Commentary: Letter to the Editor “Austere Environments Consortium for Enhanced Sepsis Outcomes (ACESO)”
No abstract available (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Commentary Source Type: research

Austere environments Consortium for Enhanced Sepsis Outcomes (ACESO)
No abstract available (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Letters to the Editor Source Type: research

Histone Deacetylase 7 in Murine Gram-Negative Acute Lung Injury
No abstract available (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Letters to the Editor Source Type: research

Letter to the Editor: “Histone Deacetylase 7 Inhibition in a Murine Model of Gram-Negative Pneumonia-Induced Acute Lung Injury”: Shock: 53:344–351, 2020
No abstract available (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Letters to the Editor Source Type: research

Improving Reproducibility and Transparency in Shock: the: Arrive: Guidelines Need Better Implementation and Enforcement
Reporting standards for animal research in Shock have not improved since Shock Society endorsed the ARRIVE guidelines in 2012. Particularly troubling is the omission of key information describing methodological quality and animal welfare. Both investigators and journal reviewers are strongly encouraged to actively consult the checklist to improve manuscript quality, and ensure that Shock upholds the highest standards of research quality and the humane treatment of animals. (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Invited Opinion Source Type: research

Postconditioning with Calreticulin Attenuates Myocardial Ischemia/Reperfusion Injury and Improves Autophagic Flux
Conclusion: These findings suggested that CRT postconditioning reduced myocardial I/R injury. CRT postconditioning also inhibited the excessive formation of autophagosomes, promoted the clearance of autophagosomes, and resorted the autophagic flux, consequently reduced the H/R injury in H9c2 cells. (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Transfusion of Anaerobically or Conventionally Stored Blood After Hemorrhagic Shock
Conclusions: Resuscitation from HS via transfusion of anaerobically stored RBCs recovered cardiac function, restored hemodynamic stability, and improved outcomes. (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Histone Deacetylase 7 Inhibition in a Murine Model of Gram-Negative Pneumonia-Induced Acute Lung Injury
Conclusion: HDAC7 appears to play a key role in the inflammatory response that leads to ALI after gram-negative pneumonia in mice. (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Integrin β3 Modulates TLR4-Mediated Inflammation by Regulation of CD14 Expression in Macrophages in Septic Condition
In conclusion, integrin β3 positively regulated TLR4-mediated inflammatory responses via CD14 expression in macrophages in septic condition. Specifically targeting integrin β3/TLR4-CD14 signaling pathway may be a potential treatment strategy for polymicrobial sepsis. (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Tracking DO2 with Compensatory Reserve During Whole Blood Resuscitation in Baboons
Hemorrhagic shock can be mitigated by timely and accurate resuscitation designed to restore adequate delivery of oxygen (DO2) by increasing cardiac output (CO). However, standard care of using systolic blood pressure (SBP) as a guide for resuscitation may be ineffective and can potentially be associated with increased morbidity. We have developed a novel vital sign called the compensatory reserve measurement (CRM) generated from analysis of arterial pulse waveform feature changes that has been validated in experimental and clinical models of hemorrhage. We tested the hypothesis that thresholds of DO2 could be accurately de...
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Club Cell Protein, CC10, Attenuates Acute Respiratory Distress Syndrome Induced by Smoke Inhalation
Conclusions: In this study, high-dose rhCC10 significantly attenuated ARDS progression and lung dysfunction and significantly reduced systemic extravasation of fluid and proteins, normalizing fluid balance. Based on these results, rhCC10 may be considered a novel therapeutic option for the treatment of SII-induced ARDS. (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Monophosphoryl Lipid a Attenuates Multiorgan Dysfunction During Post-Burn Pseudomonas Aeruginosa Pneumonia in Sheep
Conclusions: MPLA was well tolerated in burned sheep and attenuated development of acute lung injury, lactatemia, cytokinemia, vascular leak, and hemodynamic changes caused by Pseudomonas aeruginosa pneumonia. (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Admission Leukocyte Count is Associated with Late Cardiogenic Shock Development and All-Cause 30-Day Mortality in Patients with St-Elevation Myocardial Infarction
Background: Thirty-day mortality in ST-elevation myocardial infarction (STEMI) patients is primarily driven by cardiogenic shock (CS). High neutrophil counts and high neutrophil/lymphocyte ratios (NLR) have previously been associated with mortality in STEMI patients; however, there is only sparse knowledge regarding their association with CS. Purpose: We sought to assess the associations between neutrophil count and NLR with the development of CS as well as 30-day mortality in STEMI patients. Methods: Patients admitted with STEMI at two tertiary Heart Centres throughout 1 year were included in the study and stratif...
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Risk Factors of Multidrug Resistant Pathogens Induced Infection in Severe Acute Pancreatitis
Conclusions: MDR pathogen-induced infections were common in SAP patients and Acinetobacter baumannii was the main pathogen. Meanwhile, open necrosectomy was the independent risk factor for the infection of MDR pathogen. (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

S1PR1-Associated Molecular Signature Predicts Survival in Patients with Sepsis
Conclusions: Our results have confirmed the significant involvement of S1PR1-dependent genes in the development of sepsis and provided new gene signatures for predicting survival of sepsis patients. (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

The Use of Tranexamic Acid (TXA) for the Management of Hemorrhage in Trauma Patients in the Prehospital Environment: Literature Review and Descriptive Analysis of Principal Themes
Tranexamic acid (TXA) is an antifibrinolytic agent used to prevent traumatic exsanguination. It was first introduced to clinical practice for the management of patients with bleeding disorders, especially adapted to reduce bleeding in hemophiliacs undergoing oral surgical interventions. TXA exerts its action on the coagulation process by competitively inhibiting plasminogen activation, thereby reducing conversion of plasminogen into plasmin. This ultimately prevents fibrinolysis and reduces hemorrhage. Thus, TXA may be well suited for the management of traumatic hemorrhage in the prehospital setting. Despite multiplicity ...
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Review Articles Source Type: research

Remote Ischemic Conditioning in Emergency Medicine—Clinical Frontiers and Research Opportunities
Time-critical acute ischemic conditions such as ST-elevation myocardial infarction and acute ischemic stroke are staples in Emergency Medicine practice. While timely reperfusion therapy is a priority, the resultant acute ischemia/reperfusion injury contributes to significant mortality and morbidity. Among therapeutics targeting ischemia/reperfusion injury (IRI), remote ischemic conditioning (RIC) has emerged as the most promising. RIC, which consists of repetitive inflation and deflation of a pneumatic cuff on a limb, was first demonstrated to have protective effect on IRI through various neural and humoral mechanisms. It...
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Review Articles Source Type: research

Quality Control Measures and Validation in Gene Association Studies: Lessons for Acute Illness
Acute illness is a complex constellation of responses involving dysregulated inflammatory and immune responses, which are ultimately associated with multiple organ dysfunction. Gene association studies have associated single-nucleotide polymorphisms (SNPs) with clinical and pharmacological outcomes in a variety of disease states, including acute illness. With approximately 4 to 5 million SNPs in the human genome and recent studies suggesting that a large portion of SNP studies are not reproducible, we suggest that the ultimate clinical utility of SNPs in acute illness depends on validation and quality control measures. To ...
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Review Articles Source Type: research

What's New in Shock, March 2020?
No abstract available (Source: Shock)
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Commentary Source Type: research

Cholecystokinin Modulates the Mucosal Inflammatory Response and Prevents the Lipopolysaccharide-Induced Intestinal Epithelial Barrier Dysfunction
The intestinal mucosa plays a critical role in the organism, acting as an interface between the lamina propria and the harmful antigens in the lumen. Sepsis is associated with primary injury to the intestinal mucosa, which in turn induces bacterial translocation and hyperpermeability. Cholecystokinin (CCK) is a peptide synthesized by several cell types, whose immunomodulatory activity has been reported in experimental models of inflammation. We hypothesized that the CCK treatment could modulate the inflammatory response and protect the integrity of the intestinal barrier in endotoxemic rats. Ten minutes before the endotoxe...
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Neuromuscular Electrical Stimulation Improves Energy Substrate Metabolism and Survival in Mice With Acute Endotoxic Shock
This study investigated the therapeutic benefits of neuromuscular electrical stimulation (NMES). C57BL/6 mice were administered lipopolysaccharide (LPS; 20 mg/kg body weight) by intraperitoneal injection and divided into control (C) and NMES groups (n = 10–12 each). The latter received NMES to the bilateral gastrocnemius muscle for 1 h at low or high frequency (LF = 2 Hz and HF = 50 Hz, respectively) and low or high voltage (LV = 10 V and HV = 50 V, respectively). In LF–LV and LF–HV groups, NMES was performed twice and the results were compared with those for mice that rec...
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

IL-15 Improves Aging-Induced Persistent T Cell Exhaustion in Mouse Models of Repeated Sepsis
Aging is a grave problem in sepsis, and T cell exhaustion is the main cause of sepsis-induced immunosuppression. Sepsis- and aging-induced T cell exhaustion is related to secondary infection with a poor long-term outcome in the elderly. However, the trend, impact, and mechanism of T cell exhaustion are still unclear. Interleukin (IL)-15 improves survival rate of septic mice via its antiapoptotic effect on T cells; however, it is still unclear how IL-15 reverses prolonged T cell exhaustion in aged septic mice. The purpose of this study was to clarify the trend of sepsis-induced T cell exhaustion and whether IL-15 prevents a...
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

TUDCA Ameliorates Liver Injury Via Activation of SIRT1–FXR Signaling in a Rat Hemorrhagic Shock Model
Conclusion: TUDCA in the liver decreased during HS. TUDCA supplementation might attenuate HS-induced liver injury by upregulating SIRT1–FXR signaling. (Source: Shock)
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Activation of Hypoxia-Inducible Factor-1α Via Succinate Dehydrogenase Pathway During Acute Lung Injury Induced by Trauma/Hemorrhagic Shock
In this study, we found pulmonary activation of HIF-1α and inhibition of SDH during THS-induced ALI in rats and transcriptional activation of HIF-1α during ALI induced by T/HS lymph via SDH pathway in vitro. Furthermore, pharmacologic inhibition of HIF-1α attenuates lung inflammation and pulmonary edema during ALI by T/HS. Activation of HIF-1α is detrimental to ALI induced by T/HS. Thus, our data suggest that HIF-1α activation by T/HS is necessary for T/HS-induced lung injury and a critical role for SDH in the initiation of acute inflammatory response after ALI. Nevertheless, this is a preclin...
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

LPS-Induced Hypotension in Pregnancy: The Effect of Progesterone Supplementation
This study demonstrates that P4 supplementation prevented LPS-induced hypotension in pregnant mice in association with reduced myocardial inflammatory cytokine gene expression. These observations suggest that rather than being detrimental, P4 supplementation has a protective effect on the maternal cardiovascular response to sepsis. (Source: Shock)
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Administration of Candida Albicans to Dextran Sulfate Solution Treated Mice Causes Intestinal Dysbiosis, Emergence and Dissemination of Intestinal Pseudomonas Aeruginosa and Lethal Sepsis
In conclusion, gut Candida induced bacteremia in the DSS model through an inflammation-induced gut perm-selectivity defect and facilitated the growth of some gut bacteria. Treatment strategies aimed at reducing gut fungi could attenuate disease severity. Further investigation of gut fungi in inflammatory bowel disease is warranted. (Source: Shock)
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Fatty Acid-Saturated Albumin Reduces High Mortality and Fluid Requirements in a Rat Model of Hemorrhagic Shock Plus Tourniquet and Hypotensive Resuscitation
Military prehospital care for hemorrhage is often characterized by use of tourniquets (TQ) and permissive hypotensive resuscitation (PHR) with crystalloids or colloids, but these treatments have not been previously combined in an animal model. Although albumin resuscitation solutions have been tested, the potential effects of nonesterified fatty acids (NEFAs) bound to albumin have not been evaluated in vivo, and few studies have investigated concentrated albumin solutions to reduce fluid requirements. We created a militarily relevant rat model of trauma and hemorrhagic shock (T/HS) (27 mL/kg hemorrhage) with TQ and PHR. ...
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

High-Sensitivity Troponin T Predicts Postoperative Cardiogenic Shock Requiring Mechanical Circulatory Support in Patients With Valve Disease
Conclusions: The postoperative hs-TnT can be used to predict a postoperative cardiogenic shock requiring mechanical circulatory support. (Source: Shock)
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Effect of Vasopressors on the Macro- and Microcirculation During Systemic Inflammation in Humans In Vivo
Conclusions: In a highly controlled model of systemic inflammation in humans in vivo, a 5-h infusion of various vasopressors revealed distinctive effects on macrohemodynamic variables without affecting the sublingual microcirculation. (Source: Shock)
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

The Prognostic Value of Prehospital Blood Lactate Levels to Predict Early Mortality in Acute Cardiovascular Disease
Introduction: The knowledge of the prognostic value of prehospital lactate (PLA) is limited. Our objective was to evaluate the predictive capacity of PLA to predict early mortality (within 48 h) from the index event in acute cardiovascular disease (ACVD). Methods: Prospective, longitudinal, multicenter, observational study in patients, attended by advanced life support units, transferred to the emergency department of their reference hospital and diagnosed with ACVD. We collected demographic, physiological, clinical, analytical variables, main cardiological diagnosis, and data on hospital admission and early mortali...
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Antithrombin III Contributes to the Protective Effects of Fresh Frozen Plasma Following Hemorrhagic Shock by Preventing Syndecan-1 Shedding and Endothelial Barrier Disruption
Background: Endothelial dysfunction during hemorrhagic shock (HS) is associated with loss of cell-associated syndecan-1 (Sdc1) and hyperpermeability. Fresh frozen plasma (FFP) preserves Sdc1 and reduces permeability following HS, although the key mediators remain unknown. Antithrombin III (ATIII) is a plasma protein with potent anti-inflammatory and endothelial protective activity. We hypothesized that the protective effects of FFP on endothelial Sdc1 and permeability are mediated, in part, through ATIII. Methods: ATIII and Sdc1 were measured in severely injured patients upon admission (N = 125) and hospital day 3...
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: 2019 New Investigator Award Competition Source Type: research

An Aging-Related Single-Nucleotide Polymorphism is Associated With Altered Clinical Outcomes and Distinct Inflammatory Profiles in Aged Blunt Trauma Patients
The contribution of individual genetic determinants of aging to the adverse clinical outcomes and altered inflammation mediator networks characteristic of aged trauma patients is unknown. The AA genotype of the aging-related single-nucleotide polymorphism (SNP) rs2075650 in TOMM40 has been associated with longevity, while the AG and GG genotypes are associated with an increased risk of Alzheimer disease. Here, we studied the effect of rs2075650 on clinical outcomes and dynamic biomarker patterns after traumatic injury. Genomic DNA was obtained from blunt trauma patients admitted to the ICU and examined for 551,839 SNPs usi...
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: 2019 New Investigator Award Competition Source Type: research

Inhibition of Lipolysis With Acipimox Attenuates Postburn White Adipose Tissue Browning and Hepatic Fat Infiltration
Extensive burn injuries promote an increase in the lipolysis of white adipose tissue (WAT), a complication that enhances postburn hypermetabolism contributing to hyperlipidemia and hepatic steatosis. The systemic increase of free fatty acids (FFAs) due to burn-induced lipolysis and subsequent organ fatty infiltration may culminate in multiple organ dysfunction and, ultimately, death. Thus, reducing WAT lipolysis to diminish the mobilization of FFAs may render an effective means to improve outcomes postburn. Here, we investigated the metabolic effects of Acipimox, a clinically approved drug that suppresses lipolysis via inh...
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: 2019 New Investigator Award Competition Source Type: research

What's New in Shock, February 2020?
No abstract available (Source: Shock)
Source: Shock - January 15, 2020 Category: Emergency Medicine Tags: Commentary Source Type: research

Mechanical Circulatory Support in Refractory Vasodilatory Septic Shock: a Randomized Controlled Porcine Study
In conclusion, the application of VA-ECMO in this model of peritonitis-induced refractory vasodilatory septic shock aggravated hemodynamic deterioration. Our findings contribute to increasing equipoise with respect to the clinical utility of VA-ECMO in refractory vasodilatory shock. (Source: Shock)
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Inhibition of Aerobic Glycolysis Promotes Neutrophil to Influx to the Infectious Site Via CXCR2 in Sepsis
In this study, we found that glycolytic inhibitor 2-deoxyglucose (2-DG) significantly improved the survival rate in cecal ligation and puncture (CLP)-induced septic mice. 2-DG-treated mice developed increased neutrophil migration to the infectious site and more efficient bacterial clearance than untreated mice. 2-DG reversed the down-regulation of chemokine receptor 2 (CXCR2) and the impaired chemotaxis induced by CLP in mice or lipopolysaccharides (LPS) in human neutrophils. Furthermore, 2-DG reversed the down-regulation of CXCR2 in neutrophils by decreasing the expression of G protein-coupled receptor kinase-2 (GRK2), a ...
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

α-Ketoglutarate Modulates Macrophage Polarization Through Regulation of PPARγ Transcription and mTORC1/p70S6K Pathway to Ameliorate ALI/ARDS
As tissue-resident cells in the lung, alveolar macrophages display remarkable heterogeneity and play a crucial role in the development and control of septic acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Recent evidence suggests that α-ketoglutarate (α-KG) plays an important role in alternative activation of macrophage (M2) through metabolic and epigenetic reprogramming, and thus possesses anti-inflammatory properties. However, the underlying mechanisms of α-KG's effect on alveolar macrophage polarization and the potential effects of α-KG in ALI/ARDS remain unclear. Here, we exami...
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Early Peritoneal Dialysis Ameliorates Blast Lung Injury by Alleviating Pulmonary Edema and Inflammation
Conclusion: Early peritoneal dialysis can attenuate pulmonary edema and inflammation, and protect acute lung injury after blast injury. (Source: Shock)
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Effect of Pravastatin Pretreatment and Hypercapnia on Intestinal Microvascular Oxygenation and Blood Flow During Sepsis
Introduction: In septic patients, adequate microvascular oxygenation (μHBO2) of the intestine is vital for their outcome. Recent studies suggest that statins can ameliorate septic microcirculation in a variety of tissues. However, the effect on intestinal microvascular oxygenation and blood flow is largely unknown. Furthermore, there are indications that statin therapy might not be beneficial in the presence of hypercapnia, as observed in septic acute respiratory distress syndrome (ARDS) patients. Therefore, the present study explores the effect of pravastatin with and without additional moderate acute hypercapnia on ...
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

The Impact of Plasma-Derived Microvesicles From a Femoral Fracture Animal Model on Osteoblast Function
The role of microvesicles (MVs) in transcellular signal transduction has been demonstrated in different studies. However, the potential modulatory role of MVs in fracture healing remains unclear. Therefore, we investigated the impact of plasma-derived MVs after a femoral fracture on cranial osteoblasts. A femoral fracture with intramedullary stabilization was induced in Sprague Dawley rats. The animals were killed 3 days (group A), 1 week (group B), or 2 weeks (group C) after trauma induction. Animals without trauma served as controls. Osteoblasts from the cranial bone of a neonatal Sprague Dawley rats were cultured and ...
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Advanced Age Impairs Intestinal Antimicrobial Peptide Response and Worsens Fecal Microbiome Dysbiosis Following Burn Injury in Mice
In this study, we combined our well-established murine model of scald burn injury with bacterial 16S-rRNA gene sequencing to investigate how burn injury affects the fecal microbiome in aged versus young mice. Of our treatment groups, the most substantial shift in gut microbial populations was observed in aged mice that underwent burn injury. We then profiled antimicrobial peptides (AMPs) in the ileum, and found that burn injury stimulated a 20-fold rise in levels of regenerating islet-derived protein 3 gamma (Reg3γ), a 16-fold rise in regenerating islet-derived protein 3 beta (Reg3β), and an 8-fold rise in Cathe...
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Selenium and Selenoprotein P Deficiency Correlates With Complications and Adverse Outcome After Major Trauma
Background: A declining selenium (Se) status constitutes a characteristic of critical illness and may affect disease course and survival. The dynamics of trauma-induced changes in biomarkers of Se status are poorly characterized, and an association with multiple organ failure (MOF) and mortality can be hypothesized. It was the aim of this study to investigate Se and selenoprotein P (SELENOP) concentrations in major trauma patients during the early posttraumatic period. Patients and Methods: Twenty-four patients after major trauma (ISS ≥16) were included at our level one trauma center. Se supplementation ever during...
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Selenoprotein P in Myocardial Infarction With Cardiogenic Shock
Background: Reperfusion strategies in acute myocardial infarction (AMI) may result in ischemia reperfusion injury characterized by increased oxidative stress, inflammation, and ultimately death of myocardial tissue which may be of particular importance in infarct-related cardiogenic shock (CS). Many anti-oxidative and immune regulatory processes depend on selenium which in large proportions is bound to circulating selenoprotein P (SelP). Individual SelP patterns may therefore be associated with inflammatory response and possibly mortality in patients with CS post AMI. Methods: In the randomized Intra-Aortic Balloon Pu...
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Norepinephrine vs Vasopressin: Which Vasopressor Should Be Discontinued First in Septic Shock? A Meta-Analysis
Conclusions: In adults with septic shock treated with concomitant VP and NE therapy, discontinuing VP first may lead to a higher incidence of hypotension but is not associated with mortality or ICU LOS. Further prospective studies with larger sample sizes are warranted. (Source: Shock)
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Serum Lactate and A Relative Change in Lactate as Predictors of Mortality in Patients With Cardiogenic Shock – Results from the Cardshock Study
Conclusion: The main findings of the present study are that baseline lactate is a powerful predictor of 30-day mortality, lactate at 6, 12, and 24 h after admission are predictors of 30-day mortality, and a relative change in lactate is a significant predictor of survival within the first 24 h after instituting intensive care treatment adding information beyond the information from baseline values. (Source: Shock)
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Trauma-Induced Long-Term Alterations of Human T Cells and Monocytes—Results of an Explorative, Cross-Sectional Study
Conclusions: Six months following major trauma, changes of cell surface receptors on CD4+ and CD8+ T cells as well as on CD14+ monocytes were present, hinting toward an immunosuppressive phenotype. Following major trauma, although IL-6 and TNF-α release after stimulation were reduced, they did not reach statistical significance. Overall, further studies are necessary to evaluate the clinical implications of these findings. Trial registration: DRKS00009876, Internet Portal of the German Clinical Trials Register (DRKS), registration date 11.08.2016, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&...
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Acute Inflammation in Traumatic Brain Injury and Polytrauma Patients Using Network Analysis
In this study, we examined the inflammatory differences between patients with TBI versus patients with polytrauma, but no TBI (polytrauma). We hypothesize that patients with TBI have a heightened early inflammatory response compared with polytrauma. Methods: We conducted a single-center retrospective study of a cohort of patients with polytrauma, who were enrolled in the PROPPR study. These patients had blood samples prospectively collected at eight time points in the first 3 days of admission. Using radiological data to determine TBI, our polytrauma cohort was dichotomized into TBI (n = 30) or polytrauma (n = 5...
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Complement Deposition on the Surface of RBC After Trauma Serves a Biomarker of Moderate Trauma Severity: A Prospective Study
Conclusions: Our study demonstrates that the presence of C4d, C3d, and C5b-9 on the surface of RBC is linked to increased phosphorylation of band 3 and increased production of nitric oxide. Deposition of C4d and C5b-9 decreased faster over course of 3-day study in subjects with ISS less than 9. (Source: Shock)
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Population-Specific Metabolic Alterations in Professional Antigen-Presenting Cells Contribute to Sepsis-Associated Immunosuppression
Sepsis is a complex host response triggered by an infection, with the patient's immune system between hyper- and hypo-responsiveness being the main reason for the syndromes’ development and propagation. Studies conducted in peripheral blood mononuclear cells uncovered an association between an impaired immunometabolism and the severity and outcome of the disease. With this prospective observational study, we aimed to evaluate the immunometabolic phenotype of monocytes and B cells and its association with the cell function. Monocytes and B cells were isolated from patients with sepsis (n = 10; onset, days 4 and 8...
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

What's New in Shock, January 2020?
No abstract available (Source: Shock)
Source: Shock - December 18, 2019 Category: Emergency Medicine Tags: Commentary Source Type: research