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sepsis physiology

Emmet A Francis, Volkmar Heinrich
Global bursts in free intracellular calcium (Ca2+ ) are among the most conspicuous signaling events in immune cells. To test the common view that Ca2+ bursts mediate rearrangement of the actin cytoskeleton in response to the activation of G protein-coupled receptors, we combined single-cell manipulation with fluorescence imaging and monitored the Ca2+ concentration in individual human neutrophils during complement-mediated chemotaxis. By decoupling purely chemotactic pseudopod formation from cell-substrate adhesion, we showed that physiological concentrations of anaphylatoxins, such as C5a, induced nonadherent human neutrophils to form chemotactic pseudopods but did not elicit Ca2+ bursts...
March 13, 2018: Science Signaling
Jiangquan Fu, Qing Lan, Difen Wang, Ying Wang, Ying Liu
OBJECTIVE: To approach the value of red cell distribution width (RDW) on the prognostic assessment of patients with abdominal sepsis. METHODS: The clinical data of adult patients with abdominal sepsis admitted to intensive care unit (ICU) of Affiliated Hospital of Guizhou Medical University from January 2015 to September 2017 were retrospectively analyzed. The patients were divided into survival group and death group according to ICU prognosis. The levels of serum lactate (Lac), procalcitonin (PCT), RDW, and acute physiology and chronic health evaluation II (APACHE II) score within 24 hours were recorded...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Christopher J Miller, Bruce A Doepker, Andrew N Springer, Matthew C Exline, Gary Phillips, Claire V Murphy
BACKGROUND: Hypo- and hyperphosphatemia are common in severe sepsis and septic shock. Published outcome data in patients with phosphate derangements primarily focus on hypophosphatemia and the general critically ill population. This study aimed to determine the impact of serum phosphate on clinical outcomes in patients with severe sepsis and septic shock. METHODS: A retrospective cohort analysis of adult mechanically ventilated patients with severe sepsis or septic shock was performed...
January 1, 2018: Journal of Intensive Care Medicine
Gabriela Gainaru, Antonios Papadopoulos, Iraklis Tsangaris, Malvina Lada, Evangelos J Giamarellos-Bourboulis, Aikaterini Pistiki
BACKGROUND: Evidence on the changes in the absolute counts of monocyte subpopulations in sepsis is missing. METHODS: Firstly, absolute counts of circulating CD14pos /HLA-DRpos /CD45pos monocytes were measured by flow cytometry in 70 patients with Gram-negative sepsis and in 10 healthy volunteers. In the second phase, immunophenotyping was performed and the absolute count of circulating inflammatory monocytes and of circulating CD14dim /CD16pos /CD45pos patrolling monocytes were measured in another 55 patients and 10 healthy volunteers...
March 3, 2018: Critical Care: the Official Journal of the Critical Care Forum
Tolunay B Aydemir, Robert J Cousins
The SLC39A family of metal transporters was identified through homologies with the Zrt- and Irt-like (ZIP) proteins from yeast and plants. Of all the ZIP transporters, ZIP14 is arguably the most robustly characterized in terms of function at the integrative level. Mice with a global knockout of Zip14 are viable, thus providing the opportunity to conduct physiologic experiments. In mice, Zip14 expression is highly tissue specific, with the greatest abundance in the jejunum > liver > heart > kidney > white adipose tissue > skeletal muscle > spleen > pancreas...
February 1, 2018: Journal of Nutrition
Wenqi Hu, Carri W Chan, José R Zubizarreta, Gabriel J Escobar
OBJECTIVE: We sought to build on the template-matching methodology by incorporating longitudinal comorbidities and acute physiology to audit hospital quality. STUDY SETTING: Patients admitted for sepsis and pneumonia, congestive heart failure, hip fracture, and cancer between January 2010 and November 2011 at 18 Kaiser Permanente Northern California hospitals. STUDY DESIGN: We generated a representative template of 250 patients in 4 diagnosis groups...
February 26, 2018: Medical Care
Sanni Kumar, Ena Gupta, Sanket Kaushik, Vijay Kumar Srivastava, Sudhir Kumar Mehta, Anupam Jyoti
Sepsis is a condition caused by infection followed by unregulated inflammatory response which may lead to the organ dysfunction. During such condition, over-production of oxidants is one of the factors which contribute cellular toxicity and ultimately organ failure and mortality. Antioxidants having free radicals scavenging activity exert protective role in various diseases. The present study has been designed to evaluate the levels of oxidative and anti-oxidative activity in sepsis patients and their correlation with the severity of the sepsis...
February 27, 2018: Scandinavian Journal of Immunology
Sabrina Arshed, Michael R Pinsky
Fluids during resuscitation from shock increase mean systemic pressure and venous return. The pressure gradient for venous return must increase. Mean systemic pressure is the amount of vascular space in unstressed and stressed volume, mostly unstressed. Shock states can decrease mean systemic pressure by increasing unstressed volume, decreasing total blood volume, or decreasing the pressure gradient for venous return. Crystalloids across bodily spaces restore normal volume, whereas colloids remain in the intravascular space...
April 2018: Critical Care Clinics
Byuk Sung Ko, Kyuseok Kim, Sung-Hyuk Choi, Gu Hyun Kang, Tae Gun Shin, You Hwan Jo, Seung Mok Ryoo, Jin Ho Beom, Woon Yong Kwon, Kap Su Han, Han Sung Choi, Sung Phil Chung, Gil Joon Suh, Tae Ho Lim, Won Young Kim
BACKGROUND: Septic shock can be defined both by the presence of hyperlactatemia and need of vasopressors. Lactate levels should be measured after volume resuscitation (as per the Sepsis-3 definition). However, currently, no studies have evaluated patients who have been excluded by the new criteria for septic shock. The aim of this study was to determine the clinical characteristics and prognosis of these patients, based on their lactate levels after initial fluid resuscitation. METHODS: This observational study was performed using a prospective, multi-center registry of septic shock, with the participation of 10 hospitals in the Korean Shock Society, between October 2015 and February 2017...
February 24, 2018: Critical Care: the Official Journal of the Critical Care Forum
Gail Otulakowski, Doreen Engelberts, Martin Post, Claire Masterson, Brian P Kavanagh
BACKGROUND: Lower tidal volumes are increasingly used in acute respiratory distress syndrome, but mortality has changed little in the last 20 yr. Therefore, in addition to ventilator settings, it is important to target molecular mediators of injury. Sepsis and other inflammatory states increase circulating concentrations of Gas6, a ligand for the antiinflammatory receptor Axl, and of a soluble decoy form of Axl. We investigated the effects of lung stretch on Axl signaling. METHODS: We used a mouse model of early injury from high tidal volume and assessed the effects of inhibiting Axl on in vivo lung injury (using an antagonist R428, n = 4/group)...
February 23, 2018: Anesthesiology
Yu-Chang Wang, Qin-Xin Liu, Tao Liu, Xi-E Xu, Wei Gao, Xiang-Jun Bai, Zhan-Fei Li
Pyroptosis plays a pivotal role in sepsis and septic shock in animal studies. However, its clinical significance in pathological conditions has not been well elucidated. This study aimed to evaluate the correlation between the percentage of pyroptotic peripheral blood mononuclear cells (PBMCs) and the clinical index and to investigate the relationship between PBMCs pyroptosis and the development of sepsis in trauma patients.This prospective study was conducted from October 2016 to May 2017 in a comprehensive trauma center...
February 2018: Medicine (Baltimore)
Christian Ertmer, Bernhard Zwißler, Hugo Van Aken, Michael Christ, Fabian Spöhr, Axel Schneider, Robert Deisz, Matthias Jacob
BACKGROUND: Outcome data on fluid therapy in critically ill patients from randomised controlled trials may be different from data obtained by observational studies under "real-life" conditions. We conducted this prospective, observational study to investigate current practice of fluid therapy (crystalloids and colloids) and associated outcomes in 65 German intensive care units (ICUs). In total, 4545 adult patients who underwent intravenous fluid therapy were included. The main outcome measures were 90-day mortality, ICU mortality and acute kidney injury (AKI)...
February 17, 2018: Annals of Intensive Care
Chul-Gyu Kim, Kyun-Seop Bae
BACKGROUND: Nurse staffing level is an important factor on nursing sensitive outcome. The relationships of nurse staffing level with nursing sensitive outcomes such as mortality, upper gastrointestinal bleeding and pressure ulcer have been explored in the United States, Canada, Australia, and New Zealand. Lower level of hospital nurse staffing seems associated with more adverse outcomes, especially mortality. However, there is insufficient evidence of the nurse staffing level-outcome relationship in other indicators...
January 2, 2018: International Journal of Nursing Studies
Katharina Rump, Michael Adamzik
Background: Sepsis is a common cause of death in intensive care units worldwide. Due to the high complexity of this immunological syndrome development of novel therapeutic strategies is urgent. Promising drug targets or biomarkers may depict aquaporins (AQPs) as they regulate crucial key mechanisms of sepsis. Main body: Here we report on base of the current literature that several AQPs are involved in different physiological processes of sepsis. In immune system mainly AQPs 3, 5 and 9 seem to be important, as they regulate the migration of different immune cells...
2018: Cell & Bioscience
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
Chenggong Hu, Yongfang Zhou, Chang Liu, Yan Kang
The purpose of this study was to confirm the prognostic value of pentraxin-3 (PTX3), procalcitonin (PCT) and lactate in patients with severe infections requiring ICU management and to develop and validate a model to enhance mortality prediction by combining severity scores with biomarkers. We included 141 patients with the diagnosis of sepsis/septic shock. The levels of PTX3, PCT and lactate were measured on day 0, 3, 7 of hospitalization and Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were also evaluated...
January 12, 2018: Oncotarget
Maurizio Turzo, Julian Vaith, Felix Lasitschka, Markus A Weigand, Cornelius J Busch
BACKGROUND: ATP-regulated potassium channels (KATP) regulate pulmonary vascular tone and are involved in hypoxic pulmonary vasoconstriction (HPV). In patients with inflammation like sepsis or ARDS, HPV is impaired, resulting in a ventilation-perfusion mismatch and hypoxia. Since increase of vascular KATP channel Kir6.1 has been reported in animal models of endotoxemia, we studied the expression and physiological effects of Kir6.1 in murine endotoxemic lungs. We hypothesized that inhibition of overexpressed Kir6...
February 13, 2018: Respiratory Research
Hussein A Khambalia, M Yvonne Alexander, Mahesan Nirmalan, Ria Weston, Phillip Pemberton, Zia Moinuddin, Angela Summers, David van Dellen, Titus Augustine
In sepsis, trauma and major surgery, where an explicit physiological insult leads to a significant systemic inflammatory response, the acute evolution of biomarkers have been delineated. In these settings, Interleukin (IL) -6 and TNF-α are often the first pro-inflammatory markers to rise, stimulating production of acute phase proteins followed by peaks in anti-inflammatory markers. Patients undergoing SPKT as a result of diabetic complications already have an inflammatory phenotype as a result of uraemia and glycaemia...
February 8, 2018: Cytokine
Xianfeng Chen, Juntao Hu, Chi Zhang, Yiping Pan, Diansheng Tian, Fafa Kuang, Zhanhong Tang
OBJECTIVE: To investigate the mechanisms of protective effects of dexmedetomidine on lungs in patients of sepsis complicated with acute respiratory distress syndrome (ARDS). METHODS: The adult patients with sepsis complicated with ARDS, the oxygenation index (PaO2/FiO2) was 150-200 mmHg (1 mmHg = 0.133 kPa), acute physiology and chronic health evaluation II (APACHE II) score was 10-20, need mechanical ventilation (MV) treatment > 72 hours, and admitted to intensive care unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from September 2013 to June 2017 were enrolled...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Hélène Hirbec, Camille Marmai, Isabelle Duroux-Richard, Christine Roubert, Arnaud Esclangon, Séverine Croze, Joël Lachuer, Ronan Peyroutou, François Rassendren
Microglial cells have a double life as the immune cells of the brain in times of stress but have also specific physiological functions in homeostatic conditions. In pathological contexts, microglia undergo a phenotypic switch called "reaction" that promotes the initiation and the propagation of neuro-inflammation. Reaction is complex, molecularly heterogeneous and still poorly characterized, leading to the concept that microglial reactivity might be too diverse to be molecularly defined. However, it remains unknown whether reactive microglia from different pathological contexts share a common molecular signature...
February 5, 2018: Glia
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