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sepsis physiology

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https://www.readbyqxmd.com/read/28526706/cardiac-hyporesponsiveness-in-severe-sepsis-is-associated-with-nitric-oxide-dependent-activation-of-g-protein-receptor-kinase
#1
Daniela Dal-Secco, Silvia DalBó, Natalia E S Lautherbach, Fábio N Gava, Mara Rubia Nunes Celes, Patricia Oliveira Benedet, Adriana H Souza, Juliana Akinaga, Vanessa Lima, Katiussia P Silva, Luiz Ricardo A Kiguti, Marcos A Rossi, Isis do Carmo Kettelhut, André Sampaio Pupo, Fernando Queiroz Cunha, Jamil Assreuy
G protein-coupled receptor kinase isoform 2 (GRK2) has a critical role in physiological and pharmacological responses to endogenous and exogenous substances. Sepsis causes an important cardiovascular dysfunction in which nitric oxide (NO) has a relevant role. The present study aimed to assess the putative effect of inducible NO synthase (NOS-2)-derived NO on the activity of GRK2 in the context of septic cardiac dysfunction. C57BL/6 mice were submitted to severe septic injury by cecal ligation and puncture (CLP)...
May 19, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28526233/keratinocyte-growth-factor-for-the-treatment-of-the-acute-respiratory-distress-syndrome-kare-a-randomised-double-blind-placebo-controlled-phase-2-trial
#2
Daniel F McAuley, Lj Mark Cross, Umar Hamid, Evie Gardner, J Stuart Elborn, Kathy M Cullen, Ahilanandan Dushianthan, Michael Pw Grocott, Michael A Matthay, Cecilia M O'Kane
BACKGROUND: Data from in-vitro, animal, and human lung injury models suggest that keratinocyte growth factor (KGF) might be beneficial in acute respiratory distress syndrome (ARDS). The objective of this trial was to investigate the effect of KGF in patients with ARDS. METHODS: We did a double-blind, allocation concealed, randomised, placebo-controlled phase 2 trial in two intensive care units in the UK, involving patients fulfilling the American-European Consensus Conference Definition of ARDS...
May 16, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28526082/proof-of-concept-non-invasive-estimation-of-peripheral-venous-oxygen-saturation
#3
Musabbir Khan, Chris G Pretty, Alexander C Amies, Joel Balmer, Houda E Banna, Geoffrey M Shaw, J Geoffrey Chase
BACKGROUND: Pulse oximeters continuously monitor arterial oxygen saturation. Continuous monitoring of venous oxygen saturation (SvO2) would enable real-time assessment of tissue oxygen extraction (O2E) and perfusion changes leading to improved diagnosis of clinical conditions, such as sepsis. METHODS: This study presents the proof of concept of a novel pulse oximeter method that utilises the compliance difference between arteries and veins to induce artificial respiration-like modulations to the peripheral vasculature...
May 19, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28514870/biomarker-profile-of-sepsis-associated-coagulopathy-using-biochip-assay-for-inflammatory-cytokines
#4
Amanda Walborn, Debra Hoppensteadt, Daneyal Syed, Michael Mosier, Jawed Fareed
Disseminated intravascular coagulation (DIC) is a major pathophysiological mechanism of sepsis and greatly increases the risk of death in septic patients. Disseminated intravascular coagulation is a complex physiological phenomenon that involves inappropriate activation of coagulation, inflammation, and endothelial processes. The purpose of this study was to analyze the levels of inflammatory cytokines in the plasma of patients with DIC in order to compare the measured levels with those from healthy individuals, draw correlations, and provide a basis for further biomarker panel development...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28504624/-damage-control-surgery-in-patients-with-abdominal-sepsis
#5
Nikolaj Nerup, Karen Oline Larsen Langballe, Michael P Achiam, Lars B Svendsen
Damage control surgery (DCS) and resuscitation has improved the survival of trauma patients with decompensated physiology. In recent years, the principles of DCS have been used in the treatment of patients with abdominal sepsis, despite the fact that only a minimum of evidence exists. The aim is to optimize the physiology prior to definitive surgery. This implies a primary decontaminating surgical procedure with temporary abdominal closure without restoration of the intestinal continuity and avoidance of stoma formation in order to reduce time in the operating theatre...
May 8, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28503281/effect-of-septimeb-tm-as-a-new-natural-extract-on-severe-sepsis-a-randomized-clinical-trial
#6
Alieh Pourdast, Maryam Sanaei, Sirous Jafari, Mostafa Mohammadi, Hossein Khalili, Gita Shafiee, Zeinab Ahadi, Mahsa Rostami, Saba Alizad, Ramin Heshmat, Minoo Mohraz
BACKGROUND: Septimeb as a herbal medicine has regulatory effects on inflammation. This study set to evaluate the effects of Septimeb among patients with sepsis on inflammatory biomarkers and survival rate. METHODS: In this randomized clinical trial, 51 patients with sepsis from the ICU and medical ward of Imam Khomeini Hospital were divided into two groups: Septimeb (n=25) and control group (n=26). In the control group, the patients received a standard treatment only for 7 days, while Septimeb group received Septimeb (6cc vial with 500cc serum glucose infusion 5% daily for one to two hours) plus standard treatment of sepsis for 7 days...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28498331/the-roles-of-glutamine-in-the-intestine-and-its-implication-in-intestinal-diseases
#7
REVIEW
Min-Hyun Kim, Hyeyoung Kim
Glutamine, the most abundant free amino acid in the human body, is a major substrate utilized by intestinal cells. The roles of glutamine in intestinal physiology and management of multiple intestinal diseases have been reported. In gut physiology, glutamine promotes enterocyte proliferation, regulates tight junction proteins, suppresses pro-inflammatory signaling pathways, and protects cells against apoptosis and cellular stresses during normal and pathologic conditions. As glutamine stores are depleted during severe metabolic stress including trauma, sepsis, and inflammatory bowel diseases, glutamine supplementation has been examined in patients to improve their clinical outcomes...
May 12, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28494264/high-yield-scalable-and-remotely-drug-loaded-neutrophil-derived-extracellular-vesicles-evs-for-anti-inflammation-therapy
#8
Jin Gao, Sihan Wang, Zhenjia Wang
Extracellular vesicles (EVs) are nanoscale membrane-formed compartments naturally secreted from cells, which are intercellular mediators regulating physiology and pathogenesis, therefore they could be a novel therapeutic carrier for targeted delivery. However, the translation of EVs is hindered by the heterogeneous composition, low yield, inefficient drug loading and unlikely scalability. Here we report a strategy to generate EVs using nitrogen cavitation (NC-EVs) that instantly disrupts neutrophils to form nanosized membrane vesicles...
May 3, 2017: Biomaterials
https://www.readbyqxmd.com/read/28486891/assessing-contemporary-intensive-care-unit-outcome-development-and-validation-of-the-australian-and-new-zealand-risk-of-death-admission-model
#9
E Paul, M Bailey, J Kasza, D V Pilcher
The Australian and New Zealand Risk of Death (ANZROD) model currently used for benchmarking intensive care units (ICUs) in Australia and New Zealand utilises physiological data collected up to 24 hours after ICU admission to estimate the risk of hospital mortality. This study aimed to develop the Australian and New Zealand Risk of Death admission (ANZROD<sub>0</sub>) model to predict hospital mortality using data available at presentation to ICU and compare its performance with the ANZROD in Australian and New Zealand hospitals...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28484814/contemporary-approaches-to-perioperative-iv-fluid-therapy
#10
REVIEW
Paul S Myles, Sam Andrews, Jonathan Nicholson, Dileep N Lobo, Monty Mythen
BACKGROUND: Intravenous fluid therapy is required for most surgical patients, but inappropriate regimens are commonly prescribed. The aim of this narrative review was to provide evidence-based guidance on appropriate perioperative fluid management. METHOD: We did a systematic literature search of the literature to identify relevant studies and meta-analyses to develop recommendations. RESULTS: Of 275 retrieved articles, we identified 25 articles to inform this review...
May 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28473609/progression-and-variability-of-physiologic-deterioration-in-an-ovine-model-of-lung-infection-sepsis
#11
Farid Yaghouby, Chathuri Daluwatte, Satoshi Fukuda, Christina Nelson, John Salsbury, Michael P Kinsky, George C Kramer, David G Strauss, Perenlei Enkhbaatar, Christopher G Scully
In this study, a lung infection model of pneumonia in sheep (N=12) that included smoke inhalation injury followed by Methicillin-resistant Staphylococcus aureus (MRSA) placement into the lungs was used to investigate hemodynamic and pulmonary dysfunctions during the course of sepsis progression. To assess the variability in disease progression, animals were retrospectively divided into survivor (N=6) and non-survivor (N=6) groups and a range of physiological indices reflecting hemodynamic and pulmonary function were estimated and compared to evaluate variability in dynamics underlying sepsis development...
May 4, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28471985/the-clinical-significance-of-scd14-st-for-blood-biomarker-in-neonatal-hematosepsis-a-diagnostic-accuracy-study
#12
Ting Xiao, Li-Ping Chen, Li-Hua Zhang, Fu-Huang Lai, Li Zhang, Qun-Feng Qiu, Rong-Liang Que, SiSi Xie, Ding-Chang Wu
Hematosepsis is a systemic inflammatory response syndrome (SIRS) with suspected or confirmed infection, which is the most common infectious disease in clinical neonatal intensive care unit. As the rapid development of neonatal hematosepsis caused by various basic diseases, the mortality rate is high, and there are some sequelae.We report the lasted study to date with 96 cases from Fujian Longyan First Hospital between 2013 and 2015. The aim of our study is to explore the value of soluble cluster of differentiation 14 subtype (sCD14-ST) in whole blood for differential diagnosis of neonatal hematosepsis at an early stage, and used in evaluation of the severity about sepsis combined with acute physiology and chronic health evaluation II (APACHE-II) score, procalcitonin (PCT), C reactive protein (CRP), and leukocyte (WBC)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28461486/brd4-modulates-the-innate-immune-response-through-mnk2-eif4e-pathway-dependent-translational-control-of-i%C3%AE%C2%BAb%C3%AE
#13
Yan Bao, Xuewei Wu, Jinjing Chen, Xiangming Hu, Fuxing Zeng, Jianjun Cheng, Hong Jin, Xin Lin, Lin-Feng Chen
Bromodomain-containing factor Brd4 has emerged as an important transcriptional regulator of NF-κB-dependent inflammatory gene expression. However, the in vivo physiological function of Brd4 in the inflammatory response remains poorly defined. We now demonstrate that mice deficient for Brd4 in myeloid-lineage cells are resistant to LPS-induced sepsis but are more susceptible to bacterial infection. Gene-expression microarray analysis of bone marrow-derived macrophages (BMDMs) reveals that deletion of Brd4 decreases the expression of a significant amount of LPS-induced inflammatory genes while reversing the expression of a small subset of LPS-suppressed genes, including MAP kinase-interacting serine/threonine-protein kinase 2 (Mknk2)...
May 16, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28458167/downregulation-of-pi3k-%C3%AE-in-a-mouse-model-of-sepsis-induced-myocardial-dysfunction
#14
Ting-Ting Fan, Xuan-Yun Feng, Yuan-Zheng Yang, Feng Gao, Qiong Liu
A key component during sepsis is the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway, of which the PI3K-γ isoform is a major regulator in many inflammatory responses. However, the role of PI3K-γ in the development of sepsis-induced myocardial dysfunction (SIMD) is unknown. In this study, we established a model of SIMD induced by lipopolysaccharide (LPS), subsequently used the selective inhibitor LY294002 and AS605240 to block the effect of PI3K and PI3K-γ, respectively. Cardiac function was evaluated by echocardiography, hearts were obtained for histological and protein expression examinations...
April 27, 2017: Cytokine
https://www.readbyqxmd.com/read/28457316/emergent-laparotomy-and-temporary-abdominal-closure-for-the-cirrhotic-patient
#15
Tyler J Loftus, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Temporary abdominal closure (TAC) may be performed for cirrhotic patients undergoing emergent laparotomy. The effects of cirrhosis on physiologic parameters, resuscitation requirements, and outcomes following TAC are unknown. We hypothesized that cirrhotic TAC patients would have different resuscitation requirements and worse outcomes than noncirrhotic patients. METHODS: We performed a 3-year retrospective cohort analysis of 231 patients managed with TAC following emergent laparotomy for sepsis, trauma, or abdominal compartment syndrome...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28456943/the-potential-role-of-fosfomycin-in-neonatal-sepsis-caused-by-multidrug-resistant-bacteria
#16
Grace Li, Joseph F Standing, Julia Bielicki, William Hope, John van den Anker, Paul T Heath, Mike Sharland
The broad-spectrum activity of fosfomycin, including against multidrug-resistant (MDR) strains, has led to renewed interest in its use in recent years. Neonatal sepsis remains a substantial cause of morbidity and mortality at a global level, with evidence that MDR bacteria play an increasing role. The evidence for use of fosfomycin in neonatal subjects is limited. We summarise current knowledge of the pharmacokinetics and clinical outcomes for the use of fosfomycin in neonatal sepsis and issues specific to neonatal physiology...
June 2017: Drugs
https://www.readbyqxmd.com/read/28456342/comparison-of-inflammatory-cytokines-in-peritoneal-fluid-at-source-control-surgery-for-abdominal-sepsis
#17
Michael S Bleszynski, Tiffany Chan, Andrzej K Buczkowski
BACKGROUND: Open abdomen with vacuum assisted closure (VAC) is an alternate method to primary abdominal closure (PAC) in select situations for the management of severe surgical abdominal sepsis or septic shock. Peritoneal cytokines may potentially correlate with deranged physiology and help stratify severity of sepsis. The primary objective of the study was to identify if cytokines can differentiate between patients who underwent PAC or VAC at primary source control laparotomy (SCL). METHODS: Prospective case series including patients with severe abdominal sepsis/septic shock requiring urgent SCL...
April 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28447577/prognostic-value-of-adamts13-in-patients-with-severe-sepsis-and-septic-shock
#18
M Feroz Azfar, M Faisal Khan, S Shahid Habib, Z Al Aseri, A Mohammad Zubaidi, D Ocampo Aguila, M Owais Suriya, Hameed Ullah
PURPOSE: ADAMTS13 level was evaluated as a predictor of mortality in patients with severe sepsis and septic shock, and compared with Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. METHODS: This prospective observational study was conducted in the Medical and Surgical Intensive Care Units of King Khalid University Hospital. Detailed clinical evaluations were performed on 84 patients (56.08±18.18 years of age) with severe sepsis and septic shock...
April 26, 2017: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/28446249/adipose-derived-mesenchymal-stem-cells-modulate-cd14-cd16-expression-on-monocytes-from-sepsis-patients-in-vitro-via-prostaglandin-e2
#19
Guanguan Qiu, Guoping Zheng, Menghua Ge, Lanfang Huang, Haijiang Tong, Ping Chen, Dengming Lai, Yaoqin Hu, Baoli Cheng, Qiang Shu, Jianguo Xu
BACKGROUND: Mesenchymal stem cells (MSCs) have been shown to reduce sepsis-induced inflammation and improve survival in mouse models of sepsis. CD16(+) monocytes are proinflammatory and abundant in inflammatory conditions such as sepsis. The primary objective in this exploratory study was to determine the effects of adipose-derived MSCs (ASCs) on three subsets of monocytes from sepsis patients in vitro and to delineate the underlying mechanism. METHODS: This is a prospective cohort study of patients admitted to the medical intensive care unit (ICU) at an academic medical center...
April 26, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28441236/the-new-mirus-system-for-short-term-sedation-in-postsurgical-icu-patients
#20
Stefano Romagnoli, Cosimo Chelazzi, Gianluca Villa, Giovanni Zagli, Francesco Benvenuti, Paola Mancinelli, Giulio Arcangeli, Stefano Dugheri, Alessandro Bonari, Lorenzo Tofani, Andrea Belardinelli, A Raffaele De Gaudio
OBJECTIVES: To evaluate the feasibility and safety of the MIRUS system (Pall International, Sarl, Fribourg, Switzerland) for sedation with sevoflurane for postsurgical ICU patients and to evaluate atmospheric pollution during sedation. DESIGN: Prospective interventional study. SETTING: Surgical ICU. February 2016 to December 2016. PATIENTS: Postsurgical patients requiring ICU admission, mechanical ventilation, and sedation...
April 22, 2017: Critical Care Medicine
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