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lactate in sepsis

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https://www.readbyqxmd.com/read/28731900/micro-and-macro-circulatory-changes-during-sepsis-and-septic-shock-in-a-rat-model
#1
Tianfeng Hua, Xiaobo Wu, Wei Wang, Hao Li, Jennifer Bradley, Mary Ann Peberdy, Joseph P Ornato, Wanchun Tang
Microcirculation is the motor of sepsis. In the present study, we investigated whether microcirculatory alterations occur prior to changes of systemic hemodynamics in a rat model of cecum ligation and puncture (CLP)-induced sepsis. We further investigated renal microcirculatory changes during sepsis and compared those with buccal microcirculation. Twelve male Sprague-Dawley rats were randomized into a sham control group (n = 6) and a CLP group (n = 6). Perfused microvessel density (PVD) and microvascular flow index (MFI) were evaluated using sidestream dark field (SDF) video microscopy at baseline, 60, 120, 180, 240, 300, and 360 minutes following CLP...
July 20, 2017: Shock
https://www.readbyqxmd.com/read/28730906/mortality-intensive-care-treatment-and-cost-evaluation-role-of-a-polymerase-chain-reaction-assay-in-patients-with-sepsis
#2
Markota Andrej, Sinkovič Andreja
Objective We examined whether patients with a positive SeptiFast (SF) assay (LightCycler SeptiFast; Roche Diagnostics, Basel, Switzerland) developed higher long-term mortality, a more difficult course of treatment, and a higher antimicrobial treatment cost than patients with a negative SF assay. Methods We performed a post-hoc analysis of data collected in a 1-year prospective interventional study of adults with severe sepsis and septic shock. In addition to the standard treatment, an additional 5 ml of blood was obtained for an SF assay, and the antimicrobial treatment was changed according to the SF results...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28729904/impact-of-a-sepsis-bundle-in-wards-of-a-tertiary-hospital
#3
F Teles, W G Rodrigues, M G T C Alves, C F T Albuquerque, S M O Bastos, M F A Mota, E S Mota, F J L Silva
BACKGROUND: Sepsis is a prevalent disease worldwide and still exhibits high rates of mortality. In the last years, many interventions aiming a positive impact on sepsis evolution have been studied. One of the main is the use of managed care protocols (sepsis bundles), which consist in systematization of diagnosis and treatment, such as standardization of antibiotics, collection of specific tests (cultures, lactate), and fluid replacement. Some studies have shown a reduction in hospital costs and lower mortality with the use of these tools...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#4
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28727802/diagnostic-accuracy-of-procalcitonin-neutrophil-lymphocyte-count-ratio-c-reactive-protein-and-lactate-in-patients-with-suspected-bacterial-sepsis
#5
Lars Ljungström, Anna-Karin Pernestig, Gunnar Jacobsson, Rune Andersson, Barbara Usener, Diana Tilevik
BACKGROUND: Early recognition is a key factor to achieve improved outcomes for septic patients. Combinations of biomarkers, as opposed to single ones, may improve timely diagnosis and survival. We investigated the performance characteristics of sepsis biomarkers, alone and in combination, for diagnosis of verified bacterial sepsis using Sepsis-2 and Sepsis-3 criteria, respectively. METHODS: Procalcitonin (PCT), neutrophil-lymphocyte count ratio (NLCR), C-reactive protein (CRP), and lactate were determined in a total of 1,572 episodes of adult patients admitted to the emergency department on suspicion of sepsis...
2017: PloS One
https://www.readbyqxmd.com/read/28720399/prenatal-and-postnatal-administration-of-prebiotics-and-probiotics
#6
REVIEW
Kristin Sohn, Mark A Underwood
Colonization of the neonatal gut by beneficial bacteria is important for the establishment and maintenance of the mucosal barrier, thus protecting the neonate from enteric pathogens and local and systemic inflammation. The neonatal microbiome is influenced by infant diet, environment, and the maternal microbiome. Dysbiosis in pregnancy increases the risk of pre-eclampsia, diabetes, infection, preterm labor, and later childhood atopy. Dysbiosis of the neonatal gut plays an important role in colic in the term infant, in the disease processes which plague preterm infants, including necrotizing enterocolitis and sepsis, and in the long-term outcomes of neonates...
July 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28717513/unexpected-intensive-care-transfer-of-admitted-patients-with-severe-sepsis
#7
Gabriel Wardi, Arvin R Wali, Julian Villar, Vaishal Tolia, Christian Tomaszewski, Christian Sloane, Peter Fedullo, Jeremy R Beitler, Matthew Nolan, Daniel Lasoff, Rebecca E Sell
BACKGROUND: Patients with severe sepsis generally respond well to initial therapy administered in the emergency department (ED), but a subset later decompensate and require unexpected transfer to the intensive care unit (ICU). This study aimed to identify clinical factors that can predict patients at increased risk for delayed transfer to the ICU and the association of delayed ICU transfer with mortality. METHODS: This is a nested case-control study in a prospectively collected registry of patients with severe sepsis and septic shock at two EDs...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28710027/admission-lactate-predicts-poor-prognosis-independently-of-the-crb-curb-65-scores-in-community-acquired-pneumonia
#8
Frederik S Frenzen, Ulrike Kutschan, Nils Meiswinkel, Bernhard Schulte-Hubbert, Santiago Ewig, Martin Kolditz
OBJECTIVES: Community-acquired pneumonia (CAP) is associated with a high risk of respiratory failure or septic organ dysfunction. Lactate is an established early marker of prognosis and sepsis severity, but few data exist in patients with CAP. METHODS: We performed a retrospective cohort study of consecutive adult CAP patients without treatment restrictions or direct ICU admission. Lactate was measured as point of care test within the capillary admission blood gas analysis and its prognostic value was compared to the CRB/CURB-65 criteria by multivariate and ROC curve analysis...
July 11, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28709443/severity-of-acute-gastrointestinal-injury-grade-is-a-predictor-of-all-cause-mortality-in-critically-ill-patients-a-multicenter-prospective-observational-study
#9
Bangchuan Hu, Renhua Sun, Aiping Wu, Yin Ni, Jingquan Liu, Feng Guo, Lijun Ying, Guoping Ge, Aijun Ding, Yunchao Shi, Changwen Liu, Lei Xu, Ronglin Jiang, Jun Lu, Ronghai Lin, Yannan Zhu, Weidong Wu, Bo Xie
BACKGROUND: In 2012, the European Society of Intensive Care Medicine proposed a definition for acute gastrointestinal injury (AGI) based on current medical evidence and expert opinion. The aim of the present study was to evaluate the feasibility of using the current AGI grading system and to investigate the association between AGI severity grades with clinical outcome in critically ill patients. METHODS: Adult patients at 14 general intensive care units (ICUs) with an expected ICU stay ≥24 h were prospectively studied...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28692671/immune-profiles-and-clinical-outcomes-between-sepsis-patients-with-or-without-active-cancer-requiring-admission-to-intensive-care-units
#10
Wen-Feng Fang, Yu-Mu Chen, Chiung-Yu Lin, Kuo-Tung Huang, Hsu-Ching Kao, Ying-Tang Fang, Chi-Han Huang, Ya-Ting Chang, Yi-His Wang, Chin-Chou Wang, Meng-Chih Lin
BACKGROUND: Immunoparalysis was observed in both patients with cancer and sepsis. In cancer patients, Cytotoxic T lymphocyte antigen-4 and programmed cell death protein 1/programmed death-ligand 1 axis are two key components of immunoparalysis. Several emerging therapies against these two axes gained significant clinical benefit. In severe sepsis patients, immunoparalysis was known as compensatory anti-inflammatory response syndrome and this has been suggested as an important cause of death in patients with sepsis...
2017: PloS One
https://www.readbyqxmd.com/read/28687209/new-sepsis-and-septic-shock-definitions-clinical-implications-and-controversies
#11
REVIEW
Chanu Rhee, Michael Klompas
New sepsis definitions shift emphasis from the systemic inflammatory response syndrome to organ dysfunction, quantified using the Sequential Organ Failure Assessment (SOFA) score. The new definitions also propose Quick SOFA criteria to rapidly identify potentially infected patients at risk for poor outcomes. Diagnosing septic shock requires vasopressor dependence and increased lactate levels. Strengths of these definitions include their simplicity and clear association with adverse outcomes. However, their utility in identifying patients with serious infections before frank sepsis ensues remains to be seen...
July 5, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28684104/acid-base-disorders-in-liver-disease
#12
REVIEW
Scheiner Bernhard, Lindner Gregor, Reiberger Thomas, Schneeweiss Bruno, Trauner Michael, Zauner Christian, Funk Georg-Christian
Next to the kidneys and lungs, the liver has been recognized as an important regulator of acid-base homeostasis. While respiratory alkalosis is the most common acid-base disorder in chronic liver disease, various complex metabolic acid-base disorders may occur with liver dysfunction. Although the standard variables of acid-base equilibrium, such as pH and overall base excess, often fail to unmask the underlying cause of acid-base disorders, the physical-chemical acid-base model allows a more in-depth pathophysiological understanding and clinical judgement of acid-base disorders in patients with liver diseases...
July 3, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28680514/validating-a-point-of-care-lactate-meter-in-adult-patients-with-sepsis-presenting-to-the-emergency-department-of-a-tertiary-care-hospital-of-a-low-to-middle-income-country
#13
Muhammad Akbar Baig, Hira Shahzad, Erfan Hussain, Asad Mian
BACKGROUND: Timely identification of high blood lactate levels in septic patients may allow faster detection of those patients requiring immediate resuscitation. Point-of-care (POC) testing is being increasingly utilized in the emergency department (ED). We examined the accuracy and time-saving effect of a handheld POC lactate device for the measurement of fingertip and whole blood lactate as compared with reference laboratory blood testing in septic ED patients. METHODS: A convenience sample of adult ED patients receiving serum lactate testing were enrolled prospectively in the ED of a multidisciplinary tertiary care hospital serving the population of one of the major cities of Pakistan...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28679957/socs1-is-a-negative-regulator-of-metabolic-reprogramming-during-sepsis
#14
Annie Rocio Piñeros Alvarez, Nicole Glosson-Byers, Stephanie Brandt, Soujuan Wang, Hector Wong, Sarah Sturgeon, Brian Paul McCarthy, Paul R Territo, Jose Carlos Alves-Filho, C Henrique Serezani
Sepsis can induce an overwhelming systemic inflammatory response, resulting in organ damage and death. Suppressor of cytokine signaling 1 (SOCS1) negatively regulates signaling by cytokine receptors and Toll-like receptors (TLRs). However, the cellular targets and molecular mechanisms for SOCS1 activity during polymicrobial sepsis are unknown. To address this, we utilized a cecal ligation and puncture (CLP) model for sepsis; C57BL/6 mice subjected to CLP were then treated with a peptide (iKIR) that binds the SOCS1 kinase inhibitory region (KIR) and blocks its activity...
July 6, 2017: JCI Insight
https://www.readbyqxmd.com/read/28671163/predictors-of-mortality-of-severe-sepsis-among-adult-patients-in-the-medical-intensive-care-unit
#15
Aziz Kallikunnel Sayed Mohamed, Asmita Anilkumar Mehta, Ponneduthamkuzhy James
BACKGROUND: Sepsis is an important cause of mortality in the Intensive Care Units (ICUs) worldwide. Information regarding early predictive factors for mortality and morbidity is limited. AIMS AND OBJECTIVES: The primary objective of the study was to estimate the mortality of severe sepsis among adult patients admitted into the medical ICU. The secondary objective was to identify the predictors associated with mortality. MATERIALS AND METHODS: Adult patients admitted with severe sepsis in the medical ICU were studied...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28668774/clinical-predictors-of-early-death-from-sepsis
#16
Adnan Javed, Faheem W Guirgis, Sarah A Sterling, Michael A Puskarich, Jennifer Bowman, Taylor Robinson, Alan E Jones
PURPOSE: Patients with severe sepsis who experience rapid, early deterioration and death are of particular concern. Our objective was to identify predictors of early death in Emergency Department (ED) patients with severe sepsis. METHODS: Secondary analysis of two prospective studies of adult ED patients with severe sepsis. The primary outcome was early death, defined as death within 24h of triage. RESULTS: Out of 410 severe sepsis admissions, 20 patients experienced early death...
June 23, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28662085/metabolomic-profiling-to-characterize-acute-intestinal-ischemia-reperfusion-injury
#17
Rachel G Khadaroo, Thomas A Churchill, Victor Tso, Karen L Madsen, Chris Lukowski, Saad Y Salim
Sepsis and septic shock are the leading causes of death in critically ill patients. Acute intestinal ischemia/reperfusion (AII/R) is an adaptive response to shock. The high mortality rate from AII/R is due to the severity of the disease and, more importantly, the failure of timely diagnosis. The objective of this investigation is to use nuclear magnetic resonance (NMR) analysis to characterize urine metabolomic profile of AII/R injury in a mouse model. Animals were exposed to sham, early (30 min) or late (60 min) acute intestinal ischemia by complete occlusion of the superior mesenteric artery, followed by 2 hrs of reperfusion...
2017: PloS One
https://www.readbyqxmd.com/read/28659919/the-%C3%AE-d-endoglucuronidase-heparanase-is-a-danger-molecule-that-drives-systemic-inflammation-and-correlates-with-clinical-course-after-open-and-endovascular-thoracoabdominal-aortic-aneurysm-repair-lessons-learnt-from-mice-and-men
#18
Lukas Martin, Alexander Gombert, Jianmin Chen, Julia Liebens, Julia Verleger, Johannes Kalder, Gernot Marx, Michael Jacobs, Christoph Thiemermann, Tobias Schuerholz
Thoracoabdominal aortic aneurysm (TAAA) is a highly lethal disorder requiring open or endovascular TAAA repair, both of which are rare, but extensive and complex surgical procedures associated with a significant systemic inflammatory response and high post-operative morbidity and mortality. Heparanase is a β-d-endoglucuronidase that remodels the endothelial glycocalyx by degrading heparan sulfate in many diseases/conditions associated with systemic inflammation including sepsis, trauma, and major surgery. We hypothesized that (a) perioperative serum levels of heparanase and heparan sulfate are associated with the clinical course after open or endovascular TAAA repair and (b) induce a systemic inflammatory response and renal injury/dysfunction in mice...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28655033/venous-vs-arterial-lactate-and-30-day-mortality-in-pediatric-sepsis-reply
#19
Halden F Scott, Allison Kempe, Lalit Bajaj
No abstract text is available yet for this article.
June 26, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28654990/venous-vs-arterial-lactate-and-30-day-mortality-in-pediatric-sepsis
#20
Luregn J Schlapbach, Graeme MacLaren, Lahn Straney
No abstract text is available yet for this article.
June 26, 2017: JAMA Pediatrics
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