Antonio De Maio
No abstract text is available yet for this article.
March 19, 2020: Shock
Danielle Tatum, Juan Duchesne, Bruno Pereira, Bryan Cotton, Mansoor Khan, Megan Brenner, Paula Ferrada, Tal Hörer, David Kauvar, Andrew Kirkpatrick, Carlos Ordonez, Artai Pirouzram, Derek Roberts
Time to hemorrhage control is critical, as mortality in patients with severe hemorrhage that arrive to trauma centers with sign of life remains over 40%. Prompt identification and management of severe hemorrhage is paramount to reducing mortality. In traditional US trauma systems, the early hospital course of a severely hemorrhaging patient typically proceeds from the trauma resuscitation bay to the operating room or angiography suite with a potential stop for radiological imaging. This protracted journey can prove fatal as it consumes valuable minutes...
March 19, 2020: Shock
Birte Weber, Ina Lackner, Deborah Knecht, Christian Karl Braun, Florian Gebhard, Markus Huber-Lang, Frank Hildebrand, Klemens Horst, Hans-Christoph Pape, Anita Ignatius, Hubert Schrezenmeier, Melanie Haffner-Luntzer, Miriam Kalbitz
The purpose of this study was to reveal possible consequences of long-bone fracture on cardiac tissue and to analyze the role of systemically elevated danger associated molecular patterns, complement anaphylatoxins and cytokines. Blood samples of mice, pigs, and humans after a fracture were analyzed by ELISAs for complement component 5a (C5a), tumor necrosis factor (TNF) and extracellular histones. In vivo results were completed by in vitro experiments with human cardiomyocytes treated with TNF and extracellular histones...
March 19, 2020: Shock
Annabelle Hamon, Djamel Mokart, Camille Pouliquen, Jean Manuel de Guibert, Sylvie Cambon, Lam Nguyen Duong, Eric Lambaudie, Antoine Sannini, Laurent Chow-Chine, Magali Bisbal, Jacques Ewald, Olivier Turrini, Marion Faucher
BACKGROUND: Management of hemorrhagic shock is well codified by international guidelines. These guidelines are predominantly based on trauma patients. We aimed to evaluate factors associated with 30-day mortality and long-term survival after intraoperative hemorrhagic shock during major oncological surgery. METHODS: This retrospective study was conducted in a cancer referral center from January 2013 to February 2018. All adult cancer patients admitted in the operative room for scheduled or emergency oncological surgery associated with an intraoperative hemorrhagic shock were included...
March 19, 2020: Shock
Hidekazu Nakata, Kazuma Yamakawa, Daijiro Kabata, Yutaka Umemura, Hiroshi Ogura, Satoshi Gando, Ayumi Shintani, Atsushi Shiraishi, Daizoh Saitoh, Seitato Fujishima, Toshihiko Mayumi, Shigeki Kushimoto, Toshikazu Abe, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi
INTRODUCTION: Polymyxin B hemoperfusion (PMX-HP) is an adjuvant therapy for sepsis or septic shock that removes circulating endotoxin. However, PMX-HP has seldom achieved expectations in randomized trials targeting nonspecific overall sepsis patients. If used in an optimal population, PMX-HP may be beneficial. This study aimed to identify the optimal population for PMX-HP in patients with septic shock. METHODS: We used a prospective nationwide cohort targeting consecutive adult patients with severe sepsis (Sepsis-2) in 59 intensive care units in Japan...
March 17, 2020: Shock
Jian Gu, Tao Zhang, Jianrong Guo, Ke Chen, Huili Li, Jiliang Wang
Hepatic ischemia/reperfusion (I/R) injury is a major concern in liver surgery settings. Mitochondria are critical targets or the origin of tissue injury, particularly I/R injury. Mitophagy, a selective form of autophagy, is a fundamental process that removes damaged or unwanted mitochondria for mitochondrial quality control, but its role in hepatic I/R remains unclear. In the present study, we investigated the role of mitophagy in hepatic I/R by focusing on PTEN-induced putative kinase 1 (PINK1). Livers from 10-week-old mice and primary hepatocytes were subjected to in vivo hepatic I/R and in vitro hypoxia-reoxygenation (H/R), respectively...
March 17, 2020: Shock
Lisa van Manen, Adrie Maas, Joris J T H Roelofs, Alexander P J Vlaar, Robin van Bruggen, Nicole P Juffermans
BACKGROUND: Septic patients are often anemic, requiring red blood cell (RBC) transfusions. However, RBC transfusions are associated with organ injury. The mechanisms of RBC-induced organ injury are unknown, but increased clearance of donor RBCs from the circulation with trapping in the organs could play a role. We hypothesized that washing of RBCs prior to transfusion may reduce clearance and trapping of donor cells and thereby reduce organ injury. METHODS: Sprague-Dawley rats were inoculated intratracheally with 10^7 colony forming units (CFU) of S...
March 17, 2020: Shock
Hua Cheng, Wei Yan
BACKGROUND AND PURPOSE: Myocardial ischemia reperfusion (IR) injury is a serious issue in the treatment of myocardial infarction. MiR-433 is upregulated in myocardial IR injury, but its specific effects remain unclear. In this study, we explored the effect and mechanism of miR-433 in myocardial IR injury. METHODS: The expression of miR-433 was measured by qRT-PCR. H9c2 cells were transfected with miR-433 mimic and inhibitor after exposure to HR, respectively. Cell viability was detected by MTT...
March 16, 2020: Shock
Fatemeh Fattahi, Firas S Zetoune, Peter A Ward
There is abundant evidence that infectious sepsis both in humans and mice with polymicrobial sepsis results in robust activation of complement. Major complement activation products involved in sepsis include C5a anaphylatoxin and its receptors (C5aR1 and C5aR2) and, perhaps, the terminal complement activation product, C5b-9. These products (and others) also cause dysfunction of the innate immune system, with exaggerated early proinflammatory responses, followed by decline of the innate immune system, leading to immunosuppression and multiorgan dysfunction...
March 16, 2020: Shock
Russell Griffin, Jan O Jansen, Patrick Bosarge, Marisa B Marques, Jeffrey Kerby
BACKGROUND: Prior research has reported an association among trauma patients between blood type O and adverse events. More recently, another study reported that severely injured trauma patients of mostly O Rh positive blood type were more likely to die. OBJECTIVE: The objective of the current study is to examine whether the same increased association is observed for blood type O severely injured patients in a more generalizable population comprised of Rh positive and Rh negative individuals...
February 26, 2020: Shock
Qi Nie, Dawei Wang, Zhijie Ning, Tianmin Li, Xinghan Tian, Pengfei Bian, Kun Ding, Chang Hu, Zhi-Yong Peng
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. MATERIALS AND METHODS: Retrospective cohort study in ICU patients with SFTSV infection admitted in 2014-2019. Diagnosis was confirmed using reverse transcription polymerase chain reaction on serum samples...
February 24, 2020: Shock
Alexander T Williams, Alfredo Lucas, Cynthia R Muller, Carlos Munoz, Crystal Bolden-Rush, Andre F Palmer, Pedro Cabrales
BACKGROUND: Hemoglobin (Hb) based oxygen carriers (HBOCs) have been proposed as alternatives to blood for decades. Previous studies demonstrated that large molecular diameter HBOCs based on polymerized bovine Hb (PolybHb) attenuate Hb side-effects and toxicity. 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 (< 500 kDa) species and stored for 2 years...
February 21, 2020: Shock
Laurie E Kilpatrick, Mohammad F Kiani
Sepsis is a life-threatening syndrome of organ dysfunction caused by a dysregulated host response to infection characterized by excessive neutrophil infiltration into vital organs. In sepsis, patients often die of organ failure and therapies directed against endothelial cell dysfunction and tissue damage are important targets for treatment of this disease. Novel approaches are required to understand the underlying pathophysiology of neutrophil dysregulation and neutrophil-endothelial cell interactions that play a critical role in the early course of organ damage and disruption of endothelial protective barrier...
February 19, 2020: Shock
Tal M Hörer, Artai Pirouzram, Mansoor Khan, Megan Brenner, Bryan Cotton, Juan Duchesne, Paula Ferrada, David Kauvar, Andrew Kirkpatrick, Carlos Ordonez, Bruno Perreira, Derek Roberts
In recent years there has been a tremendous increase in hemorrhage control by endovascular methods. Traumatic and non-traumatic hemorrhage is being more frequently managed with endografts, embolization agents and minimal invasive methods. These methods initially were used in hemodynamically stable patients only, whereas now are being implemented in acute settings and hemodynamically unstable patients. The strategy of using endovascular and combined open-endo methods approach for hemodynamic instability in trauma and non-trauma patients has been named EVTM- EndoVascular resuscitation and Trauma Management...
February 19, 2020: Shock
Weiting Chen, Hui Wang, Zhengquan Wang, Changwei Zhao, Jiefeng Xu, Qijiang Chen
Following global ischemia reperfusion injury triggered by cardiac arrest (CA) and resuscitation, the ensuing cardiac and cerebral damage would result in high mortality and morbidity. Recently, resolvin D1 has been proven to have a protective effect on regional cardiac and cerebral ischemia reperfusion injury. In this study, we investigated the effects of resolvin D1 on cardiac and cerebral outcomes after cardiopulmonary resuscitation (CPR) in a porcine model.Twenty-eight male domestic pigs weighing between 33-41 kg were randomly divided to one of the four groups: sham, CPR, low-dose resolvin D1 (LRD), and high-dose resolvin D1 (HRD)...
February 19, 2020: Shock
Charles de Roquetaillade, Matthieu Jamme, Julien Charpentier, Jean-Daniel Chiche, Alain Cariou, Jean-Paul Mira, Frédéric Pène, Jean-François Llitjos
BACKGROUND: Impact of prior cardiovascular antihypertensive medication during the initial phase of septic shock in terms of catecholamine requirements and mortality has been poorly investigated and remains unclear. OBJECTIVES: To investigate the association between chronic prescription of cardiovascular antihypertensive medication prior to intensive care unit (ICU) admission, catecholamine requirement and mortality in patients with septic shock. METHODS: We included all consecutive patients diagnosed with septic shock within the first 24 h of ICU admission, defined as a microbiologically proven or clinically suspected infection, associated with acute circulatory failure requiring vasopressors despite adequate fluid filling...
February 19, 2020: Shock
Tao Chen, Min Ge, Wei-Wei Zhao, Dong-Jin Wang
No abstract text is available yet for this article.
February 19, 2020: Shock
Juan Duchesne, Sharven Taghavi, August Houghton, Mansoor Khan, Bruno Perreira, Bryan Cotton, Danielle Tatum, Megan Brenner, Paula Ferrada, Tal Horer, David Kauvar, Andrew Kirkpatrick, Carlos Ordonez, Artai Priouzram, Derek Roberts
Mortality secondary to trauma related hemorrhagic shock has not improved for several decades. Underlying the stall in progress is the conundrum of effective pre-hospital interventions for hemorrhage control. As we know, neither pressing hard on the gas nor "Stay and play" have changed mortality over the last 20 years. For this reason, when dealing with effective changes that will improve severe hemorrhage mortality outcomes, there is a need for the creation of a hybrid pre-hospital model.Improvements in mortality outcomes for patients with severe hemorrhage based on evidence for common civilian prehospital procedures such as in-field intubation and immediate fluid resuscitation with crystalloid solution is weak at best...
February 19, 2020: Shock
Wei Huang, Xiaoting Wang, Hongmin Zhang, Cui Wang, Dawei Liu
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...
February 11, 2020: Shock
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