Heparin Binding Protein for the Early Diagnosis and Prognosis of Sepsis in the Emergency Department: The Prompt Multicenter Study
Conclusion:
Admission HBP can be used as a tool for the early diagnosis of sepsis and for the risk of early death in the ED. (Source: Shock)
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Clinical Aspects Source Type: research
Esmolol to Treat the Hemodynamic Effects of Septic Shock: A Randomized Controlled Trial
Introduction:
Septic shock is often characterized by tachycardia and a hyperdynamic hemodynamic profile. Use of the beta antagonist esmolol has been proposed as a therapy to lower heart rate, thereby improving diastolic filling time and improving cardiac output, resulting in a reduction in vasopressor support.
Methods:
We conducted a two-center, open-label, randomized, Phase II trial comparing esmolol to placebo in septic shock patients with tachycardia. The primary endpoint was improvement in hemodynamics as measured by the difference in norepinephrine equivalent dose (NED) between groups at 6 hours after ini...
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Clinical Aspects Source Type: research
Renal Resistive Index on Intensive Care Unit Admission Correlates With Tissue Hypoperfusion Indices and Predicts Clinical Outcome
Background:
Renal resistive index (RRI) has been used to evaluate renal blood flow. Our aim was to investigate the relation between RRI and global tissue hypoperfusion indices and their association with clinical outcome, in intensive care unit (ICU) patients.
Methods:
RRI was measured within 24 h of ICU admission. Gas exchange and routine hemodynamic variables at the time of RRI assessment were recorded. An elevated RRI was defined as>0.7. The ratio of central venous-to-arterial carbon dioxide partial pressure difference by arterial-to-central venous oxygen content difference (P(cv-a)CO2/C(a-cv)O2) and lactate...
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Clinical Aspects Source Type: research
Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns
Conclusion:
PDW and PPR on day 3 and day 7 were independent risk factors for 120-day mortality in severe burn patients. These objective and readily available prognostic indicators may be more clinically favored. (Source: Shock)
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Clinical Aspects Source Type: research
Impact of Platelet Transfusion Thresholds on Outcomes of Patients With Sepsis: Analysis of the MIMIC-IV Database
Conclusions:
In patients with sepsis and thrombocytopenia, platelet transfusion at a higher threshold was associated with a greater reduction in the 28- and 90-day mortalities than that at a lower threshold. (Source: Shock)
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Clinical Aspects Source Type: research
Azithromycin and Major Adverse Kidney Events in Critically Ill Patients With Sepsis-Associated Acute Kidney Injury
Conclusions:
Early exposure to azithromycin in SA-AKI is independently associated with lower odds of MAKE at hospital discharge. (Source: Shock)
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Clinical Aspects Source Type: research
Systemic Review of Animal Models Used in the Study of Crush Syndrome
Crush syndrome (CS), also known as traumatic rhabdomyolysis, is the leading cause of death following extrication from structural collapse due to earthquakes. Due to the unfeasibility of human studies, animal models are used to study crush syndrome pathophysiology, including biochemistry and treatment regimes. The aim of this systematic literature review was to identify the differences and benefits of various animal models used in the study of CS and provide valuable information for design of future research. A systematic search was conducted in two methods: with the filters “(crush syndrome) AND (crush muscle injury)” ...
Source: Shock - March 16, 2022 Category: Emergency Medicine Tags: Review Article Source Type: research
Plasmatic NGAL Monitoring in Cardiogenic Shock: Deciphering the Past, the Present, and the Future
No abstract available (Source: Shock)
Source: Shock - March 1, 2022 Category: Emergency Medicine Tags: Letter to the Editor Source Type: research
Hydroxyl Ethyl Starch (HES) Preserves Intrarenal Microcirculatory Perfusion Shown by Contrast-Enhanced Ultrasound (Ceus), and Renal Function in a Severe Hemodilution Model in Pigs
Acute normovolemic hemodilution (ANH) is associated with low oxygen carrying capacity of blood and purposed to cause renal injury in perioperative setting. It is best accomplished in a perioperative setting by a colloid such as hydroxyl ethyl starch (HES) due its capacity to fill the vascular compartment and maintain colloidal pressure. However, alterations of intra renal microvascular perfusion, flow and its effects on renal function and damage during ANH has not been sufficiently clarified. Based on the extensive use of HES in the perioperative setting we tested the hypothesis that the use of HES during ANH is able to pe...
Source: Shock - March 1, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Omeprazole Increases Survival Through the Inhibition of Inflammatory Mediaters in Two Rat Sepsis Models
Conclusions:
OMZ inhibited the induction of several inflammatory mediators, resulting in the prevention of LPS-induced liver injury after GalN liver failure and PH, although OMZ showed different doses and mechanisms in the two models. (Source: Shock)
Source: Shock - March 1, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
δPKC-Mediated DRP1 Phosphorylation Impacts Macrophage Mitochondrial Function and Inflammatory Response to Endotoxin
Conclusion:
These data suggest that inhibiting Drp1 phosphorylation by δPKC abates the excessive mitochondrial fragmentation and mitochondrial dysfunction that is seen following LPS treatment. Furthermore, these data suggest that limiting δPKC-dependent Drp1 activation decreases the pro-inflammatory response following LPS treatment. Altogether, δPKC-dependent Drp1 phosphorylation might be an upstream mechanistic link between alterations in mitochondrial dynamics and innate immune phenotypes, and may have therapeutic potential. (Source: Shock)
Source: Shock - March 1, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Auricular Vagus Nerve Stimulation Attenuates Lipopolysaccharide-Induced Acute Lung Injury by Inhibiting Neutrophil Infiltration and Neutrophil Extracellular Traps Formation
In conclusion, AVNS reduced systemic inflammation, attenuated lung edema, and inhibited neutrophil infiltration and NETs formation in the lung in LPS mice. (Source: Shock)
Source: Shock - March 1, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
KLF6 Promotes Pyroptosis of Renal Tubular Epithelial Cells in Septic Acute Kidney Injury
Septic acute kidney injury (SAKI) represents a clinical challenge with high morbidity and mortality. The current study aimed to analyze the effects and molecular mechanism of Krüppel-like factor 6 (KLF6) on SAKI. First, SAKI mouse models were established by cecum ligation and puncture, while in vivo cell models were established using lipopolysaccharide (LPS). RT-qPCR assay was subsequently performed to detect the levels of KLF6 mRNA. SAKI mice and LPS-treated TCMK-1 cells were further treated with KLF6 siRNA. Afterward, HE staining, PAS staining, Western blot assay, and ELISA were adopted to ascertain the effects of KLF6 ...
Source: Shock - March 1, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Therapeutic Effects of Hyaluronic Acid Against Cytotoxic Extracellular Vesicles Released During Pseudomonas Aeruginosa Pneumonia
In conclusion, EVs isolated from BALF of mice with P. aeruginosa pneumonia were cytotoxic and inflammatory, and intravenous HMW HA administration was protective against P. aeruginosa pneumonia. (Source: Shock)
Source: Shock - March 1, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Neuregulin-1β Alleviates Sepsis-Induced Skeletal Muscle Atrophy by Inhibiting Autophagy via AKT/mTOR Signaling Pathway in Rats
Conclusion:
NRG-1β could alleviate sepsis-induced skeletal muscle atrophy by inhibiting autophagy via the AKT/mTOR signaling pathway. (Source: Shock)
Source: Shock - March 1, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research