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https://www.readbyqxmd.com/read/28226652/early-warnings-of-heart-rate-deterioration
#1
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/28225739/damage-control-laparotomy-utilization-rates-are-highly-variable-among-level-i-trauma-centers-pragmatic-randomized-optimal-platelet-and-plasma-ratios-findings
#2
Justin Jeremiah Joseph Watson, Jamison Nielsen, Kyle Hart, Priya Srikanth, John D Yonge, Christopher R Connelly, Phillip M Kemp Bohan, Hillary Sosnovske, Barbara C Tilley, Gerald van Belle, Bryan A Cotton, Terence S OʼKeeffe, Eileen M Bulger, Karen J Brasel, John B Holcomb, Martin A Schreiber
BACKGROUND: Damage control laparotomy (DCL) is intended to limit deleterious effects from trauma-induced coagulopathy. DCL has been associated with mortality reduction, but may increase complications including sepsis, abscess, respiratory failure, hernia, and gastrointestinal fistula. We hypothesized that (1) DCL incidence would vary between institutions; (2) mortality rates would vary with DCL rates; (3) standard DCL criteria of pH, international normalized ratio, temperature and major intra-abdominal vascular injury would not adequately capture all patients...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28224112/intravenous-vitamin-c-as-adjunctive-therapy-for-enterovirus-rhinovirus-induced-acute-respiratory-distress-syndrome
#3
Alpha A Fowler Iii, Christin Kim, Lawrence Lepler, Rajiv Malhotra, Orlando Debesa, Ramesh Natarajan, Bernard J Fisher, Aamer Syed, Christine DeWilde, Anna Priday, Vigneshwar Kasirajan
We report a case of virus-induced acute respiratory distress syndrome (ARDS) treated with parenteral vitamin C in a patient testing positive for enterovirus/rhinovirus on viral screening. This report outlines the first use of high dose intravenous vitamin C as an interventional therapy for ARDS, resulting from enterovirus/rhinovirus respiratory infection. From very significant preclinical research performed at Virginia Commonwealth University with vitamin C and with the very positive results of a previously performed phase I safety trial infusing high dose vitamin C intravenously into patients with severe sepsis, we reasoned that infusing identical dosing to a patient with ARDS from viral infection would be therapeutic...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28223734/early-thrombomodulin-%C3%AE-administration-outcome-for-acute-disseminated-intravascular-coagulopathy-in-gastrointestinal-surgery
#4
Hirotaka Konishi, Kazuma Okamoto, Katsutoshi Shoda, Tomohiro Arita, Toshiyuki Kosuga, Ryo Morimura, Shuhei Komatsu, Yasutoshi Murayama, Atsushi Shiozaki, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Eigo Otsuji
AIM: To investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery. METHODS: Thirty-six peri-operative DIC patients in the field of gastrointestinal surgery who were treated with TM-α were retrospectively investigated. The relationships between patient demographics and the efficacy of TM-α were examined. Analysis of survival at 28 d was also performed on some parameters by means of the Kaplan-Meier method...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28220742/calcific-uraemic-arteriolopathy-calciphylaxis-in-patients-on-renal-replacement-therapy
#5
S Sebastian, H F Jordaan, J W Schneider, M R Moosa, M R Davids
BACKGROUND: Calcific uraemic arteriolopathy (calciphylaxis) is an unusual and potentially fatal condition characterised by small-vessel calcification and ischaemic skin necrosis. It mainly affects patients with end-stage renal disease (ESRD) on haemodialysis, but may rarely occur in the absence of ESRD in conditions such as primary hyperparathyroidism, malignancy, alcoholic liver disease and connective tissue disease. METHODS: We reviewed the records of all patients diagnosed with calciphylaxis while on renal replacement therapy at Tygerberg Hospital, Cape Town, South Africa, between 1990 and 2014, to describe its presentation, course and final outcome...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#6
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28219767/the-biochemical-alterations-underlying-post-burn-hypermetabolism
#7
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
https://www.readbyqxmd.com/read/28219766/mitochondrial-and-endoplasmic-reticulum-dysfunction-and-related-defense-mechanisms-in-critical-illness-induced-multiple-organ-failure
#8
REVIEW
Steven E Thiessen, Greet Van den Berghe, Ilse Vanhorebeek
Patients with critical illness-induced multiple organ failure suffer from a very high morbidity and mortality, despite major progress in intensive care. The pathogenesis of this condition is complex and incompletely understood. Inadequate tissue perfusion and an overwhelming inflammatory response with pronounced cellular damage have been suggested to play an important role, but interventions targeting these disturbances largely failed to improve patient outcome. Hence, new therapeutic perspectives are urgently needed...
February 17, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28219408/the-impact-of-post-operative-sepsis-on-mortality-after-hospital-discharge-among-elective-surgical-patients-a-population-based-cohort-study
#9
Lixin Ou, Jack Chen, Ken Hillman, Arthas Flabouris, Michael Parr, Hassan Assareh, Rinaldo Bellomo
BACKGROUND: Our aim in the present study was to assess the mortality impact of hospital-acquired post-operative sepsis up to 1 year after hospital discharge among adult non-short-stay elective surgical patients. METHODS: We conducted a population-based, retrospective cohort study of all elective surgical patients admitted to 82 public acute hospitals between 1 January 2007 and 31 December 2012 in New South Wales, Australia. All adult elective surgical admission patients who stayed in hospital for ≥4 days and survived to discharge after post-operative sepsis were identified using the Admitted Patient Data Collection records linked with the Registry of Births, Deaths, and Marriages...
February 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28219189/-effects-of-phentolamine-on-haemodynamics-of-patients-with-severe-sepsis
#10
W Yang, X B Li, Y Zhou, X M Mo
Objective: To explore the effects of phentolamine on hemodynamic of patients with severe sepsis . Methods: From January 2015 to August 2016, using random number table, 59 patients with severe sepsis were divided into research group and the control group by conventional treatment in Department of Emergency, the Second People's Hospital of Nanning City. The patients of the research group were given phentolamine injection. The CI, ITBVI, EVLWI, SVRI of the patients were monitored by PICCO on 6, 12, 24, 48, 72 h before and after treatment...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28218629/fever-induced-brugada-pattern-misdiagnosed-as-an-acute-myocardial-infarction
#11
David Tadin, Roberto Quintal
The Brugada syndrome is a rare condition associated with increased risk of ventricular tachyarrhythmias and sudden cardiac death (SCD). The Brugada pattern on electrocardiogram (EKG) is known to be revealed by several precipitants including febrile illnesses. The appearance of a Brugada pattern on EKG with fever may indicate an elevated risk of arrhythmia or sudden cardiac death. We report a case in which the electrocardiographic abnormality of Brugada pattern induced by sepsis was initially misinterpreted as a ST-segment elevation myocardial infarction (STEMI)...
January 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28216665/interleukin-10-inhibits-pro-inflammatory-cytokine-responses-and-killing-of-burkholderia-pseudomallei
#12
Bianca Kessler, Darawan Rinchai, Chidchamai Kewcharoenwong, Arnone Nithichanon, Rachael Biggart, Catherine M Hawrylowicz, Gregory J Bancroft, Ganjana Lertmemongkolchai
Melioidosis, caused by Burkholderia pseudomallei, is endemic in northeastern Thailand and Northern Australia. Severe septicemic melioidosis is associated with high levels of pro-inflammatory cytokines and is correlated with poor clinical outcomes. IL-10 is an immunoregulatory cytokine, which in other infections can control the expression of pro-inflammatory cytokines, but its role in melioidosis has not been addressed. Here, whole blood of healthy seropositive individuals (n = 75), living in N. E. Thailand was co-cultured with B...
February 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28216261/modulating-the-function-of-the-immune-system-by-thyroid-hormones-and-thyrotropin
#13
REVIEW
Evelyn L Jara, Natalia Muñoz-Durango, Carolina Llanos, Carlos Fardella, Pablo A González, Susan M Bueno, Alexis M Kalergis, Claudia A Riedel
Accumulating evidence suggests a close bidirectional communication and regulation between the neuroendocrine and immune systems. Thyroid hormones (THs) can exert responses in various immune cells, e.g., monocytes, macrophages, natural killer cells, and lymphocytes, affecting several inflammation-related processes (such as, chemotaxis, phagocytosis, reactive oxygen species generation, and cytokines production). The interactions between the endocrine and immune systems have been shown to contribute to pathophysiological conditions, including sepsis, inflammation, autoimmune diseases and viral infections...
February 16, 2017: Immunology Letters
https://www.readbyqxmd.com/read/28213737/associations-among-left-ventricular-systolic-function-tachycardia-and-cardiac-preload-in-septic-patients
#14
Michael J Lanspa, Sajid Shahul, Andrew Hersh, Emily L Wilson, Troy D Olsen, Eliotte L Hirshberg, Colin K Grissom, Samuel M Brown
BACKGROUND: In sepsis, tachycardia may indicate low preload, adrenergic stimulation, or both. Adrenergic overstimulation is associated with septic cardiomyopathy. We sought to determine whether tachycardia was associated with left ventricular longitudinal strain, a measure of cardiac dysfunction. We hypothesized an association would primarily exist in patients with high preload. METHODS: We prospectively observed septic patients admitted to three study ICUs, who underwent early transthoracic echocardiography...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28213648/-state-of-the-art-in-fluid-and-volume-therapy-a%C3%A2-user-friendly-staged-concept
#15
M Rehm, N Hulde, T Kammerer, A S Meidert, K Hofmann-Kiefer
Adequate fluid therapy is highly important for the perioperative outcome of our patients. Both, hypovolemia and hypervolemia can lead to an increase in perioperative complications and can impair the outcome. Therefore, perioperative infusion therapy should be target-oriented. The main target is to maintain the patient's preoperative normovolemia by using a sophisticated, rational infusion strategy.Perioperative fluid losses should be discriminated from volume losses (surgical blood loss or interstitial volume losses containing protein)...
February 17, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28213050/reduced-frequency-of-two-activating-kir-genes-in-patients-with-sepsis
#16
Luciana M Oliveira, Pamela Portela, Joice Merzoni, Juliana D Lindenau, Fernando S Dias, Jaqueline Beppler, Pietra Graebin, Clarice S Alho, Gilberto Schwartsmann, Felipe Dal-Pizzol, Luiz Fernando Jobim, Mariana Jobim, Rafael Roesler
Natural killer (NK) cell activity is regulated by activating and inhibitory signals transduced by killer cell immunoglobulin-like receptors (KIR). Diversity in KIR gene repertoire among individuals may affect disease outcome. Sepsis development and severity may be influenced by genetic factors affecting the immune response. Here, we examined sixteen KIR genes and their human leucocyte antigen (HLA) class I ligands in critical patients, aiming to identify patterns that could be associated with sepsis. Male and female patients (ages ranging between 14 and 94years-old) were included...
February 14, 2017: Human Immunology
https://www.readbyqxmd.com/read/28212865/casein-kinase-2-interacting-protein-1-regulates-m1-and-m2-inflammatory-macrophage-polarization
#17
Yuhan Chen, Wen Liu, Yiwu Wang, Luo Zhang, Jun Wei, Xueli Zhang, Fuchu He, Lingqiang Zhang
The importance of macrophage plasticity, albeit being discovered recently, has been highlighted in a broad spectrum of biological processes operative in physiological and pathological environments. Macrophage polarized activation and inactivation has profound effects on immune and inflammatory responses with several major pathways being elucidated in the past few years. However, transcriptional regulation mechanisms governing macrophage polarization is still preliminary. In this study, we identify the Casein Kinase 2 Interacting Protein 1 (CKIP-1) as a molecular toggle manipulating macrophage speciation...
February 14, 2017: Cellular Signalling
https://www.readbyqxmd.com/read/28212163/multiple-organ-dysfunction-in-children-mechanically-ventilated-for-acute-respiratory-failure
#18
Scott L Weiss, Lisa A Asaro, Heidi R Flori, Geoffrey L Allen, David Wypij, Martha A Q Curley
OBJECTIVES: The impact of extrapulmonary organ dysfunction, independent from sepsis and lung injury severity, on outcomes in pediatric acute respiratory failure is unclear. We sought to determine the frequency, timing, and risk factors for extrapulmonary organ dysfunction and the independent association of multiple organ dysfunction syndrome with outcomes in pediatric acute respiratory failure. DESIGN: Secondary observational analysis of the Randomized Evaluation of Sedation Titration for Respiratory Failure cluster-randomized prospective clinical trial conducted between 2009 and 2013...
February 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28211488/differences-in-the-clinical-characteristics-of-early-and-late-onset-necrotizing-enterocolitis-in-full-term-infants-a-retrospective-case-control-study
#19
Qiu-Yu Li, Yao An, Li Liu, Xue-Qiu Wang, Shi Chen, Zheng-Li Wang, Lu-Quan Li
Information regarding the influence of age at onset on prognosis in full-term infants with necrotizing enterocolitis (NEC) is limited, and identifying differences between the clinical characteristics of early-onset NEC (EO-NEC) and late-onset NEC (LO-NEC) may be helpful in the determination of effective management strategies. In the present study, the medical records of 253 full-term infants with NEC were reviewed, and the clinical characteristics of the EO-NEC group (n = 150) and the LO-NEC group (n = 103) were compared...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28211096/monocyte-and-lymphocyte-surface-molecules-in-severe-sepsis-and-non-septic-critically-ill-patients
#20
Joel Jämsä, Hannu Syrjälä, Virva Huotari, Eeva-Riitta Savolainen, Tero Ala-Kokko
The aim of the present study was to investigate whether expression of monocyte and lymphocyte surface molecules differs between patients with severe sepsis and non-septic patients treated in the intensive care unit (ICU). The expression of monocyte CD14, CD40, CD80 and HLA-DR, and lymphocyte CD69 were analyzed using quantitative flow cytometry on three consecutive days in 27 patients with severe sepsis and in 15 non-septic patients. Receiver operating characteristic analyses were performed and each corresponding area under the curve (AUC) was determined...
February 17, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
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