Urantide Improves Cardiac Function, Modulates Systemic Cytokine Response, and Increases Survival in A Murine Model of Endotoxic Shock
Introduction: Urotensin II is a potent vasoactive peptide activating the the G protein-coupled urotensin II receptor UT, and is involved in systemic inflammation and cardiovascular functions. The aim of our work was to study the impact of the UT antagonist urantide on survival, systemic inflammation, and cardiac function during endotoxic shock. Methods: C57Bl/6 mice were intraperitoneally injected with lipopolysaccharide (LPS) and then randomized to be injected either by urantide or NaCl 0.9% 3, 6, and 9 h (H3, H6, H9) after LPS. The effect of urantide on the survival rate, the levels of cytokines in plasma at H6, H...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Adenoviral.βARKct Cardiac Gene Therapy Ameliorates Cardiac Function Following Cardiopulmonary Bypass in A Swine Model
Conclusion: Adv.βARKct inhibits GRK2 and ameliorates myocardial injuries following cardioplegic arrest on CPB, via stabilizing β1-AR, reducing mitochondrial damages and restoring sarcoplasmic reticulum Ca2+-handling protein expression. (Source: Shock)
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Effect of Mild Hypothermia on the Diaphragmatic Microcirculation and Function in A Murine Cardiopulmonary Resuscitated Model
Conclusion: MHT preserves the diaphragm contractility and fiber dimensions and decreases oxidative stress but does not improve the microcirculatory blood supply during prolonged MV after resuscitation. Early MHT intervention is more efficient in preventing diaphragm dysfunction than delayed intervention after CA. (Source: Shock)
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Resolvin D1 Improves Post-Resuscitation Cardiac and Cerebral Outcomes in A Porcine Model of Cardiac Arrest
In conclusion, resolvin D1 significantly improved post-resuscitation cardiac and cerebral outcomes in a porcine model of CA, in which the protective effects may be in a dose-dependent manner. (Source: Shock)
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Inhibition of PAR-2 Attenuates Neuroinflammation and Improves Short-Term Neurocognitive Functions Via ERK1/2 Signaling Following Asphyxia-Induced Cardiac Arrest in Rats
Conclusions: PAR-2 inhibition diminished neuroinflammation and thereby reduced hippocampal neuronal degeneration and neurocognitive impairment following ACA. This effect was at least partly mediated via the PAR-2/ERK1/2 signaling. (Source: Shock)
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

CA1 Hippocampal Pyramidal Cells in Rats, Resuscitated From 8 Minutes of Ventricular Fibrillation Cardiac Arrest, Recover After 20 Weeks of Survival: A Retrospective Pilot Study
Purpose: The cornu ammonis 1 (CA1) region of the hippocampus is specifically vulnerable to global ischemia. We hypothesized that histopathological outcome in a ventricular fibrillation cardiac arrest (VFCA) rat model depends on the time point of the examination. Methods: Male Sprague-Dawley rats were put into VFCA for 8 min, received chest compressions for 2 min, and were defibrillated to achieve return of spontaneous circulation. Animals surviving for 80 min, 14 days and 140 days were compared with controls. Viable neurons were counted in a 500 μm sector of the CA1 region and layer thickness measured. Micr...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

The Critical Role of Cannabinoid Receptor 2 in URB602-Induced Protective Effects Against Renal Ischemia-Reperfusion Injury in the Rat
Renal ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury (AKI) and even induces remote organ damage. Accumulating proofs demonstrates that the endocannabinoid system may provide a promising access for treatment strategy of renal IRI associated AKI. In the current study, using the established renal IRI model of rat, we tested the hypothesis that pretreatment of URB602, 30 min before renal IRI, alleviates kidney injury and relevant distant organ damage via limiting oxidative stress and inflammation. Using Western blot analysis and LC–MS/MS, renal IRI showed to increase the levels of 2-arachidon...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Regulatory Roles of Human Surfactant Protein B Variants on Genetic Susceptibility to Pseudomonas Aeruginosa Pneumonia-Induced Sepsis
This study has investigated the regulatory roles of hSP-B genetic variants on lung injury in pneumonia-induced sepsis. Methods: Wild-type (WT) FVB/NJ and humanized transgenic SP-B-T and SP-B-C mice (expressing either hSP-B C or T allele without mouse SP-B gene) were infected intratracheally with 50 μL (4 × 104 colony-forming units [CFUs]/mouse) Pseudomonas aeruginosa Xen5 or saline, and then killed 24 or 48 h after infection. Bacterial dynamic growths were monitored from 0 to 48 h postinfection by in vivo imaging. Histopathological, cellular, and molecular changes of lung tissues and bronchoalveolar lav...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Inhibition of Dimethylarginine Dimethylaminohydrolase 1 Improves the Outcome of Sepsis in Pregnant Mice
Sepsis is one of the most important causes of maternal mortality. In our previous work, we established a polymicrobial sepsis (cecal ligation and puncture [CLP]) model in murine pregnancy and found that pregnant mice had a greater susceptibility to septic shock. In this model, mortality seemed to be associated with the development of early hemodynamic dysfunction and although circulating cytokine levels were similar, “off target” lung inflammatory cell numbers were greater in pregnant mice. Here, we have used the same CLP model to test the hypothesis that inhibiting the metabolism of the endogenous inhibitor o...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Therapeutic Effects of Hyaluronic Acid in Peritonitis-Induced Sepsis in Mice
This study evaluated the therapeutic effects of intraperitoneal HMW HA administration in mice with peritonitis-induced sepsis. Sepsis was induced in C57BL/6 mice by cecal ligation and puncture (CLP), followed 4 h later by an intraperitoneal injection of HMW HA (20 mg/kg) solution or phosphate buffered saline (PBS). Survival, physiological data, organ injury, bacterial burden, and inflammatory cytokine levels were assessed in the CLP mice. To assess the effect of HA on macrophage phagocytosis activity, RAW264.7 cells, primed with lipopolysaccharide, were exposed with either PBS or HMW HA (500 μg/mL) prior to exposu...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Modulation of the HGF/c-Met Axis Impacts Prolonged Hematopoietic Progenitor Mobilization Following Trauma and Chronic Stress
Background: Trauma and hemorrhagic shock trigger mobilization of hematopoietic progenitor cells (HPC) from bone marrow to peripheral blood. Hepatocyte growth factor (HGF), tyrosine-protein kinase Met (c-Met), matrix metallopeptidase 9 (MMP-9), and corticosterone regulate this mobilization process. We hypothesized that beta-blockade with propranolol and sympathetic outflow inhibition with clonidine following trauma and chronic stress would decrease hematopoietic progenitor cell mobilization. Methods: Sprague-Dawley rats were randomized to undergo three models of injury and stress: lung contusion, LC plus hemorrhagic sh...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Suberoylanilide Hydroxamic Acid Alleviates Acute Lung Injury Induced by Severe Hemorrhagic Shock and Resuscitation in Rats
Conclusions: Total blood volume loss of 40% results in acute lung injury, whereas loss of 20% does not. Treatment with SAHA alleviates lung injury induced by severe hemorrhagic shock and resuscitation and the underlying mechanism involves a reversal of decreased histone acetylation and inhibition of the NF-κB pathway. (Source: Shock)
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Resuscitation From Hemorrhagic Shock With Fresh and Stored Blood and Polymerized Hemoglobin
The objective of this study was to test the safety and efficacy of tense state PolybHb after long-term storage. Methods and Results: PolybHb was subjected to diafiltration to remove low molecular weight ( (Source: Shock)
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Peptidylarginine Deiminase 2 Knockout Improves Survival in hemorrhagic shock
In this study, we utilize selective Pad2−/− knockout mice to elucidate loss of function of PAD2 leads to pro-survival effect in HS. Methods: HS: Pad2−/− and wild-type (WT) mice (n = 5/group) were subjected to lethal HS (55% volume hemorrhage). Survival was monitored over 7 days. Myocardial infarction (MI): Pad2−/− and WT mice (n = 9/group) were subjected to MI by permanent LAD ligation to examine the effect of ischemia on the heart. After 24 h cardiac function and infarct size were measured. Results: HS: Pad2−/− mice demonstrated 100% survival compared with 0%...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Analysis of Severe Fever With Thrombocytopenia Syndrome in Critical Ill Patients in Central China
Introduction: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging zoonosis infected by virus (SFTSV) in central and eastern China, which is associated with high mortality. However, limited clinical data have been reported about this critical illness. Patients and Methods: Retrospective cohort study in intensive care unit (ICU) patients with SFTSV infection admitted in 2014 to 2019. Diagnosis was confirmed using reverse transcription polymerase chain reaction on serum samples. Results: One hundred sixteen patients with SFTSV infection were included (mean age 63 ± 9 years, 59 [51.3%] males). ...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Potential Immunotherapeutic Targets for Hypoxia Due to COVI-Flu
The world is currently embroiled in a pandemic of coronavirus disease 2019 (COVID-19), a respiratory illness caused by the novel betacoronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The severity of COVID-19 disease ranges from asymptomatic to fatal acute respiratory distress syndrome. In few patients, the disease undergoes phenotypic differentiation between 7 and 14 days of acute illness, either resulting in full recovery or symptom escalation. However, the mechanism of such variation is not clear, but the facts suggest that patient's immune status, comorbidities, and the systemic effects of the vi...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Review Articles Source Type: research

SARS-CoV-2/COVID-19: Evolving Reality, Global Response, Knowledge Gaps, and Opportunities
Approximately 3 billion people around the world have gone into some form of social separation to mitigate the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The uncontrolled influx of patients in need of emergency care has rapidly brought several national health systems to near-collapse with deadly consequences to those afflicted by Coronavirus Disease 2019 (COVID-19) and other critical diseases associated with COVID-19. Solid scientific evidence regarding SARS-CoV-2/COVID-19 remains scarce; there is an urgent need to expand our understanding of the SARS-CoV-2 pathophysiology to facilitate p...
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Review Articles Source Type: research

What's New in Shock, October 2020?
No abstract available (Source: Shock)
Source: Shock - September 16, 2020 Category: Emergency Medicine Tags: Commentary Source Type: research

Airway Epithelial Hepcidin Coordinates Lung Macrophages and Immunity Against Bacterial Pneumonia
Conclusions: These findings identify an uncharacterized important role of airway epithelial hepcidin in protection against bacterial pneumonia and provide the basis for novel alternative therapeutic strategies for combatting bacterial pneumonia in future translational research. (Source: Shock)
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

EP2 Receptor Blockade Attenuates COX-2 Upregulation During Intestinal Inflammation
In this study, we evaluate the effect of blockade of the low affinity pro-inflammatory receptors EP1 and EP2 on expression of COX-2, the rate-limiting enzyme in PGE2 biosynthesis, and on gut barrier permeability using cultured enterocytes and three different models of intestinal injury. PGE2 upregulated COX-2 in IEC-6 enterocytes, and this response was blocked by the EP2 antagonist PF-04418948, but not by the EP1 antagonist ONO-8711 or EP4 antagonist E7046. In the neonatal rat model of NEC, EP2 antagonist and low dose of COX-2 inhibitor Celecoxib, but not EP1 antagonist, reduced NEC pathology as well as COX-2 mRNA and prot...
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Neutrophil Elastase Inhibition Ameliorates Endotoxin-induced Myocardial Injury Accompanying Degradation of Cardiac Capillary Glycocalyx
In conclusion, NE is significantly associated with myocardial injury in endotoxemia. Inhibition of NE may be a useful tool for the management of endotoxemia. (Source: Shock)
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Hydrogen Gas Inhalation Attenuates Endothelial Glycocalyx Damage and Stabilizes Hemodynamics in a Rat Hemorrhagic Shock Model
Conclusions: H2 inhalation after shock stabilized hemodynamics and improved survival rates in an HS/R model independent of XOR. The therapeutic action of H2 was partially mediated by inhibition of TNF-α-dependent syndecan-1 shedding. (Source: Shock)
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

The Effect of Burn Resuscitation Volumes on the Gut Microbiome in a Swine Model
Conclusions: We present the first report on the gut microbiome in a porcine burn model, and present data to suggest that IV fluids may influence GM and gut functional proteins following a burn. Overall, burn-induced GM diversity shifts may expose diagnostic and/or therapeutic targets to improve outcomes. (Source: Shock)
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Should Albumin be Considered for Prehospital Resuscitation in Austere Environments? A Prospective Randomized Survival Study in Rabbits
Background: The new guidelines for prehospital care of combat casualties in shock recommend administration of whole blood or blood components to increase blood pressure to a permissible hypotensive level (i.e., hypotensive resuscitation [HR]). We investigated if 2 h of HR using limited volumes of whole blood, plasma, or albumin would lead to full recovery and long-term survival of rabbits subjected to severe hemorrhagic shock (HS). Methods: Following instrumentation, laparotomy was performed on IV-anesthetized spontaneously breathing New Zealand white rabbits (3.0 kg –3.5 kg). Next, ∼40% of rabbits’ ...
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Plasma miR-370-3P as a Biomarker of Sepsis-Associated Encephalopathy, the Transcriptomic Profiling Analysis of Microrna-Arrays From Mouse Brains
In conclusion, miR-370-3p increased in brain and plasma of SAE mice but not uremic encephalopathy. Perhaps, TNF-α enhances cell susceptibility toward brain apoptosis in SAE, in part, through miR-370-3p induction in neuron. Our pilot results in patients with SAE supported the possibility that plasma miR-370-3p is an interesting SAE biomarker candidate. Further studies are warranted. (Source: Shock)
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Genistein Protects Against Burn-Induced Myocardial Injury via Notch1-Mediated Suppression of Oxidative/Nitrative Stress
This study investigated the protective effect of Gen on burn-induced myocardial injury and aimed to elucidate the mechanism of protection. Mice were injected with Gen, intraperitoneally, at different dose immediately after burn injury. The expression levels of Notch-1 intracellular domain (NICD1) and hairy and enhancer of split (Hes-1) were determined by immunoblotting. Conditional Notch-RBP-J knockout mice were used to investigate the mechanisms of Gen-induced cardioprotection. Gen alleviated burn-induced myocardial injury, as shown by improved left ventricle ejection fraction, decreased serum lactate dehydrogenase and cr...
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Overexpression of BCL-2 in the Intestinal Epithelium Prevents Sepsis-Induced Gut Barrier Dysfunction via Altering Tight Junction Protein Expression
Sepsis induces both intestinal hyperpermeability and epithelial apoptosis. While each has been implicated in mediating sepsis mortality, the relationship between these two processes is unclear. We hypothesized that preventing intestinal apoptosis would prevent gut barrier dysfunction. To test this hypothesis, transgenic mice that overexpress the anti-apoptotic protein Bcl-2 in the gut epithelium (Fabpl-Bcl-2 mice) and wild-type (WT) mice were subjected to sham laparotomy or cecal ligation and puncture and orally gavaged with fluorescein isothiocyanate conjugated-dextran (FD-4) 5 h before sacrifice. Serum FD-4 concentration...
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

HDAC Inhibitor Attenuated NETs Formation Induced by Activated Platelets In Vitro, Partially Through Downregulating Platelet Secretion
Conclusion: The HDACi attenuates NETs formation induced by activated platelets partially by modulating the secretion of platelets. (Source: Shock)
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Hemodynamic Impact of Cardiovascular Antihypertensive Medications in Patients With Sepsis-Related Acute Circulatory Failure
Conclusion: In patients admitted with septic shock, prior cardiovascular antihypertensive medication seems to have limited impact on initial hemodynamic failure and catecholamine requirement. (Source: Shock)
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Proenkephalin Compared to Conventional Methods to Assess Kidney Function in Critically Ill Sepsis Patients
Background: The assessment of renal function in clinical practice remains challenging. Using creatinine to assess the glomerular filtration rate (GFR) is notoriously inaccurate, and determination of the true GFR, e.g., using inulin or iohexol, is laborious and not feasible in daily practice. Proenkephalin (PENK) is a novel candidate biomarker for kidney function that is filtrated in the glomerulus, has shown to represent steady-state GFR in patients with different severities of renal insufficiency. In this pilot study in non-steady-state critically ill patients, we compared plasma PENK concentrations with creatinine-base...
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

The Value of Serum Uncoupling Protein-2 Level for the Patients With Sepsis
Background: To investigate the potential utility of serum uncoupling protein-2 (UCP2) level as a biomarker in septic patients. Methods: Critically ill patients with diagnoses of sepsis—sepsis non-shock group (n = 20) and septic shock group (n = 53), and a control group (n = 15) were enrolled within 24 h of entry into the ICU. Serum levels of UCP2 were measured by enzyme-linked immunosorbent assay (ELISA) at ICU admission for all the groups and at ICU discharge for septic shock group. Clinical parameters and laboratorial tests (APACHE II, SOFA, lactate, etc.) were also collected. Results: Serum U...
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Sequential Changes of NLRP3 Inflammasome Activation in Sepsis and its Relationship With Death
Conclusions: NLRP3 is activated in critically ill patients but this up-regulation is more intense in patients with sepsis. In sepsis, a sustained NLRP3 activation during the first week is protective and sepsis. An increased caspase-1 protein expression with reduced expression caspase-3 is the pattern observed in septic shock patients who survive. (Source: Shock)
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Mitochondrial Dysfunction is Associated With an Immune Paralysis Phenotype in Pediatric Sepsis
Conclusions: Children with sepsis had lower PBMC mitochondrial respiration when immunoparalysis was present compared with those without immunoparalysis. The subsets with immune paralysis and low mitochondrial respiration exhibited the highest levels of systemic inflammation. (Source: Shock)
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Inverse Correlation Between Incidence and Mortality of Acute Kidney Injury in Critically Ill Patients: A Systematic Review
Background: The reported incidence and mortality of acute kidney injury (AKI) in patients in intensive care units (ICUs) is remarkably different even with standardized AKI criteria. The aim of this study was to investigate the correlation between the incidence and mortality of patients with AKI in ICUs. Methods: We systematically reviewed clinical studies regarding adult ICU patients with AKI using Kidney Disease: Improving Global Outcomes-equivalent criteria from 2004 to May 1, 2018. We searched MEDLINE, EMBASE, and Cochrane Library to investigate the correlation between the incidence and mortality of patients with A...
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Review Article Source Type: research

What's New in Shock, September 2020?
No abstract available (Source: Shock)
Source: Shock - August 14, 2020 Category: Emergency Medicine Tags: Commentary Source Type: research

Reply to “Central Venous-Arterial CO2 Difference in Cardiac Surgery Patients—A Parameter in Relationship to Cardiac Output and Altered Microcirculatory Blood Flow”
No abstract available (Source: Shock)
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Letters to the Editor Source Type: research

Central Venous-Arterial CO2 Difference in Cardiac Surgery Patients—A Parameter in Relationship to Cardiac Output and Altered Microcirculatory Blood Flow
No abstract available (Source: Shock)
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Letters to the Editor Source Type: research

Monocytopenia and Its Impact on Outcomes in Patients with Severe Sepsis Including Septic Shock: A Case-control Study
No abstract available (Source: Shock)
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Letters to the Editor Source Type: research

Buprenorphine Analgesia: New Adverse Effects Emerge
No abstract available (Source: Shock)
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Letters to the Editor Source Type: research

Neonatal Sepsis Alters the Excitability of Regular Spiking Cells in the Nucleus of the Solitary Tract in Rats
Objective: Sepsis is a leading cause of mortality and morbidity in infants. Although the measures of autonomic dysfunction (e.g., reduced heart rate variability) predict mortality in sepsis, the mechanism of sepsis-induced autonomic dysfunction has remained elusive. The nucleus of the solitary tract (NTS) is a vital structure for the integrated autonomic response to physiological challenges. In the present study we hypothesized that sepsis alters the excitability of NTS neurons in a rat model of neonatal sepsis (14-day-old rats). Methods and Results: Sepsis was induced by intraperitoneal injection of cecal slurry (CS)...
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Early Axonal Injury and Delayed Cytotoxic Cerebral Edema are Associated with Microglial Activation in a Mouse Model of Sepsis
Sepsis-induced brain injury is associated with an acute deterioration of mental status resulting in cognitive impairment and acquisition of new functional limitations in sepsis survivors. However, the exact nature of brain injury in this setting is often subtle and remains to be fully characterized both in preclinical studies and at the bedside. Given the translation potential for the use of magnetic resonance imaging (MRI) to define sepsis-induced brain injury, we sought to determine and correlate the cellular changes with neuroradiographic presentations in a classic murine model of sepsis induced by cecal ligation and pu...
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Critical Role of Mortalin/GRP75 in Endothelial Cell Dysfunction Associated with Acute Lung Injury
In this study, we sought to determine the role of mortalin/GRP75 in mediating vascular inflammation and permeability linked to the pathogenesis of acute lung injury (ALI). In an aerosolized bacterial lipopolysaccharide inhalation mouse model of ALI, we found that administration of mortalin/GRP75 inhibitor mean kinetic temperature-077, both prophylactically and therapeutically, protected against polymorphonuclear leukocytes influx into alveolar airspaces, microvascular leakage, and expression of pro-inflammatory mediators such as interleukin-1β, E-selectin, and tumor necrosis factor TNFα. Consistent with this, th...
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Adenosine 5’-Monophosphate Protects from Hypoxia by Lowering Mitochondrial Metabolism and Oxygen Demand
Ischemia and reperfusion injury following severe trauma or cardiac arrest are major causes of organ damage in intensive care patients. The brain is particularly vulnerable because hypoxia rapidly damages neurons due to their heavy reliance on oxidative phosphorylation. Therapeutic hypothermia can reduce ischemia-induced brain damage, but cooling procedures are slow and technically difficult to perform in critical care settings. It has been previously reported that injection of naturally occurring adenosine 5’-monophosphate (AMP) can rapidly induce hypothermia in mice. We studied the underlying mechanisms and found th...
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Specific Pathogen-Free Animals for Civilian and Military Trauma: a Cautionary Note in the Translation of New Drug Therapies
Specific-pathogen free (SPF) animals were introduced into biomedical research in the early 1960s to reduce the incidence of disease into experimental design. The goal was to provide animals with selected microbiota compatible with sustained health. Sixty years later, SPF status has become a variable itself in biomedical research. Alterations in the gut microbiome–host relationship can profoundly influence basic physiology, immune/inflammatory function, susceptibility to infection and disease, and behavior. In addition, it can influence the translational success of a drug or technology from animal models to humans. We...
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Perspective Source Type: research

Endotoxin Removal in Septic Shock with the Alteco LPS Adsorber Was Safe But Showed no Benefit Compared to Placebo in the Double-Blind Randomized Controlled Trial—the Asset Study
Conclusions: In a small cohort of patients with presumed gram-negative septic shock, levels of circulating endotoxin were low and no adverse effects within 28 days after LPS adsorber-treatment were observed. No benefit compared with a sham device was seen when using a LPS adsorber in addition to standard care. Trial registration: Clinicaltrials.gov NCT02335723. Registered: November 28, 2014. (Source: Shock)
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Feasibility and Clinical Outcome of Reboa in Patients with Impending Traumatic Cardiac Arrest
Conclusions: Our study has shown that REBOA may be performed in patients with ITCA, SBP can be elevated, and 36.6% of the patients survived if REBOA placement is successful. (Source: Shock)
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Comparing Mortality Prediction by Quick Sequential Organ Failure Assessment with Emergency Physician Judgment
This study tests whether qSOFA improves physician prediction of mortality among infected Emergency Department (ED) patients. Methods: We performed a secondary analysis of a prospective, observational study of potentially septic ED patients, conducted between two urban, academic medical centers, from July 2016 to December 2017. We enrolled ED patients with two or more systemic inflammatory response syndrome criteria and severe sepsis qualifying organ dysfunction, systolic blood pressure (Source: Shock)
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Use of Intravenous Immunoglobulins in Patients with Suspected Toxin-Mediated Shock Requiring Extracorporeal Membrane Oxygenation
Conclusion: IVIG administration can be considered in a selected group of patients presenting with acute and very severe septic shock. (Source: Shock)
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

The Association Between ABO Blood Type and Mortality Among Severely Injured Trauma Patients
Conclusion: Contrary to prior research, the current results suggest no association between blood type and mortality among severely injured trauma patients. (Source: Shock)
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Complement Activation in Human Sepsis is Related to Sepsis-Induced Disseminated Intravascular Coagulation
Introduction: In human sepsis, little is known about the relationships between complement activation and the clinical characteristics of sepsis, including disseminated intravascular coagulation (DIC), interventions, and prognosis. Patients and Methods: Adult patients with sepsis admitted from November 2016 to December 2018 were included. We used the plasma levels of soluble C5b-9 (SC5b-9) as a marker of complement activation. We compared the clinical characteristics and complement components between patients with and without DIC. We also compared the clinical characteristics and each DIC parameter across quartile grou...
Source: Shock - July 30, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research