Heart Rate Control during Experimental Sepsis in Mice Comparison of Ivabradine and β-Blockers
This study assesses the effects of ivabradine, atenolol, and placebo in the setting of murine peritonitis. Mice that received atenololversus ivabradine both experienced a similar and significant decline in heart rate. The mice in the atenolol group also experienced a significant decrease in cardiac output, systolic blood pressure, and left ventricular systolic function that was not experienced by the mice who received ivabradine.Mice who received atenolol versus ivabradine versus placebo did not have significantly different survival 60 h after induction of sepsis. Future studies are needed to determine the value of ivabradine versus atenolol for heart rate control in human sepsis.Background Tachycardia is a hallmark of sepsis. An elevated heart rate could impair ventricular filling and increase myocardial oxygen demand. β-Blockers and ivabradine (a selective inhibitor of If channels in the sinoatrial node) are both able to control sinus tachycardia, with the latter drug being devoid of negative inotropic effect. This work aimed at assessing the hemodynamic effects of ivabradine as compared with a β-blocker (atenolol) during murine peritonitis.Methods Ivabradine (3 μg/g), atenolol (3 μg/g), or placebo was administered intraperitoneally 2 h after induction of peritonitis (cecal ligation and puncture) in male C57BL6 mice. The authors used invasive (left ventricular catheterization) and noninvasive (transthoracic echocardiography) monitoring to assess hemodynam ic...
Authors: Lam E, Lien YTK, Kraft WK, Piraino B, Vozmediano V, Schmidt S, Zhang J Abstract Intraperitoneal vancomycin is the first-line therapy in the management of peritoneal dialysis (PD)-related peritonitis. However, due to the paucity of data, vancomycin dosing for peritonitis in patients on automated peritoneal dialysis (APD) is empiric and based on clinical experience rather than evidence. Studies in continuous ambulatory peritoneal dialysis (CAPD) patients have been used to provide guidelines for dosing and are often extrapolated for APD use, but it is unclear whether this is appropriate. This review summarize...
CONCLUSIONS: In this randomized controlled trial, we were unable to demonstrate that regular, targeted testing and retraining of new PD patients increased the time to first peritonitis or reduced the rate of peritonitis, as the study comprised patients with a low risk of peritonitis, was underpowered, open to type 1 statistical error, and contamination between groups. PMID: 32063220 [PubMed - as supplied by publisher]
CONCLUSIONS: Adipocytokines are a predictive factor of peritoneal function and the duration of PD in patients undergoing PD. PMID: 32063216 [PubMed - as supplied by publisher]
Authors: Graham J, Nataatmadja M, Romney M, Jamal A PMID: 32063206 [PubMed - as supplied by publisher]
Authors: Matsui K, Mochida Y, Ishioka K, Moriya H, Hidaka S, Ohtake T, Kobayashi S PMID: 32063204 [PubMed - as supplied by publisher]
CONCLUSION: Large variability exists in the definitions, methods of reporting, and analysis of PD-associated peritonitis across trials and observational studies. Standardizing definitions for reporting of peritonitis and associated outcomes will better enable assessment of the comparative effect of interventions on peritonitis. This will facilitate continuous quality improvement measures through reliable benchmarking of this patient-important outcome across centers and countries. PMID: 32063197 [PubMed - as supplied by publisher]
CONCLUSIONS: Until the outcomes of this in vitro study are confirmed by appropriate in vivo studies, continuous dosing of ceftzadime-Dianeal admixtures for the treatment of PDAP may be preferred over continuous dosing of ceftazidime-Physioneal admixtures, and intermittent dosing of ceftazidime-Physioneal and ceftazidime-Dianeal admixtures, as ceftazidime remains stable and the generated levels of pyridine are below the maximum recommended daily exposure. PMID: 32063195 [PubMed - as supplied by publisher]
CONCLUSION: This TEACH-PD study has demonstrated feasibility of implementation in a real clinical setting. The outcomes of this study have informed refinement of the TEACH-PD modules prior to rigorous evaluation of its efficacy and cost-effectiveness in a large-scale study. PMID: 32063194 [PubMed - as supplied by publisher]
Authors: Nkoy AB, Ndiyo YM, Matoka TT, Odio BM, Kazadi OK, Aloni MN, Collard L, McCulloch M, Ngiyulu RM, Gini JE, Lepira FB, van den Heuvel LP, Levtchenko E, Ekulu PM Abstract In the Democratic Republic of Congo (DRC), acute kidney injury (AKI) contributes to the high rate of child mortality owing to the conjunction of poverty, deficiency of qualified health-care providers in pediatric nephrology, and the lack of pediatric dialysis programs. We aimed to describe the recent experience of the first pediatric acute peritoneal dialysis (PD) program in DRC. This is a retrospective cohort study on epidemiology, clinical ...
CONCLUSIONS: IP cefazolin and ceftazidime during the short-dwell automated exchange could provide adequate dialysate and plasma concentrations in peritonitis patients. This novel regimen is a promising regimen for peritonitis in PD patients. PMID: 32063189 [PubMed - as supplied by publisher]