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sepsis physiology

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https://www.readbyqxmd.com/read/28447577/prognostic-value-of-adamts13-in-patients-with-severe-sepsis-and-septic-shock
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28441153/discharge-criteria-for-the-late-preterm-infant-a-review-of-the-literature
#4
Jenny M Quinn, Marteen Sparks, Sheila M Gephart
BACKGROUND: Standardized late preterm infant (LPI) discharge criteria ensure best practice and help guide the neonatal provider to determine the appropriate level of care following birth. However, the location can vary from the well newborn setting to the neonatal intensive care unit (NICU). PURPOSE: The purpose of this review is to examine differences in LPI discharge criteria between the well newborn setting and the NICU by answering the clinical questions, "What are the recommended discharge criteria for the LPI and do they differ if admitted to the well newborn setting versus the NICU?" SEARCH STRATEGY: Databases searched include CINAHL, TRIP, PubMed, and the Cochrane Library...
April 24, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28439546/inositol-polyphosphate-multikinase-promotes-toll-like-receptor-induced-inflammation-by-stabilizing-traf6
#5
Eunha Kim, Jiyoon Beon, Seulgi Lee, Seung Ju Park, Hyoungjoon Ahn, Min Gyu Kim, Jeong Eun Park, Wooseob Kim, Jae-Min Yuk, Suk-Jo Kang, Seung-Hyo Lee, Eun-Kyeong Jo, Rho Hyun Seong, Seyun Kim
Toll-like receptor (TLR) signaling is tightly controlled to protect hosts from microorganisms while simultaneously preventing uncontrolled immune responses. Tumor necrosis factor receptor-associated factor 6 (TRAF6) is a critical mediator of TLR signaling, but the precise mechanism of how TRAF6 protein stability is strictly controlled still remains obscure. We show that myeloid-specific deletion of inositol polyphosphate multikinase (IPMK), which has both inositol polyphosphate kinase activities and noncatalytic signaling functions, protects mice against polymicrobial sepsis and lipopolysaccharide-induced systemic inflammation...
April 2017: Science Advances
https://www.readbyqxmd.com/read/28435684/comparison-of-the-clinical-characteristics-and-prognosis-of-primary-versus-secondary-acute-gastrointestinal-injury-in-critically-ill-patients
#6
Dong Zhang, Rao Fu, Yanhua Li, Hongyan Li, Yuting Li, Hongxiang Li
BACKGROUND: This prospective study compared clinical characteristics and prognosis between primary (P) and secondary (S) acute gastrointestinal injury (AGI) (P-AGI)/(S-AGI) in critically ill patients. METHODS: This was a prospective, single-center observational study. Patients were included if they had been hospitalized for at least 72 h before the AGI diagnosis. Patients were classified according to severity of gastrointestinal dysfunction, while P-AGI or S-AGI were defined according to whether the gastrointestinal system was directly or indirectly involved...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28426466/physician-variation-in-time-to-antimicrobial-treatment-for-septic-patients-presenting-to-the-emergency-department
#7
Ithan D Peltan, Kristina H Mitchell, Kristina E Rudd, Blake A Mann, David J Carlbom, Catherine L Hough, Thomas D Rea, Samuel M Brown
OBJECTIVES: Delayed initiation of appropriate antimicrobials is linked to higher sepsis mortality. We investigated interphysician variation in septic patients' door-to-antimicrobial time. DESIGN: Retrospective cohort study. SETTING: Emergency department of an academic medical center. SUBJECTS: Adult patients treated with antimicrobials in the emergency department between 2009 and 2015 for fluid-refractory severe sepsis or septic shock...
April 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28420988/heme-as-a-target-for-therapeutic-interventions
#8
REVIEW
Stephan Immenschuh, Vijith Vijayan, Sabina Janciauskiene, Faikah Gueler
Heme is a complex of iron and the tetrapyrrole protoporphyrin IX with essential functions in aerobic organisms. Heme is the prosthetic group of hemoproteins such as hemoglobin and myoglobin, which are crucial for reversible oxygen binding and transport. By contrast, high levels of free heme, which may occur in various pathophysiological conditions, are toxic via pro-oxidant, pro-inflammatory and cytotoxic effects. The toxicity of heme plays a major role for the pathogenesis of prototypical hemolytic disorders including sickle cell disease and malaria...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28420465/-clinical-value-of-serum-endocan-and-procalcitonin-in-early-diagnosis-and-prognosis-evaluation-of-sepsis
#9
Rong Zhao, Shimin Dong
OBJECTIVE: To investigate the clinical value of serum endocan and procalcitonin (PCT) in early diagnosis and prognosis evaluation of sepsis. METHODS: The patients with systemic inflammatory response syndrome (SIRS, n = 26) and sepsis (n = 78) admitted to intensive care unit (ICU) of the Third Hospital of Hebei Medical University from December 2014 to December 2016 were enrolled. According to the severity of disease, the sepsis patients were divided into general sepsis group (n = 20), severe sepsis group (n = 24), and septic shock group (n = 34)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28415155/letter-to-the-editor-regarding-dounousi-e-et%C3%A2-al-intact-fgf23-and-%C3%AE-klotho-during-acute-inflammation-sepsis-in-ckd-patients-eur-j-clin-invest-2016-46-234-41
#10
Axel Schlitt, Urban Sester, Martina Sester, Sarah Seiler-Mussler, Vincent Brandenburg, Elke Schäffner, Gunnar H Heine
With interest we read the recent European Journal of Clinical Investigation paper entitled "Intact FGF23 and α-Klotho during acute inflammation/sepsis in CKD patients" by E. Dounousi and coworkers (1). In their article, the authors analyse the association between acute infection and plasma levels of the phosphaturic hormone fibroblast growth factor 23 (FGF-23). The physiological regulation of FGF-23 is not fully understood so far, and hence novel pathophysiological data are of importance. Particularly the link between FGF23 and inflammation is a growing field...
April 17, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28413520/prognosis-of-patients-with-acinetobacter-baumannii-infection-in-the-intensive-care-unit-a-retrospective-analysis
#11
Dong Xiao, Lu Wang, Daquan Zhang, Dongming Xiang, Qi Liu, Xuezhong Xing
The present retrospective study aimed to investigate the prognostic factors for critically ill patients with an Acinetobacter baumannii (A. baumannii) infection. A total of 37 patients from the intensive care unit (ICU) were enrolled in the study. Data was collected from patients, including age, gender, ethnicity, A. baumannii infection status, concurrent infection status, prescribed antibiotics, Acute Physiology and Chronic Health Evaluation II (APACHE II) and sepsis-related organ failure assessment (SOFA) scores, procalcitonin level, site of infection, shock, sepsis and renal replacement therapy status...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28400680/changes-in-b-type-natriuretic-peptide-and-related-hemodynamic-parameters-following-a-fluid-challenge-in-critically-ill-patients-with-severe-sepsis-or-septic-shock
#12
Shahed Omar, Ahmad Ali, Yahya Atiya, Rudo Lufuno Mathivha, Joel M Dulhunty
CONTEXT: Severe sepsis or septic shock. AIMS: The aim of this study is to examine the effect of a fluid challenge on the B-type natriuretic peptide (BNP) and the hemodynamic state. SETTINGS AND DESIGN: This observational study was conducted in an intensivist-led academic, mixed medical-surgical Intensive Care Unit. SUBJECTS AND METHODS: Focused transthoracic echocardiogram, plasma BNP, and hemodynamic measurements were recorded at baseline and following a 500 ml fluid challenge in thirty patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28399905/cardiac-biomarkers-are-associated-with-maximum-stage-of-acute-kidney-injury-in-critically-ill-patients-a-prospective-analysis
#13
Ryan Haines, Siobhan Crichton, Jessica Wilson, David Treacher, Marlies Ostermann
BACKGROUND: This study aimed to investigate whether cardiac troponin T (cTnT), cardiac troponin I (cTnI) and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) are associated with acute kidney injury (AKI) and need for acute renal replacement therapy (RRT) in adult patients admitted to the intensive care unit (ICU). METHODS: We analysed prospectively collected data for patients admitted to the ICU between June and December 2010 for non-cardiac reasons. The Kidney Disease Improving Global Outcomes creatinine criteria were applied to identify patients with AKI including those who received acute RRT...
April 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28388526/sepsis-associated-in-hospital-cardiac-arrest-epidemiology-pathophysiology-and-potential-therapies
#14
REVIEW
Ryan W Morgan, Julie C Fitzgerald, Scott L Weiss, Vinay M Nadkarni, Robert M Sutton, Robert A Berg
Sepsis-associated cardiac arrest is a relatively common occurrence with especially poor outcomes. Of the greater than 200,000 in-hospital cardiac arrests that occur in the United States annually, between 30,000 and 60,000 occur in patients with underlying sepsis. These patients are less likely to survive than cardiac arrest victims without sepsis. In this review, we discuss the epidemiology of sepsis-associated in-hospital cardiac arrest in adults and children, the relevant physiology responsible for its pathogenesis and poor outcomes, and potential therapeutic interventions based on this pathophysiology...
March 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28373035/mung-bean-vigna-radiata-l-coat-extract-modulates-macrophage-functions-to-enhance-antigen-presentation-a-proteomic-study
#15
Akiko Hashiguchi, Keisuke Hitachi, Wei Zhu, Jingkui Tian, Kunihiro Tsuchida, Setsuko Komatsu
The immunomodulatory effect of mung bean is mainly attributed to antioxidant properties of flavonoids; however, the precise machinery for biological effect on animal cells remains uncertain. To understand the physiological change produced by mung bean consumption, proteomic and metabolomic techniques were used. In vitro assay confirmed the importance of synergistic interaction among multiple flavonoids by IL-6 expression. Proteomic analysis detected that the abundance of 190 proteins was changed in lipopolysaccharide-stimulated RAW264...
March 31, 2017: Journal of Proteomics
https://www.readbyqxmd.com/read/28372498/innate-immune-function-and-organ-failure-recovery-in-adults-with-sepsis
#16
Aline B Maddux, Terra D Hiller, Katherine H Overdier, Laura L Pyle, Ivor S Douglas
PURPOSE: Sepsis stimulates pro- and anti-inflammatory immune responses. The innate immune response is critical to organ injury repair. We tested for an association between innate immune function and organ function recovery in a prospective cohort of immune-competent adults with sepsis. METHODS: We conducted a prospective observational cohort study enrolling immune-competent adults with sepsis. We tested innate immune function by quantification of lipopolysaccharide (LPS)-stimulated tumor necrosis factor (TNF) α production capacity in whole blood samples on hospital days 1, 4, and 6...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28371470/role-of-renal-vascular-potassium-channels-in-physiology-and-pathophysiology
#17
REVIEW
Max Salomonsson, Jens Christian Brasen, Charlotte M Sorensen
The control of renal vascular tone is important for the regulation of salt and water balance, blood pressure and the protection against damaging elevated glomerular pressure. The K(+) conductance is a major factor in the regulation of the membrane potential (Vm ) in vascular smooth muscle (VSMC) and endothelial cells (EC). The vascular tone is controlled by Vm via its effect on the opening probability of voltage operated Ca(2+) channels (VOCC) in VSMC. When K(+) conductance increases Vm becomes more negative and vasodilation follows, while deactivation of K(+) channels leads to depolarization and vasoconstriction...
March 30, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28366166/a-path-to-precision-in-the-icu
#18
REVIEW
David M Maslove, Francois Lamontagne, John C Marshall, Daren K Heyland
Precision medicine is increasingly touted as a groundbreaking new paradigm in biomedicine. In the ICU, the complexity and ambiguity of critical illness syndromes have been identified as fundamental justifications for the adoption of a precision approach to research and practice. Inherently protean diseases states such as sepsis and acute respiratory distress syndrome have manifestations that are physiologically and anatomically diffuse, and that fluctuate over short periods of time. This leads to considerable heterogeneity among patients, and conditions in which a "one size fits all" approach to therapy can lead to widely divergent results...
April 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28363868/neoagarooligosaccharides-prevent-septic-shock-by-modulating-a20-and-cyclooxygenase-2-mediated-interleukin-10-secretion-in-a-septic-shock-mouse-model
#19
Da Rae Kang, Gun Young Yoon, Joon Cho, Seung Jun Lee, Su Jin Lee, Hee Jo Park, Tae Heung Kang, Hee Dong Han, Won Sun Park, Young Kyung Yoon, Yeong-Min Park, In Duk Jung
Analysis of the signaling mechanism triggered by endotoxin-mediated toll-like receptor-4 activation using immune cell systems or rodent models may help identify potential agents for the prevention of Gram-negative bacteria infection. β-agarase cleaves the β-1,4-linkages of agar to produce neoagarooligosaccharides (NAOs), which have various physiological functions. The aim of this study was to investigate the efficacy of NAOs in preventing experimental sepsis caused by the administration of endotoxin or Gram-negative bacteria...
May 13, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28356059/association-between-acute-gastrointestinal-injury-and-biomarkers-of-intestinal-barrier-function-in-critically-ill-patients
#20
Hongxiang Li, Ying Chen, Feifei Huo, Yushan Wang, Dong Zhang
BACKGROUND: To assess the associations of biomarkers of intestinal barrier function and other clinical variables with acute gastrointestinal injury (AGI) grade, and of these clinical variables with mortality in critically ill patients. METHODS: This was a single-center, observational, prospective study. Patients were included if they were diagnosed with AGI and underwent tests for the measurement of plasma levels of intestinal fatty acid-binding protein (i-FABP), D-lactate (D-la), and lipopolysaccharide...
March 29, 2017: BMC Gastroenterology
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