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lactate in sepsis

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https://www.readbyqxmd.com/read/28338650/risk-factors-associated-to-hospital-mortality-in-patients-with-acute-kidney-injury-on-hemodialysis
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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/28248722/mortality-is-greater-in-septic-patients-with-hyperlactatemia-than-with-refractory-hypotension
#9
Robert Gotmaker, Sandra L Peake, Andrew Forbes, Rinaldo Bellomo
BACKGROUND: In septic patients, it is uncertain whether isolated hyperlactatemia (lactate ≥ 4 mmol/L without refractory hypotension) can be used to diagnose septic shock and whether mortality rate differs from that of isolated refractory hypotension (refractory to 1000 ml or greater fluid bolus). AIMS: To compare baseline characteristics, treatments and outcomes of participants enrolled into the Australian Resuscitation in Sepsis Evaluation (ARISE) trial according to the presence of isolated hyperlactatemia or isolated refractory hypotension...
February 28, 2017: Shock
https://www.readbyqxmd.com/read/28237451/lactated-ringers-versus-normal-saline-in-children-with-sepsis
#10
Philip Toltzis
No abstract text is available yet for this article.
March 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28231305/effects-of-vasoactive-drugs-on-crystalloid-fluid-kinetics-in-septic-sheep
#11
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
https://www.readbyqxmd.com/read/28225738/pneumatosis-intestinalis-predictive-evaluation-study-a-multicenter-epidemiologic-study-of-the-american-association-for-the-surgery-of-trauma
#12
Paula Ferrada, Rachael Callcut, Graciela Bauza, Karen R O'Bosky, Xian Luo-Owen, Nicky J Mansfield, Kenji Inaba, Jason Pasley, Nikolay Bugaev, Bruno Pereira, Forrest O Moore, Jinfeng Han, Amelia Pasley, Joseph DuBose
BACKGROUND: Our group has previously published a retrospective review defining variables predictive of transmural bowel ischemia in the setting of pneumatosis intestinalis (PI). We hypothesize this prospective study will confirm the findings of the retrospective review, enhancing legitimacy to the predictive factors for pathologic PI previously highlighted. METHODS: Data were collected using the Research Electronic Data Capture. Forward logistic regression was utilized to identify independent predictors for pathologic PI...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28223734/early-thrombomodulin-%C3%AE-administration-outcome-for-acute-disseminated-intravascular-coagulopathy-in-gastrointestinal-surgery
#13
Hirotaka Konishi, Kazuma Okamoto, Katsutoshi Shoda, Tomohiro Arita, Toshiyuki Kosuga, Ryo Morimura, Shuhei Komatsu, Yasutoshi Murayama, Atsushi Shiozaki, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Eigo Otsuji
AIM: To investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery. METHODS: Thirty-six peri-operative DIC patients in the field of gastrointestinal surgery who were treated with TM-α were retrospectively investigated. The relationships between patient demographics and the efficacy of TM-α were examined. Analysis of survival at 28 d was also performed on some parameters by means of the Kaplan-Meier method...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28222674/administration-of-hes-in-elderly-patients-undergoing-hip-arthroplasty-under-spinal-anesthesia-is-not-associated-with-an-increase-in-renal-injury
#14
Yuanyuan Zhang, Yonghao Yu, Junya Jia, Wenli Yu, Rubin Xu, Licheng Geng, Ying Wei
BACKGROUND: Hydroxyethyl starch (HES) is applied to achieve volume expansion during surgery; however, nephrotoxicity may be induced in patients with sepsis. Simultaneously, neutrophil gelatinase-associated lipocalin (NGAL) and IL-18 have been illustrated as pivotal indicators to diagnose the acute kidney injury (AKI) early. This multi-center, randomized, double-blinded, placebo-controlled study aimed to investigate whether 6% HES 130/0.4 administration caused postoperative AKI, which can be revealed by urinary and plasma NGAL and IL-18 estimations in elderly patients with normal renal function undergoing hip arthroplasty under spinal anesthesia...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#15
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28219189/-effects-of-phentolamine-on-haemodynamics-of-patients-with-severe-sepsis
#16
W Yang, X B Li, Y Zhou, X M Mo
Objective: To explore the effects of phentolamine on hemodynamic of patients with severe sepsis . Methods: From January 2015 to August 2016, using random number table, 59 patients with severe sepsis were divided into research group and the control group by conventional treatment in Department of Emergency, the Second People's Hospital of Nanning City. The patients of the research group were given phentolamine injection. The CI, ITBVI, EVLWI, SVRI of the patients were monitored by PICCO on 6, 12, 24, 48, 72 h before and after treatment...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28207795/organ-dysfunction-during-continuous-veno-venous-high-cut-off-hemodialysis-in-patients-with-septic-acute-kidney-injury-a-prospective-observational-study
#17
Gianluca Villa, Cosimo Chelazzi, Elena Morettini, Lucia Zamidei, Serafina Valente, A Lucia Caldini, Giovanni Zagli, A Raffaele De Gaudio, Stefano Romagnoli
BACKGROUND: Continuous veno-venous hemodialysis with high cut-off membranes (HCO-CVVHD) removes inflammatory mediators involved in organ dysfunction during sepsis. The aim of the present study was to assess the variations in SOFA score and identify early predictors of short-term mortality in a cohort of patients with septic shock, treated with HCO-CVVHD for acute kidney injury (AKI). METHODS: An observational prospective multicenter cohort study was conducted in four mixed medical-surgical ICUs...
2017: PloS One
https://www.readbyqxmd.com/read/28207566/the-new-sepsis-definition-limitations-and-contribution-to-research-and-diagnosis-of-sepsis
#18
Franck Verdonk, Alice Blet, Alexandre Mebazaa
PURPOSE OF REVIEW: Based on recent clinical, epidemiological, and pathophysiological data, a third international consensus conference was carried out to define new criteria of sepsis in February 2016. This review presents the different items of this new definition, their limitations and their contribution to research and diagnosis of sepsis, in comparison with the previous definitions. RECENT FINDINGS: Incidence, management, and pathophysiological knowledge of sepsis have improved over the past 20 years...
April 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28203580/unusual-presentation-of-diffuse-large-b-cell-lymphoma-with-splenic-infarcts
#19
Vivek Kumar, Parita Soni, Vishangi Dave, Jonathan Harris
A 67-year-old man presented with a 3-day history of abdominal pain, fever, and significant weight loss over 2 months. Physical examination revealed left upper quadrant tenderness, hepatomegaly, splenomegaly, and bilateral pitting edema but peripheral lymphadenopathy was absent. Laboratory tests showed anemia, thrombocytopenia, elevated prothrombin time (PT), partial thromboplastin time (PTT), and increased lactate dehydrogenase (LDH). PTT was corrected completely in mixing study. Further workup for the cause of coagulopathy revealed decreased levels of all clotting factors except factor VIII and increase fibrinogen levels, which ruled out disseminated intravascular coagulation (DIC)...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28202033/use-of-stepwise-lactate-kinetics-oriented-hemodynamic-therapy-could-improve-the-clinical-outcomes-of-patients-with-sepsis-associated-hyperlactatemia
#20
Xiang Zhou, Dawei Liu, Longxiang Su, Bo Yao, Yun Long, Xiaoting Wang, Wenzhao Chai, Na Cui, Hao Wang, Xi Rui
BACKGROUND: Setting lactate kinetics at >30% might improve the clinical outcomes of patients with sepsis-associated hyperlactatemia. The aim of this study was to explore the outcome benefits of stepwise lactate kinetics vs central venous oxygen saturation (ScvO2)-oriented hemodynamic therapy at 6 h as the protocol goal during early resuscitation. METHODS: The relevant parameters and adverse events after different targets in 360 randomly assigned patients with sepsis-associated hyperlactatemia were recorded and compared...
February 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
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