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Mechanical sepsis

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https://www.readbyqxmd.com/read/28724580/il-7-restores-t-lymphocyte-immunometabolic-failure-in-septic-shock-patients-through-mtor-activation
#1
Fabienne Venet, Julie Demaret, Benjamin J Blaise, Christelle Rouget, Thibaut Girardot, Estellie Idealisoa, Thomas Rimmelé, François Mallet, Alain Lepape, Julien Textoris, Guillaume Monneret
T lymphocyte alterations are central to sepsis pathophysiology, whereas related mechanisms remain poorly understood. We hypothesized that metabolic alterations could play a role in sepsis-induced T lymphocyte dysfunction. Samples from septic shock patients were obtained at day 3 and compared with those from healthy donors. T cell metabolic status was evaluated in the basal condition and after T cell stimulation. We observed that basal metabolic content measured in lymphocytes by nuclear magnetic resonance spectroscopy was altered in septic patients...
July 19, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28723546/local-modulation-of-antigen-presenting-cell-development-after-resolution-of-pneumonia-induces-long-term-susceptibility-to-secondary-infections
#2
Antoine Roquilly, Hamish E G McWilliam, Cedric Jacqueline, Zehua Tian, Raphael Cinotti, Marie Rimbert, Linda Wakim, Irina Caminschi, Mireille H Lahoud, Gabrielle T Belz, Axel Kallies, Justine D Mintern, Karim Asehnoune, Jose A Villadangos
Lung infections cause prolonged immune alterations and elevated susceptibility to secondary pneumonia. We found that, after resolution of primary viral or bacterial pneumonia, dendritic cells (DC), and macrophages exhibited poor antigen-presentation capacity and secretion of immunogenic cytokines. Development of these "paralyzed" DCs and macrophages depended on the immunosuppressive microenvironment established upon resolution of primary infection, which involved regulatory T (Treg) cells and the cytokine TGF-β...
July 18, 2017: Immunity
https://www.readbyqxmd.com/read/28720602/a-reminder-of-escherichia-coli-sepsis-induced-reversible-cardiomyopathy
#3
Aung Naing Lin, Atif Shaikh, Sithu Lin, Deepika Misra
Cardiomyopathy is a progressive disease of myocardium causing either mechanical or electrical disturbances. Sepsis-induced cardiomyopathy (SICM) is an entity of cardiomyopathy which is reversible in 1â€"2 weeks after recovery from sepsis or septic shock. SICM is thought to have unpredictable cumulative mortality towards sepsis but its exact mechanism remains elusive. We report a case of Escherichia coli SICM in a 63-year-old woman presented with sudden onset of dyspnoea on exertion and orthopnoea following nausea, vomiting and diarrhoea after consuming Chinese foods...
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28719764/surgical-anatomy-does-not-affect-the-progression-of-intestinal-failure-associated-liver-disease-in-neonatal-piglets
#4
Celeste M Lavallee, Pamela R Wizzard, Marihan Lansing, Donna F Vine, Patrick N Nation, Jason Y Yap, Benjamin P Willing, Paul W Wales, Justine M Turner
BACKGROUND: Intestinal failure-associated liver disease (IFALD) causes significant morbidity in neonates with short bowel syndrome (SBS) dependent on parenteral nutrition (PN). Resected ileum, with loss of the ileocecal valve (ICV), is the most common anatomy in SBS, yet its impact on IFALD has not been adequately studied. METHODS: Neonatal piglets were randomized to 75% intestinal resection with jejunocolic anastomosis (JC, n = 12), 75% resection with jejunoileal anastomosis and intact ICV (JI, n = 13), PN-fed sham (sham, n = 14), or sow-fed control (SF, n = 8)...
July 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28717346/inflammatory-wnt5a-signalling-pathways-affecting-barrier-function-of-human-vascular-endothelial-cells
#5
Tom Skaria, Gabriele Schoedon
Wnt5A is a chemokine secreted by inflammatory-activated human macrophages that sustains their inflammatory response in an autocrine manner. High levels of Wnt5A are found in sera of patients with sepsis and septic shock. Here, we comment on recently reported Wnt5A signalling pathways in human vascular endothelial cells (VEC). In human VEC, Wnt5A regulates cytoskeleton remodelling and barrier function through Ryk receptor and Rho-associated protein serine/threonine kinase, targeting LIMK2 and CFL1 involved in actin polymerisation...
2017: Journal of Inflammation
https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#6
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28715077/age-and-gender-related-peculiarities-of-patients-with-delirium-in-the-cardiac-intensive-care-unit
#7
Pranas Serpytis, Petras Navickas, Alvydas Navickas, Rokas Serpytis, Giedrius Navickas, Sigita Glaveckaite
BACKGROUND: The overall evidence base regarding delirium has been growing steadily over the past few decades. There has been considerable analysis of delirium concerning, for example, mechanically ventilated patients, patients in the general intensive care unit (ICU) setting, and patients with exclusively postoperative delirium. Nevertheless, there are few studies regarding delirium in a cardiovascular ICU (ICCU) setting and especially scarce literature about the particular features of delirium relating to patient age and gender...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28714582/altered-levels-of-soluble-cd18-may-associate-immune-mechanisms-with-outcome-in-sepsis
#8
Tue Wenzel Kragstrup, Kristian Juul-Madsen, Stig Hill Christiansen, Xianwei Zhang, Jan Krog, Thomas Vorup-Jensen, Anders Gade Kjaergaard
The pathogenesis of sepsis involves a dual inflammatory response, with a hyper-inflammatory phase followed by, or in combination with, a hypo-inflammatory phase. The adhesion molecules LFA-1 (CD11a/CD18) and Mac-1 (CD11b/CD18) support leukocyte adhesion to intercellular adhesion molecules and phagocytosis through complement opsonisation, both processes relevant to the immune response during sepsis. Here, we investigate the role of soluble (s)CD18 in sepsis with emphasis on sCD18 as a mechanistic biomarker of immune reactions and outcome of sepsis...
July 17, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28713932/human-trypsin-inhibitor-reduces-the-apoptosis-of-lipopolysaccharide%C3%A2-induced-human-kidney%C3%A2-2-cells-by-promoting-mitochondrial-fusion
#9
Ning Liu, Zhiyi Jiang, Yongjun Liu, Yao Nie, Juan Chen, Bin Ouyang, Xiangdong Guan, Minying Chen
Imbalance in mitochondrial fusion/fission is one of the mechanisms leading to sepsis‑induced mitochondrial dysfunction and cell apoptosis. The present study examined the effects of human trypsin inhibitor (UTI), a well‑known antioxidant and anti‑inflammatory substance, on mitochondrial dynamics and cell apoptosis in lipopolysaccharide (LPS)‑induced human kidney‑2 (HK‑2) cells. The HK‑2 cells were incubated for 24 h either with LPS (800 ng/ml) or LPS (800 ng/ml) mixed with UTI (250 U/ml). Cell viability was assessed using a3‑(4,5‑dimethyl‑2‑thiazolyl)‑2, 5‑diphenyl‑2‑H‑tetrazolium bromide assay...
September 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28713509/mechanical-ventilation-practice-in-egyptian-pediatric-intensive-care-units
#10
Bassant Salah Meligy, Sally Kamal, Seham Awad El Sherbini
INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). METHODS: This prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28712645/comparison-of-qsofa-score-and-sirs-criteria-as-screening-mechanisms-for-emergency-department-sepsis
#11
Samir Haydar, Matthew Spanier, Patricia Weems, Samantha Wood, Tania Strout
OBJECTIVES: The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28711861/healthcare-infrastructure-capacity-to-respond-to-severe-acute-respiratory-infection-sari-and-sepsis-in-vietnam-a-low-middle-income-country
#12
Vu Quoc Dat, Nguyen Thanh Long, Kim Bao Giang, Pham Bich Diep, Ta Hoang Giang, Janet V Diaz
PURPOSE: This study investigated the availability of relevant structural and human resources needed for the clinical management of patients with severe acute respiratory infections and sepsis in critical care units in Vietnam. MATERIAL AND METHODS: A questionnaire survey was conducted by purposive sampling of 128 hospitals (36% of total hospitals in surveyed provinces), including 25 provincial and 103 district level hospitals, from 20 provinces in Vietnam. Data on availability of hospital characteristics, structural resources and health care workers was then analyzed...
July 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28711488/immunomodulatory-intervention-with-gamma-interferon-in-mice-with-sepsis
#13
Yu Wang, Bing-Bing Kong, Wen-Ping Yang, Xin Zhao, Rong Zhang
AIMS: Sepsis-triggered immune paralysis including T-cell dysfunction increase susceptibility to infection. Gamma interferon (IFNg) exert beneficial effects in patients with sepsis. Herein, we speculated that IFNg may attenuate T-cell dysfunction induced by sepsis, although the mechanisms remain elusive. To test this hypothesis, we used a model based on cecal ligation and puncture (CLP) to induce sepsis in mice. MAIN METHODS: Male C57BL/6 mice were pretreated with recombinant human IFNg (0...
July 12, 2017: Life Sciences
https://www.readbyqxmd.com/read/28710255/cathelicidins-inhibit-escherichia-coli-induced-tlr2-and-tlr4-activation-in-a-viability-dependent-manner
#14
Maarten Coorens, Viktoria A F Schneider, A Marit de Groot, Albert van Dijk, Marjolein Meijerink, Jerry M Wells, Maaike R Scheenstra, Edwin J A Veldhuizen, Henk P Haagsman
Activation of the immune system needs to be tightly regulated to provide protection against infections and, at the same time, to prevent excessive inflammation to limit collateral damage to the host. This tight regulation includes regulating the activation of TLRs, which are key players in the recognition of invading microbes. A group of short cationic antimicrobial peptides, called cathelicidins, have previously been shown to modulate TLR activation by synthetic or purified TLR ligands and may play an important role in the regulation of inflammation during infections...
July 14, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28710027/admission-lactate-predicts-poor-prognosis-independently-of-the-crb-curb-65-scores-in-community-acquired-pneumonia
#15
Frederik S Frenzen, Ulrike Kutschan, Nils Meiswinkel, Bernhard Schulte-Hubbert, Santiago Ewig, Martin Kolditz
OBJECTIVES: Community-acquired pneumonia (CAP) is associated with a high risk of respiratory failure or septic organ dysfunction. Lactate is an established early marker of prognosis and sepsis severity, but few data exist in patients with CAP. METHODS: We performed a retrospective cohort study of consecutive adult CAP patients without treatment restrictions or direct ICU admission. Lactate was measured as point of care test within the capillary admission blood gas analysis and its prognostic value was compared to the CRB/CURB-65 criteria by multivariate and ROC curve analysis...
July 11, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28709443/severity-of-acute-gastrointestinal-injury-grade-is-a-predictor-of-all-cause-mortality-in-critically-ill-patients-a-multicenter-prospective-observational-study
#16
Bangchuan Hu, Renhua Sun, Aiping Wu, Yin Ni, Jingquan Liu, Feng Guo, Lijun Ying, Guoping Ge, Aijun Ding, Yunchao Shi, Changwen Liu, Lei Xu, Ronglin Jiang, Jun Lu, Ronghai Lin, Yannan Zhu, Weidong Wu, Bo Xie
BACKGROUND: In 2012, the European Society of Intensive Care Medicine proposed a definition for acute gastrointestinal injury (AGI) based on current medical evidence and expert opinion. The aim of the present study was to evaluate the feasibility of using the current AGI grading system and to investigate the association between AGI severity grades with clinical outcome in critically ill patients. METHODS: Adult patients at 14 general intensive care units (ICUs) with an expected ICU stay ≥24 h were prospectively studied...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28708664/esmolol-administration-to-control-tachycardia-in-an-ovine-model-of-peritonitis
#17
Koji Hosokawa, Fuhong Su, Fabio Silvio Taccone, Emiel Hendrik Post, Adriano José Pereira, Antoine Herpain, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Excessive adrenergic signaling may be harmful in sepsis. Using β-blockers to reduce sympathetic overactivity may modulate sepsis-induced cardiovascular, metabolic, immunologic, and coagulation alterations. Using a randomized ovine fecal peritonitis model, we investigated whether administration of a short-acting β-blocker, esmolol, could control tachycardia without deleterious effects on hemodynamics, renal perfusion, cerebral perfusion, cerebral metabolism, or outcome. METHODS: After induction of fecal peritonitis, 14 anesthetized, mechanically ventilated, and hemodynamically monitored adult female sheep were randomly assigned to receive a continuous intravenous infusion of esmolol to control heart rate between 80 and 100 bpm (n = 7) or a saline infusion (control group, n = 7)...
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28699713/-potential-role-of-norepinephrine-in-the-immune-dysfunction-associated-with-sepsis
#18
Anna Bauer-Dörries, Sarah De Cupis, Lucas Liaudet
Septic shock may be complicated by a state of immune suppression, with ominous prognosis significance. Although the underlying pathophysiological mechanisms are poorly understood, it is possible that norepinephrine, used to treat circulatory failure during septic shock, plays a significant contributing role. Indeed, besides its hemodynamic effects, norepinephrine exerts multiple immunosuppressive actions, which are primarily mediated by beta-2 adrenergic receptors expressed by immune cells. Furthermore, norepinephrine has the ability to promote the growth of numerous bacteria, and could thereby foster the development of nosocomial infections...
July 12, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28694564/hmgb1-and-extracellular-histones-significantly-contribute-to-systemic-inflammation-and-multiple-organ-failure-in-acute-liver-failure
#19
REVIEW
Runkuan Yang, Xiaoping Zou, Jyrki Tenhunen, Tor Inge Tønnessen
Acute liver failure (ALF) is the culmination of severe liver cell injury from a variety of causes. ALF occurs when the extent of hepatocyte death exceeds the hepatic regenerative capacity. ALF has a high mortality that is associated with multiple organ failure (MOF) and sepsis; however, the underlying mechanisms are still not clear. Emerging evidence shows that ALF patients/animals have high concentrations of circulating HMGB1, which can contribute to multiple organ injuries and mediate gut bacterial translocation (BT)...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28694452/phosphatidylserine-mediated-platelet-clearance-by-endothelium-decreases-platelet-aggregates-and-procoagulant-activity-in-sepsis
#20
Ruishuang Ma, Rui Xie, Chengyuan Yu, Yu Si, Xiaoming Wu, Lu Zhao, Zhipeng Yao, Shaohong Fang, He Chen, Valerie Novakovic, Chunyan Gao, Junjie Kou, Yayan Bi, Hemant S Thatte, Bo Yu, Shufen Yang, Jin Zhou, Jialan Shi
The mechanisms that eliminate activated platelets in inflammation-induced disseminated intravascular coagulation (DIC) in micro-capillary circulation are poorly understood. This study explored an alternate pathway for platelet disposal mediated by endothelial cells (ECs) through phosphatidylserine (PS) and examined the effect of platelet clearance on procoagulant activity (PCA) in sepsis. Platelets in septic patients demonstrated increased levels of surface activation markers and apoptotic vesicle formation, and also formed aggregates with leukocytes...
July 10, 2017: Scientific Reports
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