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lactate in sepsis

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https://www.readbyqxmd.com/read/28891973/transfusion-of-red-blood-cells-to-patients-with-sepsis
#1
REVIEW
Yi-Ling Chan, Shih-Tsung Han, Chih-Huang Li, Chin-Chieh Wu, Kuan-Fu Chen
Sepsis is one of the major causes of death worldwide, and is the host response to infection which renders our organs malfunctioning. Insufficient tissue perfusion and oxygen delivery have been implicated in the pathogenesis of sepsis-related organ dysfunction, making transfusion of packed red blood cells (pRBCs) a reasonable treatment modality. However, clinical trials have generated controversial results. Even the notion that transfused pRBCs increase the oxygen-carrying capacity of blood has been challenged...
September 11, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28888058/increased-expression-of-programmed-cell-death-1-in-regulatory-t-cells-of-patients-with-severe-sepsis-and-septic-shock-an-observational-clinical-study
#2
Qiang Liu, Le An, Zhijiang Qi, Yongzhen Zhao, Chunsheng Li
While regulatory T-cells (Tregs) constitutively express programmed cell death-1 (PD-1), the role of PD-1 expression in Tregs of patients with sepsis remains unclear. Thus, we determined PD-1 expression in Tregs from the peripheral blood of patients with severe sepsis and septic shock Seventy-eight patients with severe sepsis and 40 with septic shock, as well as 21 healthy subjects, were enrolled in this study. The percentage of peripheral blood PD-1+ Tregs, as well as absolute Treg counts, were compared between these 3 groups...
September 9, 2017: Scandinavian Journal of Immunology
https://www.readbyqxmd.com/read/28884313/endocan-as-an-early-biomarker-of-severity-in-patients-with-acute-respiratory-distress-syndrome
#3
Diego Orbegozo, Lokmane Rahmania, Marian Irazabal, Manuel Mendoza, Filippo Annoni, Daniel De Backer, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Plasma concentrations of endocan, a proteoglycan preferentially expressed in the pulmonary vasculature, may represent a biomarker of lung (dys)function. We sought to determine whether the measurement of plasma endocan levels early in the course of acute respiratory distress syndrome (ARDS) could help predict risk of death or of prolonged ventilation. METHODS: All patients present in the department of intensive care during a 150-day period were screened for ARDS (using the Berlin definition)...
September 7, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28877132/parameters-for-ordering-blood-cultures-in-major-burn-injury-patients-improving-clinical-assessment
#4
James D Vargo, Jacob N Grow, Susan Yang, Abby Bernard, Niaman Nazir, Dhaval Bhavsar
Hypermetabolic and catabolic states in large TBSA burns lead to higher basal body temperature and tachycardia. These metabolic changes complicate the diagnosis of bacteremia and sepsis. Current indications for obtaining blood cultures (BCs) in this population are poorly described and nonstandardized. Fever, leukocytosis, and lactic acidosis are common during sepsis. This study aims to identify limits of these parameters with the highest rates of bacteremia. A retrospective review was performed for burn patients with > 20% TBSA between January 2009 and June 2011...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28869492/the-lactate-albumin-ratio-a-valuable-tool-for-risk-stratification-in-septic-patients-admitted-to-icu
#5
Michael Lichtenauer, Bernhard Wernly, Bernhard Ohnewein, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Alexander Lauten, Paul Christian Schulze, Uta C Hoppe, Malte Kelm, Christian Jung
The lactate/albumin ratio has been reported to be associated with mortality in pediatric patients with sepsis. We aimed to evaluate the lactate/albumin ratio for its prognostic relevance in a larger collective of critically ill (adult) patients admitted to an intensive care unit (ICU). A total of 348 medical patients admitted to a German ICU for sepsis between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. The association of the lactate/albumin ratio (cut-off 0...
September 2, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28854874/recognition-and-treatment-of-severe-sepsis-in-the-emergency-department-retrospective-study-in-two-french-teaching-hospitals
#6
Philippe Le Conte, Séverin Thibergien, Jean Batiste Obellianne, Emmanuel Montassier, Gilles Potel, Pierre Marie Roy, Eric Batard
BACKGROUND: Sepsis management in the Emergency Department remains a daily challenge. The Surviving Sepsis Campaign (SSC) has released three-hour bundle. The implementation of these bundles in European Emergency Departments remains poorly described. The main objective was to assess the compliance with the Severe Sepsis Campaign 3-h bundle (blood culture, lactate dosage, first dose of antibiotics and 30 ml/kg fluid challenge). Secondary objectives were the analysis of the delay of severe sepsis recognition and description of the population...
August 30, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28844961/mitochondrial-dysfunction-in-rat-splenocytes-following-hemorrhagic-shock
#7
Marie Warren, Kumar Subramani, Richard Schwartz, Raghavan Raju
The regulation of mitochondrial function is critical in cellular homeostasis following hemorrhagic shock. Hemorrhagic shock results in fluid loss and reduced availability of oxygen and nutrients to tissues. The spleen is a secondary lymphoid organ playing a key role in 'filtering the blood' and in the innate and adaptive immune responses. To understand the molecular basis of hemorrhagic shock, we investigated the changes in splenocyte mitochondrial respiration, and concomitant immune and metabolic alterations...
August 26, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28841570/diagnosis-biomarkers-in-acute-intestinal-ischemic-injury-so-close-yet-so-far
#8
REVIEW
Katell Peoc'h, Alexandre Nuzzo, Kevin Guedj, Catherine Paugam, Olivier Corcos
Acute intestinal ischemic injury (i3) is a life-threatening condition with disastrous prognosis, which is currently difficult to diagnose at the early stages of the disease; a rapid diagnosis is mandatory to avoid irreversible ischemia, extensive bowel resection, sepsis and death. The overlapping protein expression of liver and gut related to the complex physiopathology of the disease, the heterogeneity of the disease and its relative rarity could explain the lack of a useful early biochemical marker of i3...
August 25, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28839512/relationship-between-capillary-refill-time-at-triage-and-abnormal-clinical-condition-a-prospective-study
#9
Claudia M Sansone, Fabiano Prendin, Greta Giordano, Paola Casati, Anne Destrebecq, Stefano Terzoni
BACKGROUND: Capillary refill time has been studied in literature as a perfusion indicator. Two pilot studies have proposed possible reference values in healthy adults. No data exist regarding capillary refill time as an indicator of abnormal clinical conditions in adults, which might be of help for triage nurses. OBJECTIVE: We wanted to assess if any relationships existed, between altered capillary refill time and abnormal clinical conditions in the emergency department...
2017: Open Nursing Journal
https://www.readbyqxmd.com/read/28837867/the-inhibition-of-inducible-nitric-oxide-synthase-and-oxidative-stress-by-agmatine-attenuates-vascular-dysfunction-in-rat-acute-endotoxemic-model
#10
Mohammed S El-Awady, Manar A Nader, Maha H Sharawy
Vascular dysfunction leading to hypotension is a major complication in patients with septic shock. Inducible nitric oxide synthase (iNOS) together with oxidative stress play an important role in development of vascular dysfunction in sepsis. Searching for an endogenous, safe and yet effective remedy was the chief goal for this study. The current study investigated the effect of agmatine (AGM), an endogenous metabolite of l-arginine, on sepsis-induced vascular dysfunction induced by lipopolysaccharides (LPS) in rats...
August 16, 2017: Environmental Toxicology and Pharmacology
https://www.readbyqxmd.com/read/28834911/the-clinical-utility-of-splenic-fluorodeoxyglucose-uptake-for-diagnosis-and-prognosis-in-patients-with-macrophage-activation-syndrome
#11
Sung Soo Ahn, Sang Hyun Hwang, Seung Min Jung, Sang-Won Lee, Yong-Beom Park, Mijin Yun, Jason Jungsik Song
The aim of the study was to evaluate splenic glucose metabolism in macrophage activation syndrome (MAS), characterized by overwhelming systemic inflammation. Splenic F-fluorodeoxyglucose (FDG) uptake was compared in patients with MAS and sepsis using positron emission tomography/computed tomography (PET/CT).Clinical and FDG-PET/CT findings from patients with MAS and those with culture-proven sepsis were evaluated. The standardized uptake value (SUV) for the spleen and liver were measured. The maximum of the spleen to liver SUV ratio (SLRmax) was calculated as spleen SUVmax/liver SUVmean...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28828145/apigenin-alleviates-endotoxin-induced-myocardial-toxicity-by-modulating-inflammation-oxidative-stress-and-autophagy
#12
Fang Li, Fangfang Lang, Huilin Zhang, Liangdong Xu, Yidan Wang, Chunxiao Zhai, Enkui Hao
Apigenin, a component in daily diets, demonstrates antioxidant and anti-inflammatory properties. Here, we intended to explore the mechanism of apigenin-mediated endotoxin-induced myocardial injury and its role in the interplay among inflammation, oxidative stress, and autophagy. In our lipopolysaccharide- (LPS-) induced myocardial injury model, apigenin ameliorated cardiac injury (lactate dehydrogenase (LDH) and creatine kinase (CK)), cell death (TUNEL staining, DNA fragmentation, and PARP activity), and tissue damage (cardiac troponin I (cTnI) and cardiac myosin light chain-1 (cMLC1)) and improved cardiac function (ejection fraction (EF) and end diastolic left ventricular inner dimension (LVID))...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28827507/presentation-coagulopathy-and-persistent-acidosis-predict-complications-in-orthopaedic-trauma-patients
#13
Benjamin R Childs, Daniel R Verhotz, Timothy A Moore, Heather A Vallier
OBJECTIVES: To evaluate the ability of measures of coagulopathy and acidosis to predict complications. We hypothesize that increased coagulopathy and acidosis over the first 60 hours of hospitalization will result in increased rates of infection and mortality. DESIGN: Prospective, observational. SETTING: Level 1 trauma center. PATIENTS: Three hundred and seventy-six skeletally mature patients with an Injury Severity Score (ISS) greater than 16 who were surgically treated for high energy fractures of the femur, pelvic ring, acetabulum, and/or spine...
August 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816920/similar-metabolic-innate-immunity-and-adipokine-profiles-in-adult-and-pediatric-sepsis-versus-systemic-inflammatory-response-syndrome-a-pilot-study
#14
Theonymfi Tavladaki, Anna Maria Spanaki, Helen Dimitriou, Efmorfia Kondili, Christianna Choulaki, Dimitris Georgopoulos, George Briassoulis
OBJECTIVES: To examine whether the septic profiles of heat shock protein 72, heat shock protein 90α, resistin, adiponectin, oxygen consumption, CO2 production, energy expenditure, and metabolic pattern, along with illness severity, nutritional, and inflammatory indices, differ between adult and pediatric patients compared with systemic inflammatory response syndrome and healthy controls. To evaluate whether these biomolecules may discriminate sepsis from systemic inflammatory response syndrome in adult and pediatric patients...
August 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28795665/-relationship-between-blood-lactate-level-and-the-prognosis-of-patients-with-diabetic-sepsis
#15
Yimei Liu, Minjie Ju, Simeng Pan, Hongyu He, Zhe Luo, Zhunyong Gu
OBJECTIVE: To evaluate the prognostic value of blood lactate (Lac) level in sepsis patients with or without diabetes. METHODS: 106 patients admitted to intensive care unit (ICU) of Zhongshan Hospital Affiliated to Fudan University from April 2015 to November 2016 were enrolled. The patients with age > 18 years and the length of hospital stay > 24 hours were included. Records including blood Lac, serum creatinine (SCr), white blood cell count (WBC), platelet count (PLT), sequential organ failure assessment (SOFA) on the first day of admission; minimum oxygen index (PaO2/FiO2) in 3 days after admission; mechanical ventilation, whether there was a history of diabetes, usage of biguanides, etiology control treatment, usage of continuous renal replacement therapy (CRRT) were collected...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795662/-evaluation-value-of-the-levels-of-peripheral-blood-cd20-cd24-hi-cd38-hi-regulatory-b-cells-on-the-prognosis-of-elderly-patients-with-sepsis
#16
Chunmei Wang, Lunxian Tang, Huihui Xu, Xiaoming Zhang, Jianwen Bai
OBJECTIVE: To explore the predicting value of peripheral blood CD20(+) CD24(hi) CD38(hi) regulatory B cells (Bregs) on the prognosis of elderly patients with sepsis. METHODS: A prospective study was conducted. Septic patients aged > 65 years old, compliance with diagnostic criteria for Sepsis-3, admitted to emergency and emergency intensive care unit (ICU) of Shanghai East Hospital of Tongji University from April 2016 to February 2017 were enrolled. Procalcitonin (PCT), C-reaction protein (CRP) and lactate (Lac) were routinely measured...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28793880/diagnostic-value-of-pentraxin-3-in-patients-with-sepsis-and-septic-shock-in-accordance-with-latest-sepsis-3-definitions
#17
Sonja Hamed, Michael Behnes, Dominic Pauly, Dominic Lepiorz, Max Barre, Tobias Becher, Siegfried Lang, Ibrahim Akin, Martin Borggrefe, Thomas Bertsch, Ursula Hoffmann
BACKGROUND: Pentraxin-3 (PTX-3) is an acute-phase protein involved in inflammatory and infectious processes. This study assesses its diagnostic and prognostic value in patients with sepsis or septic shock in a medical intensive care unit (ICU). METHODS: The study includes 213 ICU patients with clinical criteria of sepsis and septic shock. 77 donors served as controls. Plasma levels of PTX-3, procalcitonin (PCT) and interleukin-6 were measured on day 1, 3 and 8. RESULTS: PTX-3 correlated with higher lactate levels as well as with APACHE II and SOFA scores (p = 0...
August 9, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28790230/ventilator-associated-pneumonia-vap-in-a-patient-with-guillain-barre-syndrome
#18
Anti Dharmayanti, Dalima Astrawinata
A 46-year-old man was admitted to ICU with a diagnosis at the time of admission of Guillain Barre Syndrome (GBS) and sepsis due to suspected Ventilator-Associated Pneumoniae (VAP). Specimens for the following laboratory workup were inquired, i.e. complete blood count, culture and resistance workup using specimens obtained from the tip of suction pipe, urinalysis and urine culture, blood culture and resistance, procalcitonin and lactate levels. Neutrophilia was found along with increased procalcitonin and lactate levels, which supported the sepsis diagnosis...
April 2017: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/28790011/management-of-septic-shock-in-intermediate-care-unit
#19
Eric Meaudre, Cédric Nguyen, Claire Contargyris, Ambroise Montcriol, Erwan d'Aranda, Pierre Esnault, Mourad Bensalah, Bertrand Prunet, Julien Bordes, Philippe Goutorbe
BACKGROUND: While guidelines advocate goal-directed resuscitation based on timed bundles, the management of septic shock (SS) outside an ICU setting has been poorly studied in intermediate care units (IMCU). PATIENTS AND METHOD: We reviewed all cases of septic shock patients admitted to our IMCU between January 2013 and June 2014. The characteristics of sepsis, compliance of bundles, and outcomes were collected. The IMCU population was compared with the SS patients admitted to the ICU during the same period...
August 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28789803/preliminary-performance-on-the-new-cms-sepsis-1-national-quality-measure-early-insights-from-the-emergency-quality-network-e-qual
#20
Arjun K Venkatesh, Todd Slesinger, Jessica Whittle, Tiffany Osborn, Emily Aaronson, Craig Rothenberg, Nalani Tarrant, Pawan Goyal, Donald M Yealy, Jeremiah D Schuur
STUDY OBJECTIVE: We describe current hospital-level performance for the Centers for Medicare & Medicaid Services' Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) quality measure and qualitatively assess emergency department (ED) sepsis quality improvement best practice implementation. METHODS: Using a standardized Web-based submission portal, we surveyed quality improvement data from volunteer hospital-based EDs participating in the Emergency Quality Network Sepsis Initiative...
August 5, 2017: Annals of Emergency Medicine
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