance, and do not specifically reveal the underlying dysregulation of sepsis. Here, we present prognostic models for 30-day mortality generated independently by three scientific groups by using 12 discovery cohorts containing transcriptomic data collected from primarily community-onset sepsis patients...
February 15, 2018: Nature Communications
David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W Dünser, Arjen M Dondorp, Marcus J Schultz
Background: Recommendations for haemodynamic assessment and support in sepsis and septic shock in resource-limited settings are largely lacking. Methods: A task force of six international experts in critical care medicine, all of them members of the Global Intensive Care Working Group of the European Society of Intensive Care Medicine and with extensive bedside experience in resource-limited intensive care units, reviewed the literature and provided recommendations regarding haemodynamic assessment and support, keeping aspects of efficacy and effectiveness, availability and feasibility and affordability and safety in mind...
February 9, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Chenggong Hu, Yongfang Zhou, Chang Liu, Yan Kang
The purpose of this study was to confirm the prognostic value of pentraxin-3 (PTX3), procalcitonin (PCT) and lactate in patients with severe infections requiring ICU management and to develop and validate a model to enhance mortality prediction by combining severity scores with biomarkers. We included 141 patients with the diagnosis of sepsis/septic shock. The levels of PTX3, PCT and lactate were measured on day 0, 3, 7 of hospitalization and Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were also evaluated...
January 12, 2018: Oncotarget
Seung Mok Ryoo, JungBok Lee, Yoon-Seon Lee, Jae Ho Lee, Kyoung Soo Lim, Jin Won Huh, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Won Young Kim
OBJECTIVES: This study aimed to compare the prognostic value of lactate level and lactate clearance at 6 hours after septic shock recognition. And, we performed it to determine lactate kinetics in the Sepsis-3 defined septic shock. DESIGN: This retrospective study was performed from a prospective septic shock registry. SETTINGS: This study was performed at single urban tertiary center. And, all patients were treated with protocol-driven resuscitation bundle therapy between 2010 and 2016...
February 9, 2018: Critical Care Medicine
Martin Sauer, Georg Richter, Jens Altrichter, Thomas Wild, Fanny Doß, Thomas Mencke, Sandra Doß, Stephanie Koch, Anton Schubert, Gabriele Nöldge-Schomburg, Steffen R Mitzner
A granulocyte bioreactor for the extracorporeal treatment was developed to enhance the immune cell function in patients with severe sepsis. The influence of oxygenation on the used cells was tested in a prospective clinical study. Ten patients with severe sepsis were treated twice with the granulocyte bioreactor. The used cells were screened for functionality; values of blood gases, glucose and lactate were obtained from the recirculating bioreactor circuit. Five patients were treated with an oxygenator setup (Oxy group), five without oxygenator (Non-Oxy group)...
February 8, 2018: Therapeutic Apheresis and Dialysis
Thibaut Girardot, Thomas Rimmelé, Guillaume Monneret, Julien Textoris, Fabienne Venet
BACKGROUND: Sepsis-associated hyperlactatemia is a widely used biomarker, associated with initial severity and poor outcomes. This increased circulating lactate concentration has been proposed to result in part from a mismatch between oxygen delivery and demand in organs. However, other mechanisms may participate. In particular, a metabolic reprogramming similar to the Warburg effect initially described in cancer cells could lead to increased lactate production by immune cells such as T lymphocytes after sepsis...
February 5, 2018: Intensive Care Medicine Experimental
Veerapong Vattanavanit, Theerapat Buppodom, Bodin Khwannimit
Background: The timing of intravenous antibiotic administration and lactate measurement is associated with survival of septic shock patients. Septic shock patients were admitted to the medical intensive care unit (MICU) from 2 major sources: hospital ward and emergency department (ED). This study aimed to compare the timing of antibiotic administration and lactate measurement between hospital wards and the ED. Patients and methods: Medical data were collected from adult patients admitted to the MICU with septic shock from January 2015 to December 2016...
2018: Infection and Drug Resistance
Tanvi Shah, Ethan Sterk, Megan A Rech
Recent literature has highlighted the importance of early identification and treatment of sepsis; however, limited data exists to help recognize sepsis in the emergency department (ED) through use of a screening tool. The purpose of this study was to evaluate the impact of a sepsis screening tool implemented in an academic medical center ED on compliance with the 3-hour sepsis bundle. This was a retrospective cohort study that included a total of 115 patients, of which 58 were in the pre-tool group and 57 were in the post-tool group...
January 28, 2018: American Journal of Emergency Medicine
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