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adrenalin AND sepsis

Jennifer Rickard, Christian Ngarambe, Leonard Ndayizeye, Blair Smart, Robert Riviello, Jean Paul Majyambere
BACKGROUND: Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda. METHODS: Data were collected at a tertiary referral hospital in Rwanda on patients undergoing operation for peritonitis over a 6-month period. Data included epidemiology, hospital course and outcomes...
March 19, 2018: World Journal of Surgery
Marion Griton, Jan Pieter Konsman
Although the immune and nervous systems have long been considered independent biological systems, they turn out to mingle and interact extensively. The present review summarizes recent insights into the neural pathways activated by and involved in infection-induced inflammation and discusses potential clinical applications. The simplest activation concerns a reflex action within C-fibers leading to neurogenic inflammation. Low concentrations of pro-inflammatory cytokines or bacterial fragments may also act on these afferent nerve fibers to signal the central nervous system and bring about early fever, hyperalgesia and sickness behavior...
March 14, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Chizuru Yamashita, Yoshitaka Hara, Naohide Kuriyama, Tomoyuki Nakamura, Osamu Nishida
Polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) therapy is widely used for the treatment of severe sepsis and septic shock, and is generally performed for 2 h. Although previous studies demonstrated the efficacy of PMX-DHP therapy, it currently remains unclear whether its optimal duration is 2 h. This retrospective study analyzed 37 patients with septic shock who showed a poor clinical response to 2 h of PMX-DHP, and underwent a longer duration of this therapy. The mean duration of PMX-DHP therapy was 15...
August 2015: Therapeutic Apheresis and Dialysis
Soumen Choudhury, Kandasamy Kannan, M Pule Addison, Sazad A Darzi, Vishakha Singh, Thakur Uttam Singh, Ramasamy Thangamalai, Jeevan Ranjan Dash, Subhashree Parida, Biplab Debroy, Avishek Paul, Santosh Kumar Mishra
We have recently reported that pre-treatment, but not the post-treatment with atorvastatin showed survival benefit and improved hemodynamic functions in cecal ligation and puncture (CLP) model of sepsis in mice. Here we examined whether combined treatment with atorvastatin and imipenem after onset of sepsis can prolong survival and improve vascular functions. At 6 and 18h after sepsis induction, treatment with atorvastatin plus imipenem, atorvastatin or imipenem alone or placebo was initiated. Ex vivo experiments were done on mouse aorta to examine the vascular reactivity to nor-adrenaline and acetylcholine and mRNA expressions of α1D AR, GRK2 and eNOS...
August 2015: Vascular Pharmacology
Martha Matamoros, Roger Rodriguez, Allison Callejas, Douglas Carranza, Hilda Zeron, Carlos Sánchez, Jimena Del Castillo, Jesús López-Herce
OBJECTIVES: The objective of this study was to analyze the characteristic and the prognostic factors of in-hospital pediatric cardiac arrest (CA) in a public hospital Honduras. METHODS: A prospective observational study was performed on pediatric in-hospital CA as a part of a multicenter international study. One hundred forty-six children were studied. The primary end point was survival at hospital discharge. Univariate and multivariate logistic regression analyses were performed to assess the influence of each factor on mortality...
January 2015: Pediatric Emergency Care
Jimena Del Castillo, Jesús López-Herce, Sonia Cañadas, Martha Matamoros, Antonio Rodríguez-Núnez, Ana Rodríguez-Calvo, Angel Carrillo
OBJECTIVE: The aim of the study was to analyze the mortality and neurological outcome factors of in-pediatric intensive care unit (in-PICU) cardiac arrest (CA) in a multicenter international study. PATIENTS AND METHODS: It was a prospective observational multicenter study in Latin-American countries, Spain, Portugal, and Italy. A total of 250 children aged from 1 month to 18 years who suffered in-PICU CA were studied. Countries and patient-related variables, arrest life, support-related variables, procedures, and clinical and neurological status at hospital discharge according to the Pediatric Cerebral Performance Category (PCPC) scale were registered...
October 2014: Resuscitation
Jesús López-Herce, Jimena del Castillo, Sonia Cañadas, Antonio Rodríguez-Núñez, Angel Carrillo
INTRODUCTION AND OBJECTIVES: The objective was to analyze the characteristics and prognostic factors of in-hospital pediatric cardiac arrest in Spain. METHODS: A prospective observational study was performed to examine in-hospital pediatric cardiac arrest. Two hundred children were studied, aged between 1 month and 18 years, with in-hospital cardiac arrest. Univariate and multivariate logistic regression analyses were performed to assess the influence of each factor on survival to hospital discharge...
March 2014: Revista Española de Cardiología
Pär I Johansson, Nicolai Haase, Anders Perner, Sisse R Ostrowski
PURPOSE: The purpose of this study is to investigate potential associations between sympathoadrenal activation and/or vasopressor/inotropic therapy and endothelial activation, damage, and coagulopathy in septic patients. MATERIALS AND METHODS: Septic patients included in the Scandinavian Starch for Severe Sepsis/Septic Shock trial who were expected not to receive catecholamines at screening preintervention (baseline) and had baseline blood sampled. Clinical, outcome data, and measurements of plasma concentration (p-) biomarkers reflecting sympathoadrenal activation, endothelial activation and damage, natural anticoagulation, fibrinolysis, cell damage, and platelet activation...
June 2014: Journal of Critical Care
Akash Deep, Chulananda D A Goonasekera, Yanzhong Wang, Joe Brierley
BACKGROUND: Maintaining threshold values of cardiac output (CO) and systemic vascular resistance (SVR) when used as part of the American College of Critical Care Medicine (ACCM) haemodynamic protocol improves the outcomes in paediatric septic shock. OBJECTIVE: We observed the evolution of CO and SVR during the intensive care admission of children with fluid-refractory septic shock and report this together with the eventual outcomes. DESIGN: Prospective observational study...
September 2013: Intensive Care Medicine
Sisse R Ostrowski, Ronan M G Berg, Nis A Windeløv, Martin A S Meyer, Ronni R Plovsing, Kirsten Møller, Pär I Johansson
PURPOSE: The aim of this study was to investigate associations between circulating catecholamines, endothelial damage, and coagulopathy in experimental human endotoxemia and septic patients. MATERIALS AND METHODS: Nine healthy male volunteers undergoing endotoxemia (4-hour 0.5 ng/kg/hour infusion of E. coli lipopolysaccharide, blood sampling at 0, 4, and 6 hours) and 20 patients with severe sepsis. Analysis of plasma biomarkers (adrenaline, noradrenaline, thrombomodulin, syndecan-1, soluble vascular endothelial cadherin, histone-complexed DNA fragments, soluble CD40 ligand [sCD40L], protein C, tissue-type plasminogen activator, plasminogen activator inhibitor 1) and routine coagulation tests...
October 2013: Journal of Critical Care
C Engin, T Yagdi, O Balcioglu, S Erkul, B Baysal, E Oguz, F Ayik, P Ozturk, M Ozbaran
BACKGROUND: In this report, we share our experience with left ventricular assist device (LVAD) implantation in cases with a left ventricular (LV) thrombus. METHOD: Over the 3 years, more than 100 end-stage heart failure cases have been treated with LVAD implantation in our center, including 6 patients with a LV thrombus. Three were detected using preoperative transthoracic echocardiography. Fifty percent of the patients had dilated cardiomyopathy and the remaining cases had an ischemic etiology...
April 2013: Transplantation Proceedings
Daniel De Backer, Sabino Scolletta
Cardiovascular failure in sepsis involves a combination of hypovolemia, decreased vascular tone, myocardial depression and microcirculatory alterations. Fluids represent the first line therapeutic intervention, with controversy regarding the type of fluid. Recent data indicate that albumin is safe and might even be beneficial in specific subgroups. Starches may be an alternative, although concerns exist on potential detrimental effects on renal function of old generation starches. Trials testing new generation starches are ongoing...
March 1, 2013: Current Vascular Pharmacology
Markus Bosmann, Fabien Meta, Robert Ruemmler, Mikel D Haggadone, J Vidya Sarma, Firas S Zetoune, Peter A Ward
Severe sepsis is a life-threatening disease that causes major morbidity and mortality. Catecholamines and glucocorticoids often have been used for the treatment of sepsis. Several recent studies have suggested a potential role of IL-17 during the development and progression of sepsis in small animal models. In this study, the cross-talk of catecholamines and glucocorticoids with members of the IL-17 family was investigated during sepsis in C57BL/6 mice. The concentrations in plasma of IL-17A, IL-17F, and the IL-17AF heterodimer all were increased greatly in mice after endotoxemia or cecal ligation and puncture as compared with sham mice...
April 2013: American Journal of Pathology
J-J Lehot
A 71-year-old valvular patient with cardiac arrhythmia, low ejection fraction, administered angiotensin converting enzyme inhibitor underwent aortic and mitral valvular replacement. Starting during normothermic cardiopulmonary bypass (CPB), hypotension occurred, refractory to phenylephrine, noradrenaline, terlipressin, hydrocortisone and dexchlorpheniramine. After 3 hr of CPB biventricular hyperkinesia, severe hypotension and metabolic acidosis persisted despite volume loading, sodium bicarbonate, adrenaline infusion and intraaortic conterpulsation...
May 2012: Annales Françaises D'anesthèsie et de Rèanimation
Sisse R Ostrowski, Anne Marie Sørensen, Nis A Windeløv, Anders Perner, Karen-Lise Welling, Michael Wanscher, Claus F Larsen, Pär I Johansson
BACKGROUND: The level of soluble vascular endothelial growth factor receptor 1 (sVEGFR1) is increased in sepsis and strongly associated with disease severity and mortality. Endothelial activation and damage contribute to both sepsis and trauma pathology. Therefore, this study measured sVEGFR1 levels in trauma patients upon hospital admission hypothesizing that sVEGFR1 would increase with higher injury severity and predict a poor outcome. METHODS: Prospective observational study of 80 trauma patients admitted to a Level I Trauma Centre...
2012: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
E S Gorobets, I V Nekhaev, S V Lomidze
A few modern concepts of anesthesiological and resuscitation care during complicated surgical interventions are considered with special reference to multimodal anesthesia as a principal tool for the protection of the patient from a surgical trauma based on the rational combination of three-component epidural analgesia (ropivacaine, fentanyl, and adrenalin) with sevoflurane inhalation narcosis and extention of the same epidural analgesia to the early postoperative period. The basic principles of infusion-transfusion therapy for the treatment of massive intraoperative blood loss ensuring its tolerability by the patient are discussed...
2011: Vestnik Rossiĭskoĭ Akademii Meditsinskikh Nauk
Thirunavukkarasu Arun Babu, Vijayan Sharmila
A case of 7-day-old male neonate with cefotaxime-induced near-fatal anaphylaxis is being reported. Child was started on intravenous cefotaxime on day 3 of life in view of early-onset sepsis with pneumonia, following which there was clinical improvement. Child was then shifted out of intensive care to general ward for completion of antibiotic course. One day prior to the planned discharge, child suddenly developed poor sensorium, flaccidity, apnea, and cyanosis within seconds of receiving intravenous cefotaxime and was found to have bradypnea with bradycardia...
September 2011: Indian Journal of Pharmacology
Angeliki M Tsimogianni, Ilias Andrianakis, Alex Betrosian, Emmanouil Douzinas
INTRODUCTION: Azoles, and specifically itraconazole, are often prescribed for the treatment of fungal diseases or empirically for persistent sepsis in patients who are neutropenic or in intensive care. Occasional cardiovascular adverse events have been associated with itraconazole use, and are usually attributed to the interaction of itraconazole with cisapride, terfenadine or digoxin. Its interaction with amiodarone has not been previously described. CASE PRESENTATION: A 65-year-old Caucasian man was admitted to the Intensive Care Unit at our facility for an extensive ischemic stroke associated with atrial fibrillation...
July 29, 2011: Journal of Medical Case Reports
Gereon Schälte, Dietrich Henzler, Christian Waning, Josef Tacke, Rolf Rossaint, Andreas H Mahnken
OBJECTIVE: To investigate the effects of hepatic radiofrequency ablation (RFA) in patients with malignant liver disease with respect to inflammation activation and stress response. MATERIALS AND METHODS: In an observational trial, we investigated the physiologic parameters of 17 patients (20 interventions) who underwent percutaneous RFA under general anesthesia after applying total intravenous anesthesia. TNFα, IL-6, IL-8, IL-10, adrenaline and noradrenaline, liver enzymes, lactate and creatine kinase were determined pre-interventionally after induction of anesthesia (T1), 90 minutes after initiation of RFA (T2), immediately after the conclusion of the procedure (T3), and 24 hours after the procedure (T4)...
November 2010: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Gábor Woth, Adrienn Varga, Subhamay Ghosh, Miklós Krupp, Tamás Kiss, Lajos Bogár, Diana Mühl
Severe sepsis and multiple organ distress syndrome remain a diagnostic and therapeutic challenge for intensive therapy. Platelet activating factor forms a bridge between inflammation and clot formation. Our study surveys the effect of severe sepsis on platelet function and focuses on spontaneous aggregation in severely ill patients. Daily arterial blood samples were collected from 45 patients (average age of 60.7 ± 13) for five consecutive days following admission and 30 healthy controls. Platelet aggregation was measured using adrenaline (ADR), adenosine diphosphate (ADP), collagen (COL) and normal saline (SAL)...
January 2011: Journal of Thrombosis and Thrombolysis
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