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Fluid sepsis

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https://www.readbyqxmd.com/read/29040215/role-of-receptor-for-advanced-glycation-end-products-in-regulating-lung-fluid-balance-in-lipopolysaccharide-induced-acute-lung-injury-and-infection-related-acute-respiratory-distress-syndrome
#1
Hao Wang, Tao Wang, Zhicheng Yuan, Yufang Cao, Yongfang Zhou, Junyun He, Yongchun Shen, Ni Zeng, Luqi Dai, Fuqiang Wen, Lei Chen
Receptor for advanced glycation end products (RAGE) is implicated in inflammatory responses in acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), but its role in pulmonary edema formation remains unclear, especially in infection-related ARDS mainly caused by pneumonia or sepsis. In this study, we investigated the role of RAGE in alveolar fluid regulation by using RAGE gene knockout (RAGE) mice in a murine ALI model induced by lipopolysaccharide (LPS), and by comparing soluble RAGE (sRAGE) levels in serum and bronchial alveolar lavage fluid (BALF) between ARDS patients and control subjects...
October 16, 2017: Shock
https://www.readbyqxmd.com/read/29036682/perinatal-risk-factors-for-neonatal-early-onset-group-b-streptococcal-sepsis-after-initiation-of-risk-based-maternal-intrapartum-antibiotic-prophylaxis-a-case-control-study
#2
Sridhar Santhanam, Sumita Arun, Grace Rebekah, Nithya J Ponmudi, Jolly Chandran, Ruby Jose, Atanu Kumar Jana
Objectives: To identify the perinatal risk factors for early-onset Group B Streptococcus (EOGBS) sepsis in neonates after inception of a risk-based maternal intrapartum antibiotic prophylaxis strategy in 2004. Design: Case control study. Methods: All newborn with early onset GBS sepsis (born between 2004 and 2013) were deemed to be "cases" and controls were selected in a 1:4 ratio. Results: More than three per vaginal (PV) examinations [odds ratio (OR) 8...
September 23, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29031640/the-application-of-mesenchymal-stem-cells-to-treat-thermal-and-radiation-burns
#3
Kathleen Rodgers, Sachin S Jadhav
Mesenchymal stem cells (MSCs) have been developed for a number of indications due to their regenerative and anti-inflammatory phenotypes and their utility is enhanced by the fact that allogeneic transplant is feasible with this cell type. Animal studies and early human cases indicate this has the potential to be an exciting new therapy for treating chronic non-healing wounds such as diabetic ulcers, burns and cutaneous radiation burns. This review will focus on the use of MSCs to treat thermal and radiation burns...
October 11, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29028771/mechanisms-of-thrombocytopenia-during-septic-shock-a-multiplex-cluster-analysis-of-endogenous-sepsis-mediators
#4
Alexandre Bedet, Keyvan Razazi, Florence Boissier, Mathieu Surenaud, Sophie Hue, Stéphane Giraudier, Christian Brun-Buisson, Armand Mekontso Dessap
BACKGROUND: Thrombocytopenia is a common feature of sepsis and may involve various mechanisms often related to the inflammatory response. This study aimed at evaluating factors associated with thrombocytopenia during human septic shock. In particular, we used a multiplex analysis to assess the role of endogenous sepsis mediators. METHODS: Prospective, observational study. Thrombocytopenia was defined as an absolute platelet count <100 G/L or a 50% relative decrease in platelet count during the first week of septic shock...
October 12, 2017: Shock
https://www.readbyqxmd.com/read/29026888/korean-shock-society-septic-shock-registry-a-preliminary-report
#5
Tae Gun Shin, Sung Yeon Hwang, Gu Hyun Kang, Won Young Kim, Seung Mok Ryoo, Kyuseok Kim, You Hwan Jo, Sung Phil Chung, Young Seon Joo, Jin Ho Beom, Sung-Hyuk Choi, Young Hoon Yoon, Woon Yong Kwon, Tae Ho Lim, Kap Su Han, Han Sung Choi, Gil Joon Suh
OBJECTIVE: To evaluate the clinical characteristics, therapeutic interventions, and outcomes of patients with septic shock admitted to the emergency department (ED). METHODS: This study was a preliminary, descriptive analysis of a prospective, multi-center, observational registry of the EDs of 10 hospitals participating in the Korean Shock Society. Patients aged 19 years or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion were included...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29023316/septic-shock-resuscitation-in-the-first-hour
#6
Nicholas Simpson, Francois Lamontagne, Manu Shankar-Hari
PURPOSE OF REVIEW: We reviewed the recent advances in the initial approach to resuscitation of sepsis and septic shock patients. RECENT FINDINGS: Sepsis and septic shock are life-threatening emergencies. Two key interventions in the first hour include timely antibiotic therapy and resuscitation. Before any laboratory results, the need for resuscitation is considered if a patient with suspected infection has low blood pressure (BP) or impaired peripheral circulation found at clinical examination...
October 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29022140/experimental-study-of-the-protective-effect-of-simvastatin-on-lung-injury-in-rats-with-sepsis
#7
Yu Wang, Wenping Yang, Xin Zhao, Rong Zhang
Simvastatin, which is primarily prescribed to lower cholesterol, may also mitigate lung injury caused by sepsis, although the mechanisms remain elusive. This study aimed to evaluate the protective effect of simvastatin on acute lung injury in rats with sepsis and to investigate possible mechanisms. Male Wistar rats were pretreated with simvastatin (0.2 μg/g) for 1 week before cecal ligation and puncture. Treatment with simvastatin demonstrated significant decreases in the concentration of protein, TNF-α, IL-1β, IL-6, and lipocalin 2, and the number of polymorphonuclear neutrophils in bronchoalveolar lavage fluid in septic rats...
October 11, 2017: Inflammation
https://www.readbyqxmd.com/read/28991047/vasopressors-do-not-influence-cerebral-critical-closing-pressure-during-systemic-inflammation-evoked-by-experimental-endotoxemia-and-sepsis-in-humans
#8
Judith Maria Dimphena van den Brule, Roeland Stolk, Elisabeth Janine Vinke, Lex Maxim van Loon, Peter Pickkers, Johannes Gerardus van der Hoeven, Matthijs Kox, Cornelia Wilhelmina Elisabeth Hoedemaekers
AIM: The aim of this study was to investigate the effects of different vasopressors on the cerebral vasculature during experimental human endotoxemia and sepsis. We used the critical closing pressure (CrCP) as a measure of cerebral vascular tone. METHODS: We performed a prospective pilot study, at the intensive care department (ICU) of a tertiary care university hospital in the Netherlands, in 40 healthy male subjects during experimental human endotoxemia (administration of bacterial lipopolysaccharide [LPS]) and in 10 patients with severe sepsis or septic shock...
October 4, 2017: Shock
https://www.readbyqxmd.com/read/28987477/3-hour-bundle-compliance-and-outcomes-in-undiagnosed-severe-sepsis-patients
#9
Amanda S Deis, Bristol B Whiles, Alexandra R Brown, Catherine L Satterwhite, Steven Q Simpson
BACKGROUND: To compare completion of the Surviving Sepsis Campaign, 3-hour treatment recommendations and patient-centered outcomes between patients who received a sepsis specific diagnosis to those who did not. METHODS: A retrospective cohort analysis of adult patients admitted through an academic medical center emergency department (ED), who received an antibiotic, and met criteria for severe sepsis. We measured and compared the Surviving Sepsis Campaign 3-hour treatment recommendations, along with patient-centered outcomes in patients who were and were not diagnosed with severe sepsis...
October 5, 2017: Chest
https://www.readbyqxmd.com/read/28985844/assessment-of-hemodynamic-response-to-fluid-resuscitation-of-patients-with-intra-abdominal-sepsis-in-low-and-middle-income-countries
#10
Egide Abahuje, Robert Munyaneza, Robert Riviello, Faustin Ntirenganya
BACKGROUND: Patients with intra-abdominal infections need to achieve adequate hemodynamic status before being taken to the operating room. Multiple parameters (urinary output [UOP], vital signs, inferior vena cava collapsibility index, and central venous pressure) may be used to assess hemodynamic response to fluid resuscitation, but the options are few in limited-resource settings. This study aimed at assessing if a bedside-performed ultrasound to assess the inferior vena cava collapsibility index is superior to UOP in assessing hemodynamic response to fluid resuscitation...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28982710/identification-of-extremely-premature-infants-at-low-risk-for-early-onset-sepsis
#11
Karen M Puopolo, Sagori Mukhopadhyay, Nellie I Hansen, C Michael Cotten, Barbara J Stoll, Pablo J Sanchez, Edward F Bell, Abhik Das, Angelita M Hensman, Krisa P Van Meurs, Myra H Wyckoff
BACKGROUND: Premature infants are at high risk of early-onset sepsis (EOS) relative to term infants, and most are administered empirical antibiotics after birth. We aimed to determine if factors evident at birth could be used to identify premature infants at lower risk of EOS. METHODS: Study infants were born at 22 to 28 weeks' gestation in Neonatal Research Network centers from 2006 to 2014. EOS was defined by isolation of pathogenic species from blood or cerebrospinal fluid culture at ≤72 hours age...
October 5, 2017: Pediatrics
https://www.readbyqxmd.com/read/28979774/early-detection-of-acute-cisplatin-nephrotoxicity-interest-of-urinary-monitoring-of-proximal-tubular-biomarkers
#12
Valérian Bunel, Yasmina Tournay, Thomas Baudoux, Eric De Prez, Marie Marchand, Zita Mekinda, Raphaël Maréchal, Thierry Roumeguère, Marie-Hélène Antoine, Joëlle L Nortier
BACKGROUND: Renal toxicity induced by cisplatin (CisPt) is a clinical issue in patients with or without chronic kidney disease (CKD). Proximal tubular injury can result in acute kidney injury (AKI), which may compromise the course of chemotherapy and the prognosis. The purpose of this study was to investigate the time course of urinary markers of acute tubulotoxicity and to assess the usefulness of such monitoring in a routine clinical setting. METHODS: This work is an open prospective pilot study carried out among 23 patients receiving a platinum-based chemotherapy...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28978926/beneficial-effects-of-red-light-emitting-diode-treatment-in-experimental-model-of-acute-lung-injury-induced-by-sepsis
#13
Silvia Goes Costa, Éric Diego Barioni, Aline Ignácio, Juliana Albuquerque, Niels Olsen Saraiva Câmara, Christiane Pavani, Luana Beatriz Vitoretti, Amílcar Sabino Damazo, Sandra Helena Poliselli Farsky, Adriana Lino-Dos-Santos-Franco
Sepsis is a severe disease with a high mortality index and it is responsible for the development of acute lung injury (ALI). We evaluated the effects of light-emitting diode (LED) on ALI induced by sepsis. Balb-c mice were injected with lipopolysaccharide or saline and then irradiated or not with red LED on their tracheas and lungs for 150 s, 2 and 6 h after LPS injections. The parameters were investigated 24 h after the LPS injections. Red LED treatment reduced neutrophil influx and the levels of interleukins 1β, 17 A and, tumor necrosis factor-α; in addition to enhanced levels of interferon γ in the bronchoalveolar fluid...
October 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28973227/effect-of-an-early-resuscitation-protocol-on-in-hospital-mortality-among-adults-with-sepsis-and-hypotension-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Ben Andrews, Matthew W Semler, Levy Muchemwa, Paul Kelly, Shabir Lakhi, Douglas C Heimburger, Chileshe Mabula, Mwango Bwalya, Gordon R Bernard
Importance: The effect of an early resuscitation protocol on sepsis outcomes in developing countries remains unknown. Objective: To determine whether an early resuscitation protocol with administration of intravenous fluids, vasopressors, and blood transfusion decreases mortality among Zambian adults with sepsis and hypotension compared with usual care. Design, Setting, and Participants: Randomized clinical trial of 212 adults with sepsis (suspected infection plus ≥2 systemic inflammatory response syndrome criteria) and hypotension (systolic blood pressure ≤90 mm Hg or mean arterial pressure ≤65 mm Hg) presenting to the emergency department at a 1500-bed referral hospital in Zambia between October 22, 2012, and November 11, 2013...
October 3, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28967450/blood-pressure-variability-as-an-indicator-of-sepsis-severity-in-adult-emergency-department-patients
#15
Jacob E Nouriel, Scott R Millis, Jonathon Ottolini, John M Wilburn, Robert L Sherwin, James H Paxton
STUDY OBJECTIVE: Quantify the correlation between blood pressure variability (BPV) and markers of illness severity: serum lactate (LAC) or Sequential Organ Failure Assessment (SOFA) scores. METHODS: We performed a secondary analysis of data from a prospective, observational study evaluating fluid resuscitation on adult, septic, ED patients. Vital signs and fluid infusion volumes were recorded every 15min during the 3h following ED arrival. BPV was assessed via average real variability (ARV): the average of the absolute differences between consecutive BP measurements...
September 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28965695/-evaluating-a-child-after-a-febrile-seizure-insights-on-three-important-issues
#16
S Auvin, M Antonios, G Benoist, M-A Dommergues, F Corrard, V Gajdos, C Gras Leguen, E Launay, A Salaün, L Titomanlio, L Vallée, M Milh
Febrile seizures (FS) are the most common seizures seen in the paediatric population in the out-of-hospital and emergency department settings, and they account for the majority of seizures seen in children younger than 5 years old. An FS is a seizure accompanied by fever, without central nervous system infection, occurring in children between 6 months and 5 years old. Five criteria have been used and taught to classify any FS as simple or complex FS. These factors do not bear the same significance for clinical practice, in particular, the decision to perform a lumbar puncture for cerebrospinal fluid analysis to rule out an intracranial infection...
September 28, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28958185/targeting-the-endothelial-glycocalyx-in-acute-critical-illness-as-a-challenge-for-clinical-and-laboratory-medicine
#17
Vladimir Cerny, David Astapenko, Florian Brettner, Jan Benes, Radomir Hyspler, Christian Lehmann, Zdenek Zadak
The purpose of this manuscript is to review the role of endothelial glycocalyx (EG) in the field of critical and perioperative medicine and to discuss possible future directions for investigations in this area. Under physiological conditions, EG has several well-defined functions aimed to prevent the disruption of vessel wall integrity. Under pathological conditions, the EG represent one of the earliest sites of injury during inflammation. EG structure and function distortion contribute to organ dysfunction related to sepsis, trauma, or global ischemia of any origin...
August 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28953310/adverse-effects-of-crystalloid-and-colloid-fluids
#18
Robert G Hahn
Guidelines for infusion fluid therapy rarely take into account that adverse effects occur in a dose-dependent fashion. Adverse effects of crystalloid fluids are related to their preferential distribution to the interstitium of the subcutis, the gut, and the lungs. The gastrointestinal recovery time is prolonged by 2 days when more than 2 litres is administered. Infusion of 6-7 litres during open abdominal surgery results in poor wound healing, pulmonary oedema, and pneumonia. There is also a risk of fatal postoperative pulmonary oedema that might develop several days after the surgery...
September 27, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28941540/adjunctive-steroid-therapy-for-treatment-of-pediatric-septic-shock
#19
REVIEW
Jerry J Zimmerman
Septic shock remains the major cause of childhood morbidity and mortality worldwide. Although early sepsis recognition, fluid resuscitation, timely administration of antimicrobials, and vasoactive-inotropic drug infusions are all key to achieving good sepsis outcomes, therapy using various steroid drug classes remains an attractive adjunctive intervention to minimize the duration of septic shock and transition to multiple organ dysfunction syndrome. All steroid drug classes possess biological plausibility to affect a beneficial clinical effect among children with septic shock, but none has undergone rigorous, prospective assessment in a large, high-quality pediatric interventional trial...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28940011/guidelines-for-the-diagnosis-and-management-of-critical-illness-related-corticosteroid-insufficiency-circi-in-critically-ill-patients-part-i-society-of-critical-care-medicine-sccm-and-european-society-of-intensive-care-medicine-esicm-2017
#20
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. PARTICIPANTS: A multispecialty task force of 16 international experts in Critical Care Medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. DESIGN/METHODS: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies from 2008 to 2017 and were formulated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology...
September 21, 2017: Intensive Care Medicine
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