Incidence of hypotension according to the discontinuation order of vasopressors in the management of septic shock: a prospective randomized trial (DOVSS)

Vasopressin (AVP) is commonly added to norepinephrine (NE) to reverse shock in patients with sepsis. However, there are no data to support the appropriate strategy of vasopressor tapering in patients on concom...
Source: Critical Care - Category: Intensive Care Authors: Tags: Research Source Type: research

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Scott HF, Colborn KL, Sevick CJ, Bajaj L, Kissoon N, Deakyne Davies SJ, et al. Development and Validation of a Predictive Model of the Risk of Pediatric Septic Shock Using Data Known at the Time of Hospital Arrival. J Pediatr 2019;217:146-52.
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: Current Best Evidence Source Type: research
Authors: Handke J, Piazza O, Larmann J, Tesoro S, De Robertis E Abstract Presepsin is the soluble fragment of CD14, a multifunctional glycoprotein expressed on the surface of innate immune cells. In healthy individuals, presepsin is present in very low concentrations with reference values ranging from 60 to 382 pg/ml. Several studies have shown that presepsin is a valuable biomarker for sepsis diagnosis in adults. Only lately, presepsin has been evaluated for prediction and early detection of neonatal sepsis and septic shock. Elevated plasma presepsin concentration has also been reported in patients undergoing card...
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
Streptococcus suis is an important porcine bacterial pathogen and zoonotic agent responsible for sudden death, septic shock, and meningitis. These pathologies are a consequence of elevated bacterial replication leading to exacerbated and uncontrolled inflammation, a hallmark of the S. suis systemic and central nervous system (CNS) infections. Monocytes and neutrophils are immune cells involved in various functions, including proinflammatory mediator production. Moreover, monocytes are composed of two main subsets: shorter-lived inflammatory monocytes and longer-lived patrolling monocytes. However, regardless of their prese...
Source: Infection and Immunity - Category: Infectious Diseases Authors: Tags: Host Response and Inflammation Source Type: research
CONCLUSION: The use of RGP prior to ureteral stent placement for an obstructing ureteral stone with concomitant UTI was not associated with unfavorable clinical outcomes in our retrospective series. While these findings support the safety of RGP in this setting, prospective trials are warranted. PMID: 32065871 [PubMed - in process]
Source: Canadian Journal of Urology - Category: Urology & Nephrology Tags: Can J Urol Source Type: research
Source: Intensive Care Medicine - Category: Intensive Care Source Type: research
Conclusions: FFPE tissue samples can be suitable for gene expression studies as well as immunostaining of specific cells or molecules. The most pronounced gene expression patterns were found in the organs with highest levels of Neisseria meningitidis DNA. Thousands of protein-coding and non-coding RNA transcripts were altered in lungs, heart and kidneys. We identified specific biomarker panels both protein-coding and non-coding RNA transcripts, which differed from organ to organ. Involvement of many genes and pathways add up and the combined effect induce organ failure.
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Source: Intensive Care Medicine - Category: Intensive Care Source Type: research
In Reply We agree with Dr Rehberg and colleagues that our study demonstrated that selepressin had a number of advantageous physiologic effects on blood pressure, urine output, and other features associated with septic shock. In this way, as the authors suggest, it appears that selepressin shares a set of properties similar to that of other agents used for cardiovascular support in septic shock, including the recently approved angiotensin II. In contrast to the study on which angiotensin II was approved, we chose a primary outcome designed to determine whether care with selepressin improved downstream patient-centered outco...
Source: JAMA - Category: General Medicine Source Type: research
To the Editor Compared with placebo, the nonadrenergic vasopressor angiotensin II was shown to increase mean arterial pressure after 3 hours in patients with vasodilatory shock in the Angiotensin II for the Treatment of High-Output Shock (ATHOS-3) trial (primary end point). In addition, angiotensin II also reached the secondary goal of a greater reduction in the cardiovascular Sequential Organ Failure Assessment (SOFA) score after 48 hours vs placebo. As a consequence, research with angiotensin II continued and it was approved by the US Food and Drug Administration.
Source: JAMA - Category: General Medicine Source Type: research
CONCLUSIONS: The incidence of pregnancy-related AKI remains high in the maternal ICU setting. Septic shock, hypovolemic shock, and higher APACHE II and SOFA scores were independently associated dialysis therapy (hemodialysis in all cases). KDIGO stages 2 and 3 were less frequent than KDIGO stage 1 in patients with gestational hypertension. Norepinephrine and hemodialysis therapy were independently associated with maternal mortality in patients with pregnancy-related AKI. KDIGO stage 3 was associated with higher maternal mortality. PMID: 32072506 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
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