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    5145 results match your criteria Multisystem Organ Failure of Sepsis

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    Multiple Organ Dysfunction in Children Mechanically Ventilated for Acute Respiratory Failure.
    Pediatr Crit Care Med 2017 Feb 16. Epub 2017 Feb 16.
    1Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 2Department of Cardiology, Boston Children's Hospital, Boston, MA. 3Division of Pediatric Critical Care, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI. 4Division of Critical Care, Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, MO. 5Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA. 6Department of Pediatrics, Harvard Medical School, Boston, MA. 7School of Nursing, University of Pennsylvania, Philadelphia, PA. 8Critical Care and Cardiovascular Program, Boston Children's Hospital, Boston, MA.
    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. Read More

    A fatal suppurative pneumonia in piglets caused by a pathogenic coagulase-positive strain of Staphylococcus hyicus.
    Vet Res Commun 2017 Feb 16. Epub 2017 Feb 16.
    Key Laboratory for Zoonosis Research, Ministry of Education, Institute of Zoonosis, Jilin University, Changchun, China.
    Staphylococcus hyicus is one of the opportunistic pathogens that cause infections to animals. Early studies have demonstrated that S. hyicus is the causative agents of exudative epidermitis in pigs, arthritis in horses and chicken, mastitis in cow, and bacteremia, sepsis and multiple organ failure in humans. Read More

    Zoonotic necrotizing myositis caused by Streptococcus equi subsp. zooepidemicus in a farmer.
    BMC Infect Dis 2017 Feb 15;17(1):147. Epub 2017 Feb 15.
    The Gade Research Group for Infection and Immunity, Department of Clinical Science, University of Bergen, Bergen, Norway.
    Background: Streptococcus equi subsp. zooepidemicus is a beta-hemolytic group C streptococcus mainly causing infections in domesticated animals. Here we describe the first case of zoonotic necrotizing myositis caused by this bacterium. Read More

    Fatal Rhabdomyolysis Caused by Morganella morganii in a Patient with Multiple Myeloma.
    Intern Med 2017 1;56(3):369-371. Epub 2017 Feb 1.
    Division of Hematology and Stem Cell Transplantation, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Japan.
    A 64-year-old Japanese man with multiple myeloma was admitted to our institute due to fever and hypotension. He had received multiple courses of chemotherapy just before his febrile episode. Blood culturing detected Morganella morganii. Read More

    Vancomycin during the Last Hour of the Hemodialysis Session: A Pharmacokinetic Analysis.
    Nephron 2017 Feb 3. Epub 2017 Feb 3.
    Department of Nephrology and Clinical Immunology, CHRU Tours, Tours, France.
    Background: Vancomycin is usually administered after the dialysis sessions to patients undergoing hemodialysis. Administration of vancomycin during (as opposed to after) sessions would save time, and would be more acceptable to patients and staff, but may lead to vancomycin underexposure. The aim of this study was to propose a new dosing regimen of vancomycin taking into account the dialysis-related losses of vancomycin when administered during dialysis. Read More

    Contamination of burn wounds by Achromobacter Xylosoxidans followed by severe infection: 10-year analysis of a burn unit population.
    Ann Burns Fire Disasters 2016 Sep;29(3):215-222
    Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany.
    Gram-negative infections predominate in burn surgery. Until recently, Achromobacter species were described as sepsis-causing bacteria in immunocompromised patients only. Severe infections associated with Achromobacter species in burn patients have been rarely reported. Read More

    Hemadsorption with Adult CytoSorb® in a Low Weight Pediatric Case.
    Case Rep Crit Care 2017 3;2017:6987167. Epub 2017 Jan 3.
    "Carol Davila" University of Medicine & Pharmacy Bucharest, 37 Dionisie Lupu Street, District 1, 020021 Bucharest, Romania.
    Cytokine adsorber (CytoSorb) has been used successfully as adjunctive treatment for adult patients with elevated cytokine levels in the setting with severe sepsis and septic shock and to reduce blood myoglobin, unconjugated bilirubin, and conjugated bilirubin. In this article we present the case of a nine-month-old male infant who was admitted to the NICU due to sepsis after cardiac surgery, Fallot tetralogy, and multisystem organ failure (MSOF) including liver failure and renal failure which was successfully treated by a combination of continuous hemodiafiltration (HDF) and hemadsorption with CytoSorb. HDF was safe and effective from the first day for urea removal, but the patient's bilirubin levels kept increasing gradually, culminating on the 9th day with a maximum value of 54 mg/dL of total bilirubin and 31. Read More

    Effect of extracorporeal cytokine removal on vascular barrier function in a septic shock patient.
    J Intensive Care 2017 21;5:12. Epub 2017 Jan 21.
    0000 0000 9529 9877grid.10423.34Department of Medicine, Division of Nephrology & Hypertension, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
    Background: Sepsis and septic shock are major healthcare problems, affecting millions of individuals around the world each year. Pathophysiologically, septic multiple organ dysfunction (MOD) is a life-threatening condition caused by an overwhelming systemic inflammatory response of the host's organism to an infection. We experimentally tested if high circulating cytokine levels might increase vascular permeability-a critical hallmark of the disease-and if this phenomenon can be reversed by therapeutic cytokine removal (CytoSorb®) in an exemplary patient. Read More

    Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit.
    JAMA 2017 01;317(3):290-300
    Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Prahran, Melbourne, Australia3Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Prahran, Melbourne, Australia8Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, Australia.
    Importance: The Sepsis-3 Criteria emphasized the value of a change of 2 or more points in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score, introduced quick SOFA (qSOFA), and removed the systemic inflammatory response syndrome (SIRS) criteria from the sepsis definition.

    Objective: Externally validate and assess the discriminatory capacities of an increase in SOFA score by 2 or more points, 2 or more SIRS criteria, or a qSOFA score of 2 or more points for outcomes among patients who are critically ill with suspected infection.

    Design, Setting, And Participants: Retrospective cohort analysis of 184 875 patients with an infection-related primary admission diagnosis in 182 Australian and New Zealand intensive care units (ICUs) from 2000 through 2015. Read More

    Sepsis-related acute respiratory distress syndrome in children with cancer: the respiratory dynamics of a devastating condition.
    Rev Bras Ter Intensiva 2016 Oct-Dec;28(4):436-443
    Departamento de Oncologia Pediátrica, Grupo de Apoio ao Adolescente e à Criança com Câncer, Instituto de Oncologia Pediátrica, Universidade Federal de São Paulo - São Paulo (SP), Brasil.
    Objective:: To evaluate the clinical course and respiratory parameters of mechanically ventilated children with cancer suffering from sepsis-related acute respiratory distress syndrome.

    Methods:: This 2-year prospective, longitudinal, observational cohort study enrolled 29 children and adolescents. Clinical data, measurements of blood gases and ventilation parameters were collected at four different time points. Read More

    Factors associated with maternal death in an intensive care unit.
    Rev Bras Ter Intensiva 2016 Oct-Dec;28(4):397-404
    Programa de Pós-Graduação em Saúde Coletiva, Universidade de Fortaleza - Fortaleza (CE), Brasil.
    Objective:: To identify factors associated with maternal death in patients admitted to an intensive care unit.

    Methods:: A cross-sectional study was conducted in a maternal intensive care unit. All medical records of patients admitted from January 2012 to December 2014 were reviewed. Read More

    Application of autologous hematopoietic stem cell transplantation for pemphigus.
    Int J Dermatol 2017 Mar 17;56(3):296-301. Epub 2017 Jan 17.
    Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
    Background: Pemphigus is a rare and fatal autoimmune disease for which the treatment options are limited. This study aimed to evaluate the efficacy of autologous peripheral hematopoietic stem cell transplantation (APHSCT) for pemphigus.

    Methods: We conducted APHSCT for 12 pemphigus patients (seven males and five females, mean age 23. Read More

    Assessment of resuscitation as measured by markers of metabolic acidosis and features of injury.
    Bone Joint J 2017 Jan;99-B(1):122-127
    MetroHealth Medical Center, Case Western Reserve University, Department of Orthopaedic Surgery, 2500 MetroHealth Drive, Cleveland, Ohio, 44109, USA.
    Aims: The best time for definitive orthopaedic care is often unclear in patients with multiple injuries. The objective of this study was make a prospective assessment of the safety of our early appropriate care (EAC) strategy and to evaluate the potential benefit of additional laboratory data to determine readiness for surgery.

    Patients And Methods: A cohort of 335 patients with fractures of the pelvis, acetabulum, femur, or spine were included. Read More

    The Effectiveness of Corticosteroid Usage in Complex Therapy for Severe Sepsis and Acute Respiratory Distress Syndrome in Cases of Severe Traumatic Brain Injury.
    Adv Clin Exp Med 2016 Nov-Dec;25(6):1223-1226
    Pope John Paul II State School of Higher Education, Biała Podlaska, Poland.
    Background: Severe traumatic brain injury (STBI) is an important issue in contemporary medicine and treatment strategies are still in need of improvement. The most dangerous complications of STBI are multiple organ failure and severe sepsis. As many as 80% of STBI patients with multiple organ failure have acute respiratory distress syndrome (ARDS). Read More

    Celecoxib administration reduced mortality, mesenteric hypoperfusion, aortic dysfunction and multiple organ injury in septic rats.
    Biomed Pharmacother 2017 Feb 23;86:583-589. Epub 2016 Dec 23.
    Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
    Background: The cyclooxygenase (COX)-2 overexpression is associated with vascular injury and multiple organ failure in sepsis. However, constitutive COX-1 and basal COX-2 expressions have physiological effects. We aimed to investigate the effects of partial and selective COX-2 inhibition without affecting constitutive COX-1 and basal COX-2 activities by celecoxib on mesenteric artery blood flow (MABF), vascular reactivity, oxidative and inflammatory injuries, and survival in septic rats accomplished by cecal ligation and puncture (CLP). Read More

    Treatment of Sepsis Pathogenesis with High Mobility Group Box Protein 1-Regulating Anti-inflammatory Agents.
    J Med Chem 2017 Jan 21;60(1):170-179. Epub 2016 Dec 21.
    CRI Center for Chemical Proteomics, Department of Chemistry, Seoul National University , Seoul 08826, Korea.
    Sepsis is one of the major causes of death worldwide when associated with multiple organ failure. However, there is a critical lack of adequate sepsis therapies because of its diverse patterns of pathogenesis. The pro-inflammatory cytokine cascade mediates sepsis pathogenesis, and high mobility group box proteins (HMGBs) play an important role as late-stage cytokines. Read More

    Accuracy of SOFA score in prediction of 30-day outcome of critically ill patients.
    Turk J Emerg Med 2016 Dec 19;16(4):146-150. Epub 2016 Nov 19.
    Emergency Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
    Objectives: Researchers have attempted to design various scoring systems to determine the severity and predict the outcome of critically ill patients. The present study aimed to evaluate the accuracy of SOFA score in predicting 1-month outcome of these patients in emergency department.

    Methods: The present study is a prospective cross-sectional study of >18 year old non-trauma critically ill patients presented to EDs of 3 hospitals, Tehran, Iran, during October 2014 to October 2015. Read More

    Pathological Role and Diagnostic Value of Endogenous Host Defense Peptides in Adult and Neonatal Sepsis: A Systematic Review.
    Shock 2016 Dec 9. Epub 2016 Dec 9.
    *Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong †State Key Laboratory of Digestive Disease, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong ‡Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong §The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong ¶Department of Rehabilitation, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Background: Sepsis is a systemic host response to an infection leading to organ failure. This is associated with dynamic expression of endogenous host defense peptides. Dysregulation of these peptides is associated with septic morbidity and mortality. Read More

    13-Ethylberberine reduces HMGB1 release through AMPK activation in LPS-activated RAW264.7 cells and protects endotoxemic mice from organ damage.
    Biomed Pharmacother 2017 Feb 7;86:48-56. Epub 2016 Dec 7.
    Department of Pharmacology, School of Medicine Gyeongsang National University and Institute of Health Sciences, Jinju 52527, Republic of Korea; Department of Convergence of Biomedical Sciences (BK21 PLUS Program), Gyeongsang National University and Institute of Health Sciences, Jinju 52527, Republic of Korea. Electronic address:
    High mobility group box 1 (HMGB1), a highly conserved non-histone DNA-binding protein, plays an important role in the pathogenesis of sepsis. Previously, the authors reported 13-ethylberberine (13-EBR) has anti-inflammatory and antibacterial effects. However, the effect of 13-EBR on HMGB1 release was not investigated. Read More

    Sphingosine-1-phosphate (S1P): A Potential Biomarker and Therapeutic Target for Endothelial Dysfunction and Sepsis?
    Shock 2016 Dec 2. Epub 2016 Dec 2.
    *Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany †Department Intensive Care Medicine, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany ‡Department of Anesthesiology and Intensive Care Medicine, Center for Sepsis Control and Care (CSCC), and the Center for Molecular Biomedicine (CMB), University Hospital Jena, Hans-Knöll-Str. 2, 07745 Jena, Germany §Clinic and Polyclinic for Vascular Medicine, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany.
    Sepsis is an acute life-threatening multiple organ failure caused by a dysregulated host response to infection. Endothelial dysfunction, particularly barrier disruption leading to increased vascular permeability, edema and insufficient tissue oxygenation is critical to sepsis pathogenesis. Sphingosine-1-phosphate (S1P) is a signaling lipid that regulates important pathophysiological processes including vascular endothelial cell permeability, inflammation and coagulation. Read More

    [Lung transplantation for phase Ⅲ silicosis: a series of 32 cases].
    Zhonghua Wai Ke Za Zhi 2016 Dec;54(12):902-907
    Department of Thoracic Surgery, Lung Transplant Center, Affiliated Wuxi People's Hospital, Nanjing Medical University, Key Laboratory of Human Organ Transplant in Jiangsu Province, Wuxi 214023, China.
    Objective: To evaluate the effect of lung transplantation for phase Ⅲ silicosis. Methods: From September 2002 to September 2015, 32 patients with end-stage silicosis underwent lung transplantation at Department of Thoracic Surgery, Affiliated Wuxi People's Hospital, Nanjing Medical University. There were 29 male and 3 female patients aged from 24 to 63 years. Read More

    Kidney Transplant Recipients Requiring Critical Care Admission Within One Year of Transplant.
    Exp Clin Transplant 2017 Feb 2;15(1):40-46. Epub 2016 Dec 2.
    From the Department of Transplantation, Central Manchester University Hospitals, United Kingdom.
    Objectives: Kidney transplant is the gold standard for treatment of renal failure. With the increasing age of the recipient population, which carries significant comorbidities, and the use of more marginal organs, there is potential for increased critical care admissions. In this study, we investigated the incidence, indications, and outcomes of patients admitted to critical care within 1 year of transplant. Read More

    Presence of Cytotoxic Extracellular Histones in Machine Perfusate of Donation after Circulatory Death Kidneys.
    Transplantation 2016 Dec 1. Epub 2016 Dec 1.
    1Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands 2Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands 3Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands 4Department of Nephrology, Maastricht University Medical Center, Maastricht, The Netherlands 5Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
    Background: Extracellular histones are cytotoxic molecules that are related to cell stress and death. They have been shown to play a crucial role in multiple pathophysiologic processes like sepsis, inflammation, vascular dysfunction and thrombosis. Their role in organ donation and graft function and survival is still unknown. Read More

    Evaluation of major trauma in elderly patients - a single trauma center analysis.
    Wien Klin Wochenschr 2016 Dec 28;128(Suppl 7):535-542. Epub 2016 Nov 28.
    Trauma Department, General and Teaching Hospital Celje, Oblakova 5, 3000, Celje, Slovakia.
    Background: The objective of the study was to gather information about elderly major trauma patients admitted to one particular Slovenian trauma centre in Celje and examine this group of polytrauma patients, specifically with respect to mechanisms of injury, injury severity and distribution of injuries. Further on, to identify morbidity and mortality rates and compare these to the younger population and, finally, to determine the factors that have the most impact on treatment results.

    Methods: The study gathered and evaluated data of 532 patients included in the Trauma Register DGU® of the German Trauma Society (TR-DGU) during a 10-year period and two distinct groups of patients were established, separated on account of age as older or younger than 65 years. Read More

    Dose-dependent mortality and organ injury in a cecal slurry peritonitis model.
    J Surg Res 2016 Dec 20;206(2):427-434. Epub 2016 Aug 20.
    Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
    Background: The cecal slurry model was introduced as an alternative method for creating an animal sepsis model. This study was performed to evaluate dose-dependent mortality and organ injury in a sepsis model of cecal slurry peritonitis.

    Materials And Methods: Male Sprague-Dawley rats were divided into 5. Read More

    PPARα augments heart function and cardiac fatty acid oxidation in early experimental polymicrobial sepsis.
    Am J Physiol Heart Circ Physiol 2017 Feb 23;312(2):H239-H249. Epub 2016 Nov 23.
    Department of Pediatrics (Cardiology), University of Washington School of Medicine, Seattle, Washington.
    Children with sepsis and multisystem organ failure have downregulated leukocyte gene expression of peroxisome proliferator-activated receptor-α (PPARα), a nuclear hormone receptor transcription factor that regulates inflammation and lipid metabolism. Mouse models of sepsis have likewise demonstrated that the absence of PPARα is associated with decreased survival and organ injury, specifically of the heart. Using a clinically relevant mouse model of early sepsis, we found that heart function increases in wild-type (WT) mice over the first 24 h of sepsis, but that mice lacking PPARα (Ppara(-/-)) cannot sustain the elevated heart function necessary to compensate for sepsis pathophysiology. Read More

    Sequential therapy consisting of glucocorticoid infusions followed by granulocyte-monocyte absorptive apheresis in patients with severe alcoholic hepatitis.
    J Gastroenterol 2016 Nov 17. Epub 2016 Nov 17.
    Department of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-cho, Iruma-gun, Saitama, 350-0495, Japan.
    Background: Activated leukocytes infiltrating the liver contribute to the provocation of alcoholic hepatitis. Glucocorticoid induces the demargination of leukocytes from the hepatic sinusoids, whereas granulocyte-monocyte absorptive apheresis (GMA) removes leukocytes from the circulation. Thus, the usefulness of a sequential therapy consisting of glucocorticoid infusions followed by GMA was evaluated in patients with severe alcoholic hepatitis. Read More

    Trends in 1029 trauma deaths at a level 1 trauma center: Impact of a bleeding control bundle of care.
    Injury 2017 Jan 3;48(1):5-12. Epub 2016 Nov 3.
    Center for Translational Injury Research, Division of Acute Care Surgery, Department of Surgery, Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address:
    Background: Over the last decade the age of trauma patients and injury mortality has increased. At the same time, many centers have implemented multiple interventions focused on improved hemorrhage control, effectively resulting in a bleeding control bundle of care. The objective of our study was to analyze the temporal distribution of trauma-related deaths, the factors that characterize that distribution and how those factors have changed over time at our urban level 1 trauma center. Read More

    Natural product HTP screening for antibacterial (E.coli 0157:H7) and anti-inflammatory agents in (LPS from E. coli O111:B4) activated macrophages and microglial cells; focus on sepsis.
    BMC Complement Altern Med 2016 Nov 15;16(1):467. Epub 2016 Nov 15.
    College of Pharmacy & Pharmaceutical Sciences, Florida A&M University, Room 104 Dyson Pharmacy Building, 1520 ML King Blvd, Tallahassee, FL, 32307, USA.
    Background: Acute systemic inflammatory response syndrome arising from infection can lead to multiple organ failure and death, with greater susceptibility occurring in immunocompromised individuals. Moreover, sub-acute chronic inflammation is a contributor to the pathology of diverse degenerative diseases (Parkinson's disease, Alzheimer's disease and arthritis). Given the known limitations in Western medicine to treat a broad range of inflammatory related illness as well as the emergence of antibiotic resistance, there is a renewed interest in complementary and alternative medicines (CAMs) to achieve these means. Read More

    Assessment of Severity of Peritonitis Using Mannheim Peritonitis Index.
    Niger J Surg 2016 Jul-Dec;22(2):118-122
    Department of General Surgery, Government Medical College, Amritsar, Punjab, India.
    Introduction: Peritonitis is one of the most common problems in general surgery practice with high mortality rate. One of the reasons for high mortality is that peritonitis affects the general condition and leads to complications causing multiple organ failure, renal failure, sepsis, and postoperative ventilatory support. Early prognostic evaluation of patients with peritonitis is desirable to select high-risk patients for intensive management and also to provide a reliable objective classification of severity and operative risk. Read More

    Clinical outcome of critically ill patients with thrombocytopenia and hypophosphatemia in the early stage of sepsis.
    Anaesthesiol Intensive Ther 2016 11;48(5):294-299. Epub 2016 Nov 11.
    Department of Anaesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Centre, Ben-Gurion University of the Negev, Beer Sheva, Israel.
    Background: Hypophosphatemia and thrombocytopenia may both be independent risk factors for the development of multiple organ failure and correlate well with the severity of sepsis. In the present study we wanted to analyze the potential clinical role and prognostic significance of both early hypophosphatemia and thrombocytopenia on clinical outcomes of critically ill ICU patients with severe sepsis.

    Methods: We analyzed the clinical data, including the outcome of critically ill ICU patients with severe sepsis who presented during a 5 year period with early hypophosphatemia and thrombocytopenia. Read More

    Critical role of endogenous histamine in promoting end-organ tissue injury in sepsis.
    Intensive Care Med Exp 2016 Dec 8;4(1):36. Epub 2016 Nov 8.
    Department of Molecular and Medical Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
    Background: Histamine assumes an important role as a major mediator in various pathologic disorders associated with inflammation and immune reactions. However, the involvement of histamine in the pathological conditions and symptoms of sepsis remains entirely unknown. In this study, we establish that histamine is identified as a contributory mediator to promoting the development of organ injury in sepsis. Read More

    Trends in intubation rates and durations in ventilated severely injured trauma patients: an analysis from the TraumaRegister DGU®.
    Patient Saf Surg 2016 3;10:24. Epub 2016 Nov 3.
    Department of Orthopedics Trauma Surgery, University of Aachen Medical Center, 52074 Aachen, Germany ; Harald Tscherne Laboratory, RWTH Aachen University, 52074 Aachen, Germany.
    Background: Endotracheal intubation in severely injured patients is known to be a risk factor for systemic complications. We aimed to examine the changes in intubation rates and durations in severely injured trauma patients, and rates of the systemic complications associated with ventilation changes by using a large trauma registry over the period of 13 years.

    Methods: Patient demographics, Injury Severity Score (ISS), ventilation days, ventilation free days (VFD), and prevalence of systemic complications (sepsis and multiple organ failure (MOF)) were obtained from the TraumaRegister DGU® and were compared over the study period. Read More

    Effect and mechanism of hydrocortisone on organ function in patients with severe burns.
    J Crit Care 2016 Dec 23;36:200-206. Epub 2016 Jun 23.
    Department of Internal Medicine and Rheumatology, Martini Hospital, Groningen, The Netherlands.
    Introduction: In patients with severe burns, resuscitation with large volumes of fluid is needed, partly because of an increase in capillary leakage. Corticosteroids might be beneficial by diminishing capillary leakage. This study aimed to assess in severely burned nonseptic patients whether hydrocortisone (HC) improved outcome and diminished capillary leakage. Read More

    Intraoperative Adverse Events in Abdominal Surgery: What Happens in the Operating Room Does Not Stay in the Operating Room.
    Ann Surg 2016 Nov 1. Epub 2016 Nov 1.
    *Department of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, MA †Department of Surgery, MedStar Washington Hospital Center, Washington, DC ‡Department of Surgery, Oregon Health & Science University, Portland, OR §Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Boston, MA.
    Objective: We sought to assess the impact of intraoperative adverse events (iAEs) on 30-day postoperative mortality, 30-day postoperative morbidity, and postoperative length of stay (LOS) among patients undergoing abdominal surgery. We hypothesized that iAEs would be associated with significant increases in each outcome.

    Summary Of Background Data: The relationship between iAEs and postoperative clinical outcomes remains largely unknown. Read More

    Modulation of inflammation and disease tolerance by DNA damage response pathways.
    FEBS J 2016 Sep 30. Epub 2016 Sep 30.
    Instituto Gulbenkian de Ciência, Oeiras, Portugal.
    The accurate replication and repair of DNA is central to organismal survival. This process is challenged by the many factors that can change genetic information such as replication errors and direct damage to the DNA molecule by chemical and physical agents. DNA damage can also result from microorganism invasion as an integral step of their life cycle or as collateral damage from host defense mechanisms against pathogens. Read More

    Neutrophil Extracellular Traps Form a Barrier between Necrotic and Viable Areas in Acute Abdominal Inflammation.
    Front Immunol 2016 10;7:424. Epub 2016 Oct 10.
    Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen , Erlangen , Germany.
    Neutrophils form neutrophil extracellular traps (NETs) of decondensed DNA and histones that trap and immobilize particulate matter and microbial pathogens like bacteria. NET aggregates reportedly surround and isolate large objects like monosodium urate crystals, which cannot be sufficiently cleared from tissues. In the setting of acute necrotizing pancreatitis, massive tissue necrosis occurs, which is organized as pancreatic pseudocysts (1). Read More

    Epidemiology of accidental hypothermia in polytrauma patients: An analysis of 15,230 patients of the TraumaRegister DGU.
    J Trauma Acute Care Surg 2016 Nov;81(5):905-912
    From the Department of Trauma Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany (M.W., A.B., S.L., L.M., S.F.-O., P.B., A.S., T.K.); Institute for Research in Operative Medicine (IFOM), University Witten/Herdecke, Cologne, Germany (R.L.); Committee on Emergency Medicine (TraumaRegister DGU), Cologne, Germany, Intensive Care and Trauma Management of the German Trauma Society (Sektion NIS), Berlin, Germany; and Department of Anesthesiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany (T.I., J.H.).
    Background: Accidental hypothermia (AH) endangers the patient after polytrauma. Past studies have emphasized this entity as a major risk factor. The aim of this study was to describe the epidemiology of AH in major trauma considering the preclinical and clinical course. Read More

    Classification of soft-tissue injuries in open femur fractures: Relevant for systemic complications?
    J Trauma Acute Care Surg 2016 Nov;81(5):824-833
    From the Department of Orthopaedics and Trauma, RWTH Aachen University, Aachen, Germany (C.D.W., T.D., P.K., R.M.S., F.H., H.-C.P.); Harald Tscherne Laboratory for Orthopaedic Research, Aachen, Germany (C.D.W.); Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany (R.L.); and Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU), Germany (T.R.).
    Background: A broad range of systemic complications has been described to occur in patients with open major fractures. Various causes have been claimed to play a role. We therefore surveyed a nationwide trauma registry to assess risk factors associated with closed and various types of open femur fractures. Read More

    Vitamin D deficiency in critically ill children with sepsis.
    Paediatr Int Child Health 2016 Feb 27;36(1):15-21. Epub 2015 Jun 27.
    Department of Paediatrics, Advanced Paediatric Center, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India.
    Background: Data on the prevalence of vitamin D deficiency (VDD) in critically ill children with sepsis and its association with illness severity and outcome are limited.

    Aim: To investigate the prevalence of VDD in critically ill children with sepsis.

    Methods: One hundred and twenty-four critically ill children with sepsis aged 1-12 years were prospectively enrolled in a paediatric intensive care unit (PICU) in North India over a 1-year period. Read More

    A novel PINK1- and PARK2-dependent protective neuroimmune pathway in lethal sepsis.
    Autophagy 2016 Dec 18;12(12):2374-2385. Epub 2016 Oct 18.
    a Department of Surgery , University of Pittsburgh , Pittsburgh , PA , USA.
    Although the PINK1-PARK2 pathway contributes to the pathogenesis of Parkinson disease, its roles in sepsis (a major challenge for critical care) were previously unknown. Here, we show that pink1(-/-) and park2(-/-) mice are more sensitive to polymicrobial sepsis-induced multiple organ failure and death. The decrease in the circulating level of the neurotransmitter dopamine in pink1(-/-) and park2(-/-) mice accelerates the release of a late sepsis mediator, HMGB1, via HIF1A-dependent anaerobic glycolysis and subsequent NLRP3-dependent inflammasome activation. Read More

    Empirical Micafungin Treatment and Survival Without Invasive Fungal Infection in Adults With ICU-Acquired Sepsis, Candida Colonization, and Multiple Organ Failure: The EMPIRICUS Randomized Clinical Trial.
    JAMA 2016 Oct;316(15):1555-1564
    UMR1137-IAME Inserm, Paris Diderot University, Paris, France2Medical and Infectious Diseases ICU, Bichat-Claude Bernard University Hospital, Paris, France.
    Importance: Although frequently used in treating intensive care unit (ICU) patients with sepsis, empirical antifungal therapy, initiated for suspected fungal infection, has not been shown to improve outcome.

    Objective: To determine whether empirical micafungin reduces invasive fungal infection (IFI)-free survival at day 28.

    Design, Setting, And Participants: Multicenter double-blind placebo-controlled study of 260 nonneutropenic, nontransplanted, critically ill patients with ICU-acquired sepsis, multiple Candida colonization, multiple organ failure, exposed to broad-spectrum antibacterial agents, and enrolled between July 2012 and February 2015 in 19 French ICUs. Read More

    Effect of Postextubation High-Flow Nasal Cannula vs Noninvasive Ventilation on Reintubation and Postextubation Respiratory Failure in High-Risk Patients: A Randomized Clinical Trial.
    JAMA 2016 Oct;316(15):1565-1574
    Hospital Sant Joan de Deu-Fundació Althaia, Manresa, Spain6Universitat Internacional de Catalunya, Spain7CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
    Importance: High-flow conditioned oxygen therapy delivered through nasal cannulae and noninvasive mechanical ventilation (NIV) may reduce the need for reintubation. Among the advantages of high-flow oxygen therapy are comfort, availability, lower costs, and additional physiopathological mechanisms.

    Objective: To test if high-flow conditioned oxygen therapy is noninferior to NIV for preventing postextubation respiratory failure and reintubation in patients at high risk of reintubation. Read More

    Pediatric Sepsis Biomarker Risk Model-II: Redefining the Pediatric Sepsis Biomarker Risk Model With Septic Shock Phenotype.
    Crit Care Med 2016 Nov;44(11):2010-2017
    1Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center and Cincinnati Children's Research Foundation, Cincinnati, OH. 2Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. 3UCSF Benioff Children's Hospital Oakland, Oakland, CA. 4Children's Hospital of Orange County, Orange, CA. 5Children's Mercy Hospital, Kansas City, MO. 6Penn State Hershey Children's Hospital, Hershey, PA. 7Akron Children's Hospital, Akron, OH. 8The Children's Hospital of Philadelphia, Philadelphia, PA. 9Texas Children's Hospital and Baylor College of Medicine, Houston, TX. 10Miami Children's Hospital, Miami, FL. 11CS Mott Children's Hospital at the University of Michigan, Ann Arbor, MI. 12Nationwide Children's Hospital, Columbus, OH. 13Children's Hospital of Wisconsin, Milwaukee, WI. 14Children's National Medical Center, Washington, DC. 15Children's Hospital and Clinics of Minnesota, Minneapolis, MN. 16Riley Hospital for Children, Indianapolis, IN. 17Hackensack University Medical Center, Joseph M. Sanzari Children's Hospital, Hackensack, NJ. 18Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.
    Objective: The Pediatric Sepsis Biomarker Risk Model (PERSEVERE), a pediatric sepsis risk model, uses biomarkers to estimate baseline mortality risk for pediatric septic shock. It is unknown how PERSEVERE performs within distinct septic shock phenotypes. We tested PERSEVERE in children with septic shock and thrombocytopenia-associated multiple organ failure (TAMOF), and in those without new onset thrombocytopenia but with multiple organ failure (MOF). Read More

    P2X7 Receptor Signaling Contributes to Sepsis-Associated Brain Dysfunction.
    Mol Neurobiol 2016 Oct 11. Epub 2016 Oct 11.
    Laboratory of Immunophysiology, Biophysics Institute Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
    Sepsis results in unfettered inflammation, tissue damage, and multiple organ failure. Diffuse brain dysfunction and neurological manifestations secondary to sepsis are termed sepsis-associated encephalopathy (SAE). Extracellular nucleotides, proinflammatory cytokines, and oxidative stress reactions are associated with delirium and brain injury, and might be linked to the pathophysiology of SAE. Read More

    Endothelial adhesion molecules and multiple organ failure in patients with severe sepsis.
    Cytokine 2016 Dec 1;88:267-273. Epub 2016 Oct 1.
    University of Texas Health Science Center San Antonio, San Antonio, TX, USA; South Texas Veterans Health Care System, USA. Electronic address:
    Objective: To determine if serum levels of endothelial adhesion molecules were associated with the development of multiple organ failure (MOF) and in-hospital mortality in adult patients with severe sepsis.

    Design: This study was a secondary data analysis of a prospective cohort study.

    Setting: Patients were admitted to two tertiary intensive care units in San Antonio, TX, between 2007 and 2012. Read More

    The Endothelial Glycocalyx: New Diagnostic and Therapeutic Approaches in Sepsis.
    Biomed Res Int 2016 6;2016:3758278. Epub 2016 Sep 6.
    Department of Intensive Care and Intermediate Care, University Hospital Aachen, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany.
    Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. The endothelial glycocalyx is one of the earliest sites involved during sepsis. This fragile layer is a complex network of cell-bound proteoglycans, glycosaminoglycan side chains, and sialoproteins lining the luminal side of endothelial cells with a thickness of about 1 to 3 μm. Read More

    Coexistence of Th1/Th2 and Th17/Treg imbalances in patients with post traumatic sepsis.
    Cytokine 2016 Dec 24;88:214-221. Epub 2016 Sep 24.
    Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India. Electronic address:
    Introduction: Multiple organ dysfunction syndrome (MODS) developed due to the insult of trauma is a leading cause of death. The high mortality rate in these patients with and without sepsis has been reported up to 50%, throughout the world and thus required an urgent insight to overcome this problem.

    Objective: The aim of this study is to examine the differential changes in subsets of T cells, imbalance in cytokine profile, immune-paralysis (T cell anergy) in Trauma hemorrhagic shock (THS) and post traumatic sepsis patients. Read More

    The diagnostic and prognostic value of systems biology research in major traumatic and thermal injury: a review.
    Burns Trauma 2016 21;4:33. Epub 2016 Sep 21.
    NIHR Surgical Reconstruction and Microbiology Research Centre, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, B15 2TT UK.
    As secondary complications remain a significant cause of morbidity and mortality amongst hospitalised trauma patients, the need to develop novel approaches by which to identify patients at risk of adverse outcome is becoming increasingly important. Centred on the idea that patients who experience "poor" outcome post trauma elicit a response to injury that is distinct from those who experience "good" outcome, tailored therapeutics is an emerging concept aimed at improving current treatment regimens by promoting patient-specific therapies. Making use of recent advancements in the fields of genomics, proteomics and metabolomics, numerous groups have undertaken a systems-based approach to analysing the acute immune and inflammatory response to major traumatic and thermal injury in an attempt to uncover a single or combination of biomarkers that can identify patients at risk of adverse outcome. Read More

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