Changhe Ren, Milian Chen, Guo Mu, Suangchun Peng, Xiangbo Liu, Cehua Ou
Patients with chronic neuropathic pain (NP) have a significantly increased risk of central nervous degeneration. Trigeminal neuralgia (TN) is a typical NP, and this manifestation is more obvious. In addition to severe pain, patients with TN are often accompanied by cognitive dysfunction and have a higher risk of central nervous system degeneration, but the mechanism is not clear. The NLRP3 inflammasome assembles inside of microglia on activation, which plays an important role in neurodegeneration such as Alzheimer disease...
July 8, 2021: Shock
Yaxin Wang, Xiangzhi Fang, Yiyi Yang, Lin Chen, Wei Xiong, Limin Song, Bo Li, Ting Zhou, Yuan Yu, Xiaobo Yang, Huaqing Shu, Shiying Yuan, Shanglong Yao, You Shang
OBJECTIVES: Mechanical stretch induced alveolar epithelial cell (AEC) apoptosis participates in the onset of ventilator induced lung injury (VILI). In this study, we explored whether death associated protein kinase 1 (DAPK1) mediated cyclic stretch (CS) induced AEC apoptosis and VILI though P53 pathway. MATERIALS AND METHODS: AEC apoptosis was induced by CS using the FX-5000T Flexercell Tension Plus system. C57BL/6 mouse received high tidal volume ventilation to build VILI model...
July 8, 2021: Shock
Hanna Louise Ratcovich, Jakob Josiassen, Ole Kristian Lerche Helgestad, Louise Linde, Lisette Okkels Jensen, Hanne Berg Ravn, Francis R Joshi, Thomas Engstrøm, Henrik Schmidt, Christian Hassager, Jacob E Møller, Lene Holmvang
INTRODUCTION: Despite advances in treatment of patients with cardiogenic shock following acute myocardial infarction (AMICS) in-hospital mortality remains around 50%. Outcome varies among patient subsets and the elderly often have a poor a priori prognosis. We sought to investigate outcome among elderly AMICS patients referred to evaluation and treatment at a tertiary university hospital. METHODS: Current analysis was based on the RETROSHOCK registry comprising consecutive AMICS patients admitted to tertiary care...
July 8, 2021: Shock
Pedro Miguel Coelho Medeiros, Camilla Schjalm, Dorte Christiansen, Marina Sokolova, Soeren Erik Pischke, Reinhard Würzner, Tom Eirik Mollnes, Andreas Barratt-Due
Vitamin C combined with hydrocortisone is increasingly being used to treat septic patients, even though this treatment regimen is based on questionable evidence. When used, a marked effect on key players of innate immunity would be expected, as sepsis is featured by a dysregulated immune response.Here, we explored the effect of vitamin C and hydrocortisone alone and combined, in an ex vivo human whole-blood model of Escherichia coli- or Staphylococcus aureus-induced inflammation. Inflammatory markers for activation of complement (TCC), granulocytes (myeloperoxidase), platelets (β-thromboglobulin), cytokines (TNF, IL-1β, IL6 and IL-8) and leukocytes (CD11b and oxidative burst) were quantified, by ELISA, multiplex technology and flow cytometry...
July 8, 2021: Shock
Tiffanie K Jones, John P Reilly, Brian J Anderson, Todd A Miano, Thomas G Dunn, Ariel R Weisman, Roseline Agyekum, Rui Feng, Caroline A G Ittner, Michael G S Shashaty, Nuala J Meyer
BACKGROUND: Matrix Metalloproteinases (MMP) respond to tissue damage during sepsis. Higher plasma concentrations of MMPs and the tissue-inhibitor of matrix metalloproteinases (TIMP) have been reported in sepsis compared to healthy controls. The objective of this study was to examine if plasma levels of MMP-3, MMP-9, and TIMP-1 associate with mortality and organ dysfunction during sepsis. METHODS: We conducted a prospective cohort study of critically ill patients with sepsis adjudicated per Sepsis-3 criteria at a tertiary academic medical center...
July 8, 2021: Shock
Jenny Juschten, Lieuwe D J Bos, Harm-Jan de Grooth, Ulrich Beuers, Armand R J Girbes, Nicole P Juffermans, Stephan A Loer, Tom van der Poll, Olaf L Cremer, Marc J M Bonten, Marcus J Schultz, Pieter Roel Tuinman
OBJECTIVE: To investigate the incidence, clinical characteristics and outcomes of early hyperbilirubinemia in critically ill patients. DESIGN AND SETTING: This is a post-hoc analysis of a prospective multicenter cohort study. PATIENTS: Patients with measured bilirubin levels within the first 2 days after ICU admission were eligible. Patients with liver cirrhosis were excluded. ENDPOINTS: The primary endpoint was the incidence of early hyperbilirubinemia, defined as bilirubin ≥ 33 μmol/L within 2 days after ICU admission...
July 7, 2021: Shock
Pan Pan, Jie Chen, Xudong Liu, Junping Fan, Dong Zhang, Weiguo Zhao, Lixin Xie, Longxiang Su
The incidence and mortality of acute respiratory distress syndrome (ARDS) are high, but the relevant mechanism for this disorder remains unclear. Autophagy plays an important role in the development of ARDS. The mitochondrial outer membrane protein FUNDC1 is involved in hypoxia-mediated mitochondrial autophagy, which may contribute to ARDS development. This study explored whether FUNDC1 regulates autophagy by inhibiting ROS-NLRP3 signaling to avoid apoptosis in the lung in a lipopolysaccharide-induced mouse model...
July 7, 2021: Shock
Bo Yang, Rong Wang, Lin-Lin Ji, Xiao-Ping Li, Xiao-He Li, Hong-Gang Zhou, Zhan-Kun He, Hong-Liang Xu, Fan-Jie Meng, Guang-Shun Wang
OBJECTIVE: Ginsenoside Rd (GSRd) displays a variety of pharmacological effects. However, the underlying role in acute lung injury (ALI) is not clear. In this study, the protective effect of GSRd on lipopolysaccharide (LPS)-induced ALI is investigated to explore the potential mechanisms. METHODS: GSRd-target-ALI-related gene set was constructed. And bioinformatics tools were used to discover the potential mechanism. We observed the survival of subjects for 72 hours...
June 24, 2021: Shock
Sara Fernández, Ana B Moreno-Castaño, Marta Palomo, Julia Martinez-Sanchez, Sergi Torramadé-Moix, Adrián Téllez, Helena Ventosa, Ferran Seguí, Ginés Escolar, Enric Carreras, Josep M Nicolás, Edward Richardson, David García-Bernal, Carmelo Carlo-Stella, José M Moraleda, Paul G Richardson, Maribel Díaz-Ricart, Pedro Castro
BACKGROUND: Endotheliopathy is a key element in COVID-19 pathophysiology, contributing to both morbidity and mortality. Biomarkers distinguishing different COVID-19 phenotypes from sepsis syndrome remain poorly understood. OBJECTIVE: To characterize circulating biomarkers of endothelial damage in different COVID-19 clinical disease stages compared with sepsis syndrome and normal volunteers. METHODS: Patients with COVID-19 pneumonia (n = 49) were classified into moderate, severe, or critical (life-threatening) disease...
June 24, 2021: Shock
Mats Koeneman, Rebecca Koch, Harry van Goor, Peter Pickkers, Matthijs Kox, Sebastian Bredie
INTRODUCTION: Early diagnosis and treatment can reduce the risk of organ failure and mortality in systemic inflammatory conditions. Heart rate variability (HRV) has potential for early identification of the onset of systemic inflammation, as it may detect changes in sympathetic nervous system activity resulting from the developing inflammatory response before clinical signs appear. With the use of new methodologies, we investigated the onset and kinetics of HRV changes as well as several inflammatory parameters and symptoms during experimental human endotoxemia, a model of systemic inflammation in humans in vivo...
June 24, 2021: Shock
Satoshi Gando, Takeshi Wada
BACKGROUND: The pathomechanisms of hypoxemia and treatment strategies for type H and type L acute respiratory distress syndrome (ARDS) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced coronavirus disease 2019 (COVID-19) have not been elucidated. MAIN TEXT: SARS-CoV-2 mainly targets the lungs and blood, leading to ARDS, and systemic thrombosis or bleeding. Angiotensin II-induced coagulopathy, SARS-CoV-2-induced hyperfibrin(ogen)olysis, and pulmonary and/or disseminated intravascular coagulation due to immunothrombosis contribute to COVID-19-associated coagulopathy...
June 24, 2021: Shock
Ashley Weiss, Cathyyen Dang, Danielle Mabrey, Matthew Stanton, Jessica Feih, Lisa Rein, Ryan Feldman
BACKGROUND: The optimal vasoactive agent for management of patients with return of spontaneous circulation (ROSC) after cardiac arrest has not yet been identified. The Advanced Cardiac Life Support (ACLS) guidelines recommend initiation of either norepinephrine (NE), epinephrine (EPI), or dopamine (DA) to maintain adequate hemodynamics after ROSC is achieved. The goal of this study is to retrospectively assess the impact of initial vasopressor agent on incidence rate of rearrest, death, or need for additional vasopressor in post-cardiac arrest emergency department (ED) patients...
June 24, 2021: Shock
Daniel N Darlington
No abstract text is available yet for this article.
August 1, 2021: Shock
Michael Gröger, Melanie Hogg, Essam Abdelsalam, Sandra Kress, Andrea Hoffmann, Bettina Stahl, Veronique Saub, Nicole Denoix, Oscar McCook, Enrico Calzia, Eva-Maria Wolfschmitt, Ulrich Wachter, Josef A Vogt, Rui Wang, Peter Radermacher, Tamara Merz, Benedikt L Nussbaum
BACKGROUND: Sodium thiosulfate (Na2S2O3) is a clinically established drug with antioxidant and sulfide releasing properties. Na2S2O3 mediated neuro- and cardioprotective effects in ischemia/reperfusion models and anti-inflammatory effects in LPS-induced acute lung injury. Moreover, Na2S2O3 improved lung function during resuscitation from hemorrhagic shock in swine with pre-existing atherosclerosis, characterized by decreased expression of cystathionine γ-lyase (CSE), a major source of hydrogen sulfide (H2S) synthesis in the vasculature...
June 24, 2021: Shock
Lauren S Kelly, Camille G Apple, Dijoia B Darden, Kolenkode B Kannan, Erick E Pons, Brittany P Fenner, Hari K Parvataneni, Jennifer E Hagen, Scott C Brakenridge, Philip A Efron, Alicia M Mohr
BACKGROUND: Severe trauma is associated with severe systemic inflammation and neuroendocrine activation that is associated with erythroid progenitor growth suppression and refractory anemia. Although distinct transcriptional profiles have been detected in numerous tissue types after trauma, no study has yet characterized this within the bone marrow. This study sought to identify a unique bone marrow transcriptomic response following trauma. METHODS: In a prospective observational cohort study, bone marrow was obtained from severely injured trauma patients with a hip or femur fracture (n = 52), elective hip replacement patients (n = 33) and healthy controls (n = 11)...
June 24, 2021: Shock
Laura Piccolo Serafim, Douglas A Simonetto, Alexandra L Anderson, Dae Hee Choi, Timothy J Weister, Andrew C Hanson, Patrick S Kamath, Ognjen Gajic, Alice Gallo de Moraes
PURPOSE: Evidence regarding the utility of systemic steroids in treating patients with cirrhosis and septic shock remains equivocal. This study aimed to evaluate and elucidate the association of steroid use with outcomes and adverse effects in a cohort of patients with cirrhosis and septic shock. MATERIALS AND METHODS: Retrospective cohort study of patients with cirrhosis and septic shock admitted to a tertiary hospital ICU from January 2007 to May 2017, using a validated ICU Datamart...
June 14, 2021: Shock
Itay Ayalon, Lauren Bodilly, Jennifer Kaplan
In the last few decades, obesity became one of the world's greatest health challenges reaching a size of global epidemic in virtually all socioeconomic statuses and all age groups. Obesity is a risk factor for many health problems and as its prevalence gradually increases is becoming a significant economic and health burden. In this manuscript we describe how normal respiratory and cardiovascular physiology is altered by obesity. We review past and current literature to describe how obesity affects outcomes of patients facing critical illnesses and discuss some controversies related to this topic...
June 10, 2021: Shock
Sidnéia Sousa Santos, Milena Karina Colo Brunialti, Francisco Garcia Soriano, Csaba Szabo, Reinaldo Salomão
Sepsis' pathogenesis involves multiple mechanisms that lead to a dysregulation of the host's response. Significant efforts have been made in search of interventions that can reverse this situation and increase patient survival. Poly (ADP-polymerase) (PARP) is a constitutive nuclear and mitochondrial enzyme, which functions as a co-activator and co-repressor of gene transcription, thus regulating the production of inflammatory mediators. Several studies have already demonstrated an overactivation of PARP1 in various human pathophysiological conditions and that its inhibition has benefits in regulating intracellular processes...
June 10, 2021: Shock
Susumu Nakahashi, Hiroshi Imai, Nobutake Shimojo, Yasuhiro Magata, Takahiro Einama, Mineji Hayakawa, Takeshi Wada, Yuji Morimoto, Satoshi Gando
Ventilator-induced lung injury (VILI) can be life-threatening and it is important to prevent the development of VILI. It remains unclear whether the prone position affects neutrophilic inflammation in the lung regions in vivo, which plays a crucial role in the pathogenesis of VILI. This study aimed to assess the relationship between the use of the prone position and the development of VILI-associated regional neutrophilic lung inflammation. Regional neutrophilic lung inflammation and lung aeration during low tidal volume mechanical ventilation were assessed using in vivo 2-deoxy-2-[(18)F] fluoro-D-glucose (18F-FDG) positron emission tomography and computed tomography in acutely experimentally injured rabbit lungs (lung injury induced by lung lavage and excessive ventilation)...
June 8, 2021: Shock
Zhenqian Lv, Feng'e Wang, Xingfeng Zhang, Xiting Zhang, Jing Zhang, Ran Liu
BACKGROUND: Ferroptosis has been found to play an important role in myocardial ischemia reperfusion (MIR) injury (MIRI). This study aimed to explore whether the improvement effect of Etomidate (Eto) on MIRI was related to ferroptosis. METHODS: The MIRI rats were constructed using left anterior descending artery occlusion for 30 min followed by reperfusion for 3 h. The Eto post-conditioning was performed by Eto administration at the beginning of the reperfusion...
June 4, 2021: Shock
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