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Condition: Septic Shock

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Total 242 results found since Jan 2013.

Fulminant Cerebral Infarction of Anterior and Posterior Cerebral Circulation after Ascending Type of Facial Necrotizing Fasciitis
Necrotizing fasciitis is a soft tissue infection that is characterized by extensive necrosis of the subcutaneous fat, neurovascular structures, and fascia. Cerebral infarction after facial necrotizing fasciitis has been rarely reported. A 61-year-old woman with diabetes was admitted with painful swelling of her right cheek. One day later, she was stuporous and quadriplegic. A computed tomographic scan of her face revealed right facial infection in the periorbital soft tissue, parotid, buccal muscle, and maxillary sinusitis. A computed tomographic scan of the brain revealed cerebral infarction in the right hemisphere, left ...
Source: Journal of Stroke and Cerebrovascular Diseases - August 31, 2012 Category: Neurology Authors: Jun Ho Lee, Hui-Chul Choi, Chulho Kim, Jong Hee Sohn, Heung Cheol Kim Tags: Case Reports Source Type: research

Kinin Receptors in Vascular Biology and Pathology.
Abstract Endogenous kinins are important vasoactive peptides whose effects are mediated by two G-Protein-coupled receptors (R), named B2R (constitutive) and B1R (inducible). They are involved in vascular homeostasis, ischemic pre- and post- conditioning, but also in cardiovascular diseases. They contribute to the therapeutic effects of angiotensin-1 converting enzyme inhibitors (ACEI) and angiotensin AT1 receptor blockers. Benefits derive primarily from vasodilatory, antiproliferative, antihypertrophic, antifibrotic, antithrombic and antioxidant properties, which are associated with the release of endothelial fact...
Source: Current Vascular Pharmacology - February 26, 2014 Category: Drugs & Pharmacology Authors: Couture R, Blaes N, Girolami JP Tags: Curr Vasc Pharmacol Source Type: research

Perspectives on the therapeutic modulation of an alternative cell death, programmed necrosis (Review).
Abstract In response to overwhelming external stimuli, cells are forced to die in different ways. By default, cells are prone to apoptosis, a programmed cell death through the activation of the caspase cascade. However, this process would be blocked if one of the proteins involved in executing apoptosis was genetically impaired or chemically inhibited, or if the apoptotic machinery was not properly operated under specific conditions, such as ischemia and microbial infection. To address these issues, the paradigm of programmed cell death needs to be revised; thus, an alternative form of cell death, programmed necro...
Source: Molecular Medicine - March 27, 2014 Category: Molecular Biology Authors: Cho YS Tags: Int J Mol Med Source Type: research

N-terminal prohormone of brain natriuretic peptide—how far can we extrapolate?
We read the article by Velibey et al with interest. Their result is consistent with various other studies done in the past, but long-term (4 years) survival prediction on hospital admission with a single plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) level is a new and important finding. The mean value of NT-proBNP is significantly correlated with ejection fraction and the functional class (New York Heart Association Class) of heart failure . The author had neither commented on the functional status of the patients nor on the etiology of acute shortness of breath at the time of admission. Testing the...
Source: The American Journal of Emergency Medicine - December 23, 2013 Category: Emergency Medicine Authors: Nayer Jamshed, Fouzia F. Ozair, Meera Ekka, Praveen Aggarwal Tags: Correspondence Source Type: research

Prognostic value of echocardiographic and Doppler parameters in horses admitted for colic complicated by systemic inflammatory response syndrome
ConclusionsEchocardiography may provide prognostic information in colic horses with clinical evidence of SIRS. Especially, PEP/ET and E/Em could be useful markers of systolic and diastolic dysfunction, respectively, to detect horses with a high risk of death requiring more intensive cardiovascular monitoring as it has been reported in human patients with septic shock.
Source: Journal of Veterinary Emergency and Critical Care - April 1, 2014 Category: Veterinary Research Authors: Laura Borde, Hélène Amory, Sigrid Grulke, Aurélia A. Leroux, Rosa M. Houben, Johanne Detilleux, Charlotte C. Sandersen Tags: Original Study Source Type: research

Ventriculo-arterial decoupling in human septic shock
Conclusions: On admission to ICU patients in septic shock often display significant ventriculo-arterial decoupling that is associated with impaired left ventricular performance. Since Ea/Ees decoupling alters cardiovascular efficiency and cardiac energetic requirements independent of Ea or Ees, we speculate that uncoupled septic patients may benefit from therapy aimed at normalizing Ea/Ees.
Source: Critical Care - April 24, 2014 Category: Intensive Care Authors: Fabio GuarracinoBaldassarre FerroAndrea MorelliPietro BertiniRubia BaldassarriMichael Pinsky Source Type: research

Arginine infusion in septic shock patients increases nitric oxide production without hemodynamic instability
In conclusion, a4-fold increase of plasma arginine with intravenous arginine infusion in sepsis stimulates de novo arginine and NO production and reduces whole body protein breakdown. These potential beneficial metabolic effects occurred without negative alterations in hemodynamic parameters, although improvement of regional perfusion could not be demonstrated in the eight patients with septic shock that were studied.
Source: Clinical Science - July 18, 2014 Category: Biomedical Science Authors: Y C Luiking, M Poeze, N EP Deutz Source Type: research

Optimizing Oxygen Delivery in the Critically Ill: Assessment of Volume Responsiveness in the Septic Patient
Assessing volume responsiveness, defined as an increase in cardiac index after infusion of fluids, is important when caring for critically ill patients in septic shock, as both under- and over-resuscitation can worsen outcomes. This review article describes the currently available methods of assessing volume responsiveness for critically ill patients in the emergency department, with a focus on patients in septic shock.The single-pump model of the circulation utilizing cardiac-filling pressures is reviewed in detail. Additionally, the dual-pump model evaluating cardiopulmonary interactions both invasively and noninvasively...
Source: The Journal of Emergency Medicine - July 31, 2014 Category: Emergency Medicine Authors: Benjamin de Witt, Raj Joshi, Harvey Meislin, Jarrod M. Mosier Source Type: research

Risk factors for venous thromboembolism in patients undergoing craniotomy for neoplastic disease
Abstract Patients undergoing neurosurgical procedures for neoplasia have historically been considered at higher risk for developing venous thromboembolism (VTE). We sought to identify risk factors associated with VTE in patients undergoing craniotomy for tumor resection. We reviewed a national surgical quality database (American College of Surgeons National Surgical Quality Improvement Project, ACS-NSQIP, http://site.acsnsqip.org/). Patients undergoing non-emergent craniotomy for neoplastic indications were identified based on current procedural terminology codes. Clinical factors were identified that were associ...
Source: Journal of Neuro-Oncology - November 19, 2014 Category: Cancer & Oncology Source Type: research

Optimization of preload in severe sepsis and septic shock.
Authors: Shujaat A, Bajwa AA Abstract In sepsis both under- and overresuscitation are associated with increased morbidity and mortality. Moreover, sepsis can be complicated by myocardial dysfunction, and only half of the critically ill patients exhibit preload responsiveness. It is of paramount importance to accurately, safely, and rapidly determine and optimize preload during resuscitation. Traditional methods of determining preload based on measurement of pressure in a heart chamber or volume of a heart chamber ("static" parameters) are inaccurate and should be abandoned in favor of determining preload responsive...
Source: Critical Care Research and Practice - December 1, 2014 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Single induction dose of etomidate versus other induction agents for endotracheal intubation in critically ill patients.
CONCLUSIONS: Although we have not found conclusive evidence that etomidate increases mortality or healthcare resource utilization in critically ill patients, it does seem to increase the risk of adrenal gland dysfunction and multi-organ system dysfunction by a small amount. The clinical significance of this finding is unknown. This evidence is judged to be of moderate quality, owing mainly to significant attrition bias in some of the smaller studies, and new research may influence the outcomes of our review. The applicability of these data may be limited by the fact that 42% of the patients in our review were intubated for...
Source: Cochrane Database of Systematic Reviews - January 8, 2015 Category: Journals (General) Authors: Bruder EA, Ball IM, Ridi S, Pickett W, Hohl C Tags: Cochrane Database Syst Rev Source Type: research

FloTrac® Monitoring System: What Are Its Uses in Critically Ill Medical Patients?
Abstract : The FloTrac®/Vigileo device uses arterial pressure waveform analysis to calculate stroke volume and cardiac output; it does not require calibration against an independent measurement of cardiac output. Consequently, it provides a method to determine hemodynamic status, changes in the clinical course and responses to therapeutic interventions in patients who have arterial catheters in place. These devices perform relatively well in stable patients undergoing surgery and having an acceptable percentage error in differences between the FloTrac® device and invasive monitoring using pulmonary catheters. Ho...
Source: The American Journal of the Medical Sciences - January 12, 2015 Category: Journals (General) Authors: Argueta E, Berdine G, Pena C, Nugent KM Tags: Am J Med Sci Source Type: research

Myocardial dysfunction in severe sepsis and septic shock - no correlation with inflammatory cytokines in real-life clinical setting.
Conclusions: Unlike cardiac biomarkers, none of the measured inflammatory cytokines correlates with systolic or diastolic myocardial dysfunction in severe sepsis or septic shock. PMID: 25591166 [PubMed - as supplied by publisher]
Source: Chest - January 15, 2015 Category: Respiratory Medicine Authors: Landesberg G, Levin PD, Gilon D, Goodman S, Georgieva M, Weissman C, Jaffe AS, Sprung CL, Barak V Tags: Chest Source Type: research

Dynamic arterial elastance predicts mean arterial pressure decrease associated with decreasing norepinephrine dosage in septic shock
IntroductionGradual reduction of the dosage of norepinephrine (NE) in patients with septic shock is usually left to the physician?s discretion. No haemodynamic indicator predictive of the possibility of decreasing the NE dosage is currently available at the bedside. The respiratory pulse pressure variation / respiratory stroke volume variation (dynamic arterial elastance (Eadyn)) ratio has been proposed as an indicator of vascular tone. The purpose of this study was to determine whether Eadyn can be used to predict the decrease in arterial pressure when decreasing the NE dosage in resuscitated septic patients. Methods: A p...
Source: Critical Care - January 19, 2015 Category: Intensive Care Authors: Pierre-Grégoire GuinotEugénie BernardMélanie LevrardHervé DupontEmmanuel Lorne Source Type: research