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sepsis physiology

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https://www.readbyqxmd.com/read/28301336/sepsis-in-obstetrics-clinical-features-and-early-warning-tools
#1
Sheryl E Parfitt, Mary L Bogat, Sandra L Hering, Charlotte Ottley, Cheryl Roth
Morbidity and mortality associated with sepsis has gained widespread attention on a local, state, and national level, yet, it remains a complicated disorder that can be difficult to identify in a timely manner. Sepsis in obstetric patients further complicates the diagnosis as alterations in physiology related to pregnancy can mask sepsis indicators normally seen in the general population. If early signs of sepsis go unrecognized, septic shock can develop, leading to organ dysfunction and potential death. Maternal early warning tools have been designed to assist clinicians in recognizing early indications of illness...
March 15, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28296993/clinical-characteristics-and-outcomes-of-patients-with-cellulitis-requiring-intensive-care
#2
Duncan R Cranendonk, Lonneke A van Vught, Maryse A Wiewel, Olaf L Cremer, Janneke Horn, Marc J Bonten, Marcus J Schultz, Tom van der Poll, W Joost Wiersinga
Importance: Cellulitis is a commonly occurring skin and soft tissue infection and one of the most frequently seen dermatological diseases in the intensive care unit (ICU). However, clinical characteristics of patients with cellulitis requiring intensive care treatment are poorly defined. Necrotizing fasciitis is often confused for cellulitis at initial presentation and is considered to be more severe and thus has previously been described in more detail. Objective: To describe the clinical presentation and outcomes of patients with ICU-necessitating cellulitis and to compare them with patients with necrotizing fasciitis...
March 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28294401/endothelial-progenitor-cell-mobilization-in-preterm-infants-with-sepsis-is-associated-with-improved-survival
#3
Vahid Siavashi, Simin Asadian, Masoud Taheri-Asl, Samaneh Keshavarz, Mohamad Zamani-Ahmadmahmudi, Seyed Mahdi Nassiri
Microvascular dysfunction plays a key role in the pathology of sepsis, leading to multi-organ failure and death. Circulating endothelial progenitor cells (cEPCs) are critically involved in the maintenance of the vascular homeostasis in both physiological and pathological contexts. In this study, concentration of cEPCs in preterm infants with sepsis was determined to recognize whether the EPC mobilization would affect the clinical outcome of infantile sepsis. 133 preterm infants (81 with sepsis and 52 without sepsis) were enrolled in this study...
March 10, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28292760/phenylalanine-isotope-pulse-method-to-measure-effect-of-sepsis-on-protein-breakdown-and-membrane-transport-in-the-pig
#4
Gabriella A M Ten Have, Marielle Pkj Engelen, Robert R Wolfe, Nicolaas E P Deutz
The primed-continuous (PC) phenylalanine (Phe) stable isotope infusion methodology is often used as a proxy for measuring whole body protein breakdown (WbPB) in sepsis. It is unclear, if WbPB data obtained by an easy-to-use single IV Phe isotope pulse administration (PULSE) are comparable to those by PC. Compartmental modeling with PULSE could provide us more insight in WbPB in sepsis. Therefore, in the present study, we compared PULSE with PC as proxy for WbPB in an instrumented pig model with Pseudomonas aeruginosa induced severe sepsis (Healthy: n=9; Sepsis: n=13)...
March 14, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28271450/patient-important-outcomes-in-randomized-controlled-trials-in-critically-ill-patients-a-systematic-review
#5
REVIEW
Stéphane Gaudry, Jonathan Messika, Jean-Damien Ricard, Sylvie Guillo, Blandine Pasquet, Emeline Dubief, Tanissia Boukertouta, Didier Dreyfuss, Florence Tubach
BACKGROUND: Intensivists' clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide acceptance in most fields of clinical research. We sought to systematically review how well patient-important outcomes are reported in published randomized controlled trials (RCTs) in critically ill patients. METHODS: Literature search was conducted to identify eligible trials indexed from January to December 2013...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28268479/early-warnings-of-heart-rate-deterioration
#6
Vania G Almeida, Ian T Nabney
Hospitals can experience difficulty in detecting and responding to early signs of patient deterioration leading to late intensive care referrals, excess mortality and morbidity, and increased hospital costs. Our study aims to explore potential indicators of physiological deterioration by the analysis of vital-signs. The dataset used comprises heart rate (HR) measurements from MIMIC II waveform database, taken from six patients admitted to the Intensive Care Unit (ICU) and diagnosed with severe sepsis. Different indicators were considered: 1) generic early warning indicators used in ecosystems analysis (autocorrelation at-1-lag (ACF1), standard deviation (SD), skewness, kurtosis and heteroskedasticity) and 2) entropy analysis (kernel entropy and multi scale entropy)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268442/using-demographic-and-time-series-physiological-features-to-classify-sepsis-in-the-intensive-care-unit
#7
Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma
Sepsis, a systemic inflammatory response to infection, is a major health care problem that affects millions of patients every year in the intensive care units (ICUs) worldwide. Despite the fact that ICU patients are heavily instrumented with physiological sensors, early sepsis detection remains challenging, perhaps because clinicians identify sepsis by (i) using static scores derived from bed-side measurements individually, and (ii) deriving these scores at a much slower rate than the rate for which patient data is collected...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267667/smartphone-based-enzymatic-biosensor-for-oral-fluid-l-lactate-detection-in-one-minute-using-confined-multilayer-paper-reflectometry
#8
Donato Calabria, Cristiana Caliceti, Martina Zangheri, Mara Mirasoli, Patrizia Simoni, Aldo Roda
The development of smartphone-based biosensors for point-of-care testing (POCT) applications allows realizing "all in one" instruments, with large potential distribution among the general population. With this respect, paper color-based detection performed by reflectance measurement is the most popular, simple, inexpensive and straightforward method. Despite the large number of scientific publications related to these biosensors, they still suffer from a poor detectability and reproducibility related to inhomogeneity of color development, which leads to low assay reproducibility...
March 1, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28266902/soluble-triggering-receptor-expressed-on-myeloid-cells-1-as-a-novel-marker-for-abdominal-sepsis
#9
Xiaofei Song, Yucheng Song, Xuedong Zhang, Huanzhou Xue
BACKGROUND: The aim of the study was to investigate the concentration and diagnostic significance of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in acute abdominal conditions. METHODS: Plasma specimens were obtained from 68 patients with abdominal sepsis, 60 patients with systemic inflammatory response syndrome (SIRS), and 60 healthy individuals. The sepsis group was divided into the survival and death groups according to the 28-d outcome...
March 7, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28264021/antimicrobial-use-in-paediatric-patients-in-a-teaching-hospital-in-ethiopia
#10
Hafte Kahsay Kebede, Hailay Abrha Gesesew, Tewodros Eyob Woldehaimanot, Kabaye Kumela Goro
BACKGROUND: Antibiotics use in in children are different from adults due to a lack of data on pharmacokinetics, pharmacodynamics, efficacy and safety of drugs, different physiological spectrum, pediatrics populations being vulnerable to the majority of the illnesses, and the adverse effect of their irrational use is more serious. However, antibiotic use is not explored much in a paediatric population. The current study focused on antibiotic use among pediatric population using data from a tertiary hospital in Ethiopia...
2017: PloS One
https://www.readbyqxmd.com/read/28257335/serial-procalcitonin-predicts-mortality-in-severe-sepsis-patients-results-from-the-multicenter-procalcitonin-monitoring-sepsis-moses-study
#11
Philipp Schuetz, Robert Birkhahn, Robert Sherwin, Alan E Jones, Adam Singer, Jeffrey A Kline, Michael S Runyon, Wesley H Self, D Mark Courtney, Richard M Nowak, David F Gaieski, Stefan Ebmeyer, Sascha Johannes, Jan C Wiemer, Andrej Schwabe, Nathan I Shapiro
OBJECTIVES: To prospectively validate that the inability to decrease procalcitonin levels by more than 80% between baseline and day 4 is associated with increased 28-day all-cause mortality in a large sepsis patient population recruited across the United States. DESIGN: Blinded, prospective multicenter observational clinical trial following an Food and Drug Administration-approved protocol. SETTING: Thirteen U.S.-based emergency departments and ICUs...
March 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28256016/circulating-syndecans-during-critical-illness
#12
Axel Nelson, Joakim Johansson, Jonas Tydén, Mikael Bodelsson
Circulating syndecans are proposed to be markers of glycocalyx degradation and previous investigations have found higher plasma levels of syndecan-1 among patients with different pathological conditions. We wanted to investigate if levels of other syndecans (-2,-3 and -4) are altered during critical illness and compare the levels to syndecan-1. In 137 consecutive intensive care unit (ICU) patients with sepsis, cardiac arrest, gastrointestinal bleeding, intoxication or trauma, plasma levels of syndecan-1, -2, -3 and -4 were measured using ELISA...
March 3, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28252537/daily-lowest-hemoglobin-and-risk-of-organ-dysfunctions-in-critically-ill-patients
#13
Sarah J Hemauer, Adam J Kingeter, Xue Han, Matthew S Shotwell, Pratik P Pandharipande, Liza M Weavind
OBJECTIVES: To determine the association between hemoglobin levels and the daily risk of individual organ dysfunctions in critically ill patients. DESIGN: Post hoc analysis of prospectively collected data. SETTING: Vanderbilt University Medical Center and Saint Thomas Hospital Medical and Surgical ICUs. PATIENTS: Medical and surgical ICU patients admitted with respiratory failure or shock. INTERVENTIONS: Baseline demographic data, and detailed in-ICU and hospital data, including daily lowest hemoglobin, were collected up to hospital day 30...
March 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28248228/role-of-protein-carbonylation-in-skeletal-muscle-mass-loss-associated-with-chronic-conditions
#14
REVIEW
Esther Barreiro
Muscle dysfunction, characterized by a reductive remodeling of muscle fibers, is a common systemic manifestation in highly prevalent conditions such as chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), cancer cachexia, and critically ill patients. Skeletal muscle dysfunction and impaired muscle mass may predict morbidity and mortality in patients with chronic diseases, regardless of the underlying condition. High levels of oxidants may alter function and structure of key cellular molecules such as proteins, DNA, and lipids, leading to cellular injury and death...
May 6, 2016: Proteomes
https://www.readbyqxmd.com/read/28245459/the-somatotrope-growth-hormone-releasing-hormone-growth-hormone-insulin-like-growth-factor-1-axis-in-immunoregulation-and-immunosenescence
#15
Gwennaëlle Bodart, Khalil Farhat, Chantal Charlet-Renard, Roberto Salvatori, Vincent Geenen, Henri Martens
Most scientific reports debate the thymotropic and immuno-stimulating properties of the somatotrope growth hormone-releasing hormone (GHRH)/growth hormone (GH)/insulin-like growth factor (IGF)-1 axis, but there is still some disagreement about the physiological role of this axis in basal conditions. Moreover, some authors have hypothesized that the physiological role of the somatotrope axis only appears in stressful conditions (such as sepsis or infective and inflammatory diseases). This chapter will provide an extended overview of the expression of the components (signals and receptors) of the somatotrope axis and their properties on cells of the innate and adaptive immune system...
2017: Frontiers of Hormone Research
https://www.readbyqxmd.com/read/28226652/early-warnings-of-heart-rate-deterioration
#16
Vania G Almeida, Ian T Nabney, Vania G Almeida, Ian T Nabney, Ian T Nabney, Vania G Almeida
Hospitals can experience difficulty in detecting and responding to early signs of patient deterioration leading to late intensive care referrals, excess mortality and morbidity, and increased hospital costs. Our study aims to explore potential indicators of physiological deterioration by the analysis of vital-signs. The dataset used comprises heart rate (HR) measurements from MIMIC II waveform database, taken from six patients admitted to the Intensive Care Unit (ICU) and diagnosed with severe sepsis. Different indicators were considered: 1) generic early warning indicators used in ecosystems analysis (autocorrelation at-1-lag (ACF1), standard deviation (SD), skewness, kurtosis and heteroskedasticity) and 2) entropy analysis (kernel entropy and multi scale entropy)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226613/using-demographic-and-time-series-physiological-features-to-classify-sepsis-in-the-intensive-care-unit
#17
Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma, Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma, Sridevi V Sarma, Sabato Santaniello, Kristin Gunnarsdottir, Matthew Kerr, Vijay Sadashivaiah
Sepsis, a systemic inflammatory response to infection, is a major health care problem that affects millions of patients every year in the intensive care units (ICUs) worldwide. Despite the fact that ICU patients are heavily instrumented with physiological sensors, early sepsis detection remains challenging, perhaps because clinicians identify sepsis by (i) using static scores derived from bed-side measurements individually, and (ii) deriving these scores at a much slower rate than the rate for which patient data is collected...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28223455/acute-fetal-demise-with-first-trimester-maternal-infection-resulting-from-listeria-monocytogenes-in-a-nonhuman-primate-model
#18
Bryce Wolfe, Gregory J Wiepz, Michele Schotzko, Gennadiy I Bondarenko, Maureen Durning, Heather A Simmons, Andres Mejia, Nancy G Faith, Emmanuel Sampene, Marulasiddappa Suresh, Sophia Kathariou, Charles J Czuprynski, Thaddeus G Golos
Infection with Listeria monocytogenes during pregnancy is associated with miscarriage, preterm birth, and neonatal complications, including sepsis and meningitis. While the risk of these conditions is thought to be greatest during the third trimester of pregnancy, the determinants of fetoplacental susceptibility to infection, the contribution of gestational age, and the in vivo progression of disease at the maternal-fetal interface are poorly understood. We developed a nonhuman primate model of listeriosis to better understand antecedents of adverse pregnancy outcomes in early pregnancy...
February 21, 2017: MBio
https://www.readbyqxmd.com/read/28220740/the-spectrum-and-outcome-of-surgical-sepsis-in-pietermaritzburg-south-africa
#19
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28219767/the-biochemical-alterations-underlying-post-burn-hypermetabolism
#20
REVIEW
Christopher Auger, Osai Samadi, Marc G Jeschke
A severe burn can trigger a hypermetabolic state which lasts for years following the injury, to the detriment of the patient. The drastic increase in metabolic demands during this phase renders it difficult to meet the body's nutritional requirements, thus increasing muscle, bone and adipose catabolism and predisposing the patient to a host of disorders such as multi-organ dysfunction and sepsis, or even death. Despite advances in burn care over the last 50 years, due to the multifactorial nature of the hypermetabolic phenomenon it is difficult if not impossible to precisely identify and pharmacologically modulate the biological mediators contributing to this substantial metabolic derangement...
February 17, 2017: Biochimica et Biophysica Acta
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