The Differences of CPR duration between Shockable and Nonshockable Rhythms in Predicting the Benefit of Target Temperature Management
Background:
Among cardiac arrest (CA) survivors, whether the combination of duration of cardiopulmonary resuscitation (CPR) and shockable/nonshockable rhythms during resuscitation can help predict the benefit of targeted temperature management (TTM) remains un-investigated.
Materials and methods:
This multicenter retrospective cohort study enrolled 479 nontraumatic adult CA survivors with TTM and CPR duration (Source: Shock)
Source: Shock - May 1, 2022 Category: Emergency Medicine Tags: Clinical Aspects (Human Subjects) Source Type: research
Temperature Trajectory Sub-phenotypes and the Immuno-Inflammatory Response in Pediatric Sepsis
Conclusions:
Critically ill septic children can be categorized into temperature trajectory-defined sub-phenotypes that parallel adult sepsis. Hypothermic children exhibit a blunted cytokine and chemokine profile. Group-based trajectory modeling has utility for identifying subtypes of clinical syndromes by incorporating readily available longitudinal data, rather than relying on inputs from a single timepoint. (Source: Shock)
Source: Shock - May 1, 2022 Category: Emergency Medicine Tags: Clinical Aspects (Human Subjects) Source Type: research
Association between Vitamin D deficiency and Neurologic Outcomes in Patients after Cardiopulmonary Resuscitation
Aim:
We investigated the association between vitamin D deficiency and neurologic outcomes after cardiopulmonary resuscitation.
Method:
Data from the prospective cardiac arrest registry in the emergency department between October 2019 and April 2021 were retrospectively analyzed. Blood samples were obtained during cardiopulmonary resuscitation wherein 25-hydroxyvitamin D serum levels were analyzed; deficiency was defined as levels (Source: Shock)
Source: Shock - May 1, 2022 Category: Emergency Medicine Tags: Clinical Aspects (Human Subjects) Source Type: research
Influence of Immune Cell Subtypes on Mitochondrial Measurements in Peripheral Blood Mononuclear Cells From Children with Sepsis
Conclusions:
Mitochondrial measurements from PBMCs varied with changes in immune cell composition in children with and without sepsis. However, differences in PBMC mitochondrial measurements between sepsis patients and controls were at least partially attributable to the effects of sepsis rather than solely an epiphenomena of variable immune cell composition. (Source: Shock)
Source: Shock - May 1, 2022 Category: Emergency Medicine Tags: Clinical Aspects (Human Subjects) Source Type: research
A Comprehensive Appraisal of Risk Prediction Models for Cardiogenic Shock
Despite advances in early revascularization, percutaneous hemodynamic support platforms, and systems of care, cardiogenic shock (CS) remains associated with a mortality rate higher than 50%. Several risk stratification models have been derived since the 1990 s to identify patients at high risk of adverse outcomes. Still, limited information is available on the differences between scoring systems and their relative applicability to both acute myocardial infarction and advanced decompensated heart failure CS. Thus, we reviewed the similarities, differences, and limitations of published CS risk prediction models and herein ...
Source: Shock - May 1, 2022 Category: Emergency Medicine Tags: Review Article Source Type: research
Patho-Mechanisms for Hemorrhage/Sepsis-Induced Indirect Acute Respiratory Distress Syndrome: A Role for Lung TIE1 and Its Regulation by Neutrophils
Conclusion:
Together, these data imply that shock-induced increased expression of Tie1 can contribute to EC activation by inhibiting Ang:Tie2 interaction, culminating in EC dysfunction and the development of iARDS. (Source: Shock)
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Lipopolysaccharide-Induced Cytokine Secretion from In Vitro Mouse Slow and Fast Limb Muscle
In conclusion, intact slow and fast mouse muscles have similar cytokine/chemokine responses to LPS but depend on the presence of low levels of plasma constituents. Though sCD14 plays some role in EDL muscle, neither sCD14 nor LBP can fully account for the strong effects of plasma on LPS sensitivity. (Source: Shock)
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
NRF2 Inhibits Cardiomyocyte Pyroptosis Via Regulating CTRP1 in Sepsis-Induced Myocardial Injury
C1q/tumor necrosis factor-related protein 1 (CTRP1) has been demonstrated as a crucial regulator in myocardial injury (MI). The present study aims to evaluate the mechanism of CTRP1 in sepsis-induced MI. The septic mouse model was established via cecal ligation and puncture and the in vitro cell model was established via lipopolysaccharide treatment. The mouse survival rate within 96 h was recorded. Morphologic changes of cardiomyocytes were observed and cell viability and cardiac functions were detected. CTRP1 and nuclear factor erythroid 2-related factor (Nrf2) expressions, creatine troponin-T, and creatine phosphokina...
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Autoresuscitation of Poloxamer 188 in Pigs With Traumatic Severe Hemorrhage
This study investigated the effects of P188 on blood volume and coagulation in pigs after traumatic hemorrhage and hypotensive resuscitation.
Methods:
Femur fracture was performed in 17 anesthetized pigs, followed by hemorrhage of 55% of estimated blood volume and a 10 min shock period. Afterwards, pigs were randomized to be resuscitated with either normal saline (n = 9, 4 mL/kg, NS group) or P188 (n = 8, 1.33 mL/kg at 150 mg/mL, plus 2.67 mL NS/kg, P188 group). Pigs were monitored for 2 h or until death. Hemodynamics were recorded and blood samples were taken at baseline (BL), after hemorrhage, sh...
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Changes of Key Rate-Limiting Enzyme Activity in Glucose Metabolism After Cardiopulmonary Resuscitation
Conclusions:
Lowered key rate-limiting enzymes activity in glucose metabolism resulted in impairment of energy production in the early stage of ROSC, but partially recovered in 24 h. This process has a role in the mechanism of impaired myocardial energy metabolism after CPR. This investigation might shed light on new strategies to treat post resuscitation myocardial dysfunction. (Source: Shock)
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Pro-Resolving Mediator Resolvin E1 Restores Alveolar Fluid Clearance in Acute Respiratory Distress Syndrome
Acute respiratory distress syndrome (ARDS) is a life-threatening condition characterized by increased permeability of the alveolar-capillary barrier and impaired alveolar fluid clearance. Resolvin E1 (RvE1) is a specialized pro-resolving mediator derived endogenously from omega-3-polyunsaturated fatty acids. RvE1 (10 μg/kg i.v.) was injected to rats 6 h post-lipopolysaccharide (LPS) (14 mg/kg) induction. After another 3 h, alveolar fluid clearance was measured in live rats (n = 8–9). The primary Type II alveolar epithelial cell was isolated and treated by LPS (1 μg/mL) with or without RvE1 (250 nM). The expre...
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Pyruvate-Driven Oxidative Phosphorylation is Downregulated in Sepsis-Induced Cardiomyopathy: A Study of Mitochondrial Proteome
Conclusions:
These data demonstrate a broad mitochondrial protein remodeling, PDH inactivation and impaired pyruvate-fueled oxidative phosphorylation during SIC, and provide a molecular framework for further exploration. (Source: Shock)
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Recombinant Activated Protein C (rhAPC) Affects Lipopolysaccharide-Induced Mechanical Compliance Changes and Beat Frequency of mESC-Derived Cardiomyocyte Monolayers
Conclusion:
LPS-induced contraction dysfunction and the reversal effects of rhAPC were successfully assessed by the mechanical properties of mESC-CMs. The CellDrum technology proved a decent tool to simulate sepsis in-vitro. (Source: Shock)
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
MicroRNA-541-5p REgulates Type II Alveolar Epithelial Cell Proliferation and Activity by Modulating the HMGB1 Expression
In this study, a model of ALI was established using LPS, and ATII cells were isolated and treated with LPS. Hematoxylin and eosin staining revealed the injury to lung tissues. In this study we found that miR-541-5p expression was significantly decreased in ALI tissue and in the LPS-induced ATII cell model. Additionally, the LPS-induced model showed suppression of ATII cell proliferation and activity. Furthermore, overexpression of miR-541-5p was found to promote cell activity and proliferation in the LPS-induced ATII cell model. Moreover, a luciferase assay illustrated that HMGB1 is a target of miR-541-5p, HMGB1 knockdown ...
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
The Characteristics of Organ Function Damage of Hemorrhagic Shock in Hot Environment and the Effect of Hypothermic Fluid Resuscitation
Conclusions:
Hot environment accelerated the death of hemorrhagic shock rats, which was related to the disorder of internal environment, the increase of inflammatory and stress factors. Furthermore, moderate hypothermic (10°C) fluid resuscitation was suitable for the treatment of hemorrhagic shock in hot environment. (Source: Shock)
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
