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Sepsis, hemorrhagic shock,

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https://www.readbyqxmd.com/read/28937407/time-course-of-septic-shock-in-immunocompromised-and-nonimmunocompromised-patients
#1
Matthieu Jamme, Fabrice Daviaud, Julien Charpentier, Nathalie Marin, Michaël Thy, Yannick Hourmant, Jean-Paul Mira, Frédéric Pène
OBJECTIVES: To address the impact of underlying immune conditions on the course of septic shock with respect to both mortality and the development of acute infectious and noninfectious complications. DESIGN: An 8-year (2008-2015) monocenter retrospective study. SETTING: A medical ICU in a tertiary care center. PATIENTS: Patients diagnosed for septic shock within the first 48 hours of ICU admission were included. Patients were classified in four subgroups with respect to their immune status: nonimmunocompromised and immunocompromised distributed into hematologic or solid malignancies and nonmalignant immunosuppression...
September 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28906284/effect-of-transfusion-on-mortality-and-other-adverse-events-among-critically-ill-septic-patients-an-observational-study-using-a-marginal-structural-cox-model
#2
Claire Dupuis, Maité Garrouste-Orgeas, Sébastien Bailly, Christophe Adrie, Dany Goldgran-Toledano, Elie Azoulay, Stéphane Ruckly, Guillaume Marcotte, Bertrand Souweine, Michael Darmon, Yves Cohen, Carole Schwebel, Guillaume Lacave, Lila Bouadma, Jean-Francois Timsit
OBJECTIVES: RBC transfusion is often required in patients with sepsis. However, adverse events have been associated with RBC transfusion, raising safety concerns. A randomized controlled trial validated the 7 g/dL threshold, but previously transfused patients were excluded. Cohort studies led to conflicting results and did not handle time-dependent covariates and history of treatment. Additional data are thus warranted to guide patient's management. DESIGN: To estimate the effect of one or more RBC within 1 day on three major outcomes (mortality, ICU-acquired infections, and severe hypoxemia) at day 30, we used marginal structural models...
September 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28900672/extracorporeal-membrane-oxygenation-in-adult-patients-with-acute-fulminant-myocarditis-clinical-outcomes-and-risk-factor-analysis
#3
X Liao, B Li, Z Cheng
BACKGROUND: Our study aimed to summarize the clinical outcomes of extracorporeal membrane oxygenation (ECMO) in adult patients with acute fulminant myocarditis and to investigate the risk factors associated with its application. PATIENTS AND METHODS: We retrospectively examined patients with cardiogenic shock and acute fulminant myocarditis. The following data were collected: patients' preoperative general condition, related clinical factors during ECMO, complications, and outcomes of ECMO...
September 12, 2017: Herz
https://www.readbyqxmd.com/read/28868314/cause-of-death-following-surgery-for-acute-type-a-dissection-evidence-from-the-canadian-thoracic-aortic-collaborative
#4
R Scott McClure, Maral Ouzounian, Munir Boodhwani, Ismail El-Hamamsy, Michael W A Chu, Zlatko Pozeg, Francois Dagenais, Khokan C Sikdar, Jehangir J Appoo
BACKGROUND: Surgery confers the best chance of survival following acute Type A dissection (ATAD), yet perioperative mortality remains high. Although perioperative risk factors for mortality have been described, information on the actual causes of death is sparse. In this study, we aimed to characterize the inciting events causing death during surgical repair of ATAD. METHODS: Nine centers participated in the study. We included all patients who died following surgical repair for ATAD between January 2007 and December 2013...
April 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28844961/mitochondrial-dysfunction-in-rat-splenocytes-following-hemorrhagic-shock
#5
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/28827548/cith3-a-reliable-blood-biomarker-for-diagnosis-and-treatment-of-endotoxic-shock
#6
Baihong Pan, Hasan B Alam, Wei Chong, James Mobley, Baoling Liu, Qiufang Deng, Yinjian Liang, Yanming Wang, Eric Chen, Tianbing Wang, Muneesh Tewari, Yongqing Li
Current biomarkers for sepsis are limited by their non-specificity, short half-life, and insensitive response to therapy. Recently, we have demonstrated that citrullinated histone H3(CitH3) is released into the blood from neutrophil extracellular traps(NETs) in response to severe infection, and CitH3 may be a potential biomarker for sepsis. In the present study, we found that NET components were released in mouse models of both lipopolysaccharide(LPS)-induced shock (LPSS) and hemorrhagic shock (HS). To further quantify CitH3 in the NETs, we established a CitH3 specific enzyme-linked immunosorbent assay...
August 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28751369/wearable-technology-for-compensatory-reserve-to-sense-hypovolemia
#7
Victor A Convertino, Michael N Sawka
Traditional monitoring technologies fail to provide accurate or early indications of hypovolemia-mediated extremis because physiological systems (as measured by vital signs) effectively compensate until circulatory failure occurs. Hypovolemia is the most life-threatening physiological condition associated with circulatory shock in hemorrhage or sepsis, and it impairs one's ability to sustain physical exertion during heat stress. This review focuses on the physiology underlying the development of a novel non-invasive wearable technology that allows for real-time evaluation of the cardiovascular system's ability to compensate to hypovolemia, or its compensatory reserve, which provides an individualized estimate of impending circulatory collapse...
July 27, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#8
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
October 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28615325/calcium-calmodulin-dependent-protein-kinase-regulates-the-pink1-parkin-and-dj-1-pathways-of-mitophagy-during-sepsis
#9
Xianghong Zhang, Du Yuan, Qian Sun, Li Xu, Emma Lee, Anthony J Lewis, Brian S Zuckerbraun, Matthew R Rosengart
During sepsis and shock states, mitochondrial dysfunction occurs. Consequently, adaptive mechanisms, such as fission, fusion, and mitophagy, are induced to eliminate damaged portions or entire dysfunctional mitochondria. The regulatory PINK1/Parkin and DJ-1 pathways are strongly induced by mitochondrial depolarization, although a direct link between loss of mitochondrial membrane potential (ΔΨ) and mitophagy has not been identified. Mitochondria also buffer Ca(2+), and their buffering capacity is dependent on ΔΨ Here, we characterize a role for calcium/calmodulin-dependent protein kinase (CaMK) I in the regulation of these mechanisms...
October 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28598064/emphysematous-gastritis-with-air-in-portal-venous-system
#10
Omesh Goyal, Ajesh Bansal, Prerna Goyal
Emphysematous gastritis is a rare but severe form of phlegmonous gastritis caused by gastric mucosal disruption and infection of stomach wall by gas-forming bacteria. Ingestion of corrosive substances is the most common predisposing factor, followed by alcohol abuse, abdominal surgery, diabetes and immunosuppression. Patients usually present with abdominal pain, vomiting, diarrhea, constipation and/or gastro-intestinal hemorrhage. Characteristic radiological findings include presence of gas in the gastric wall...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28592932/lactate-prognostic-biomarker-in-severely-burned-patients
#11
A Mokline, A Abdenneji, I Rahmani, L Gharsallah, S Tlaili, I Harzallah, B Gasri, R Hamouda, A A Messadi
Plasma lactate (PL) has been used as a marker of cellular hypoxia and shock. The correlation between PL and clinical outcome has been well accepted in hemorrhagic and septic shock. In contrast to the existing evidence, there are no or almost no data dealing with lactate and burn-related outcome. We attempted to assess whether early plasma lactate (PL) is a useful parameter to predict outcome in burned patients. A prospective study was conducted in a 20-bed adult burn ICU at a university-affiliated teaching hospital in Tunis...
March 31, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28591008/plasma-resuscitation-improved-survival-in-a-cecal-ligation-and-puncture-rat-model-of-sepsis
#12
Ronald Chang, John B Holcomb, Par I Johansson, Shibani Pati, Martin A Schreiber, Charles E Wade
BACKGROUND: The paradigm shift from crystalloid to plasma resuscitation of traumatic hemorrhagic shock has improved patient outcomes due in part to plasma-mediated reversal of catecholamine and inflammation-induced endothelial injury, decreasing vascular permeability and attenuating organ injury. Since sepsis induces a similar endothelial injury as seen in hemorrhage, we hypothesized that plasma resuscitation would increase 48-hour survival in a rat sepsis model. METHODS: Adult male Sprague-Dawley rats (375-425 g) were subjected to 35% cecal ligation and puncture (CLP) (t = 0 h)...
June 6, 2017: Shock
https://www.readbyqxmd.com/read/28584040/perinatal-and-maternal-morbidity-and-mortality-after-attempted-operative-vaginal-delivery-at-midpelvic-station
#13
Giulia M Muraca, Yasser Sabr, Sarka Lisonkova, Amanda Skoll, Rollin Brant, Geoffrey W Cundiff, K S Joseph
BACKGROUND: Increased use of operative vaginal delivery (i.e., forceps or vacuum application), of which 20% occurs at midpelvic station, has been advocated to reduce the rate of cesarean delivery. We aimed to quantify severe perinatal and maternal morbidity and mortality associated with attempted midpelvic operative vaginal delivery. METHODS: We studied all term singleton deliveries in Canada between 2003 and 2013, by attempted midpelvic operative vaginal or cesarean delivery with labour (with and without prolonged second stage)...
June 5, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28579457/metformin-ameliorates-gender-and-age-dependent-hemodynamic-instability-and-myocardial-injury-in-murine-hemorrhagic-shock
#14
Dzmitry Matsiukevich, Giovanna Piraino, Patrick Lahni, Paul W Hake, Vivian Wolfe, Michael O'Connor, Jeanne James, Basilia Zingarelli
Severity of multiple organ failure is significantly impacted by age and gender in patients with hemorrhagic shock. However, the molecular mechanisms underlying the enhanced organ injury are not fully understood. AMP-activated protein kinase (AMPK) is a pivotal orchestrator of metabolic responses during stress. We investigated whether hemorrhage-induced myocardial injury is age and gender dependent and whether treatment with metformin, an AMPK activator, affords cardioprotective effects. C57/BL6 young (3-5months) and mature (9-12months) male and female mice were subjected to hemorrhagic shock by blood withdrawing followed by resuscitation with blood and Lactated Ringer's solution...
June 1, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28552748/characterization-of-a-previously-unrecognized-clinical-phenomenon-delayed-shock-after-cardiac-implantable-electronic-device-extraction
#15
Arwa Younis, Roy Beinart, Nofrat Nehoray, Elad Asher, Shlomy Matetzky, Roy Beigel, Anat Wieder, Michael Glikson, Eyal Nof
BACKGROUND: Transvenous lead extraction remains a challenging procedure with inherent risk and associated complications. OBJECTIVE: We sought to characterize and evaluate predictors of delayed shock after transvenous lead extraction with no intraprocedural complications. METHODS: We retrospectively analyzed data of 217 consecutive patients who underwent extraction between 2010 and 2015. The primary end point was sudden onset of shock more than 4 hours after the completion of the procedure...
October 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28485313/clinical-characteristics-and-current-interventions-in-shock-patients-in-chinese-emergency-departments-a-multicenter-prospective-cohort-study
#16
Shu-Bin Guo, Yun-Xia Chen, Xue-Zhong Yu
BACKGROUND: Shock is a life-threatening condition in emergency departments (EDs) and is associated with a high mortality; however, its clinical characteristics and current interventions in China are seldom reported. This study investigated the clinical characteristics and current interventions of shock patients in Chinese EDs. METHODS: This multicenter prospective cohort study was conducted in the EDs of 33 academic hospitals in 16 Chinese provinces. Adult shock patients were enrolled from December 2013 to April 2014...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28356662/pregnancy-related-acute-kidney-injury-an-analysis-of-165-cases
#17
E Mahesh, S Puri, V Varma, P R Madhyastha, S Bande, K C Gurudev
Pregnancy-related acute kidney injury (PRAKI) contributes to 3-7% of overall acute kidney injury (AKI) cases in Indian subcontinent. The aim of this study was to determine the outcomes of PRAKI and risk factors associated with renal injury and maternal mortality. One hundred and sixty-five patients with PRAKI, seen at M. S. Ramaiah Medical College between 2005 and 2014, were included in this, observational study. AKI was analyzed in terms of maximal stage of renal injury attained as per Risk, Injury, Failure, Loss of function, and End-stage renal disease (RIFLE) criteria...
March 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28318633/capillary-leak-syndrome-etiologies-pathophysiology-and-management
#18
REVIEW
Eric Siddall, Minesh Khatri, Jai Radhakrishnan
In various human diseases, an increase in capillary permeability to proteins leads to the loss of protein-rich fluid from the intravascular to the interstitial space. Although sepsis is the disease most commonly associated with this phenomenon, many other diseases can lead to a "sepsis-like" syndrome with manifestations of diffuse pitting edema, exudative serous cavity effusions, noncardiogenic pulmonary edema, hypotension, and, in some cases, hypovolemic shock with multiple-organ failure. The term capillary leak syndrome has been used to describe this constellation of disease manifestations associated with an increased capillary permeability to proteins...
July 2017: Kidney International
https://www.readbyqxmd.com/read/28261769/evaluation-of-risk-factors-and-development-of-acute-kidney-injury-in-aneurysmal-subarachnoid-hemorrhage-head-injury-and-severe-sepsis-septic-shock-patients-during-icu-treatment
#19
Ceren Kamar, Achmet Ali, Demet Altun, Günseli Orhun, Akın Sabancı, Altay Sencer, İbrahim Özkan Akıncı
BACKGROUND: There are few studies examining development of acute kidney injury (AKI) in the various types of patients in intensive care units (ICUs). Presently described is evaluation of risk factors and development of AKI in different groups of ICU patients. METHODS: Present study was performed in 3 different ICUs. Development of AKI was measured using Acute Kidney Injury Network (AKIN) classification system. Total of 300 patients who were treated in trauma, neurosurgery, or general ICU departments (due to head injury, aneurysmal subarachnoid hemorrhage [aSAH], or severe sepsis/septic shock, respectively) were assessed for incidence, risk factors, and development of AKI...
January 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#20
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
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