Circulating myeloperoxidase is elevated in septic shock and is associated with systemic organ failure and mortality in critically ill patients

2020 ◽  
Vol 152 ◽  
pp. 462-468 ◽  
Author(s):  
Anitra C. Carr ◽  
Emma Spencer ◽  
Teagan S. Hoskin ◽  
Patrice Rosengrave ◽  
Anthony J. Kettle ◽  
...  
Keyword(s):  
Septic Shock ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients

scholarly journals Exosomal CD63 in critically ill patients with sepsis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yunjoo Im ◽  
Hongseok Yoo ◽  
Ryoung-Eun Ko ◽  
Jin Young Lee ◽  
Junseon Park ◽  
...  
Keyword(s):  
Septic Shock ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mortality Prediction ◽  
Enzyme Linked Immunosorbent Assay ◽  
Linear Regression Method ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Sepsis And Septic Shock

AbstractCD63 is one of the tetraspanin protein family members that is ubiquitously expressed on exosomes and is involved in the signal transduction of various types of immune cells. It may thus contribute to immunometabolic mechanisms of cellular and organ dysfunction in sepsis. Nonetheless, the association of exosomal CD63 with the severity and mortality of sepsis is not well known. Therefore, in the present study, the overall levels of exosomal CD63 were evaluated to ascertain whether they were associated with organ failure and mortality in patients with sepsis. Exosomal CD63 was measured from prospectively enrolled critically-ill patients with sepsis (n = 217) and healthy control (n = 20). To detect and quantify exosomes in plasma, a commercially available enzyme-linked immunosorbent assay kit was used according to the manufacturer’s protocol. The total number of exosomal CD63 was determined by quantifying the immunoreactive CD63. The association between plasma levels of exosomal CD63 and sequential organ failure assessment (SOFA) score was assessed by a linear regression method. The best cut-off level of exosomal CD63 for 28-day mortality prediction was determined by Youden’s index. Among 217 patients with sepsis, 143 (66%) patients were diagnosed with septic shock. Trends of increased exosomal CD63 levels were observed in control, sepsis, and septic-shock groups (6.6 µg/mL vs. 42 µg/mL vs. 90 µg/mL, p < 0.001). A positive correlation between exosomal CD63 and SOFA scores was observed in patients with sepsis (r value = 0.35). When patients were divided into two groups according to the best cut-off level, the group with higher exosomal CD63 levels (more than 126 µg/mL) was significantly associated with 28-day and in-hospital mortality. Moreover, the Kaplan–Meier survival method showed a significant difference in 90-day survival between patients with high- and low-exosomal CD63 levels (log-rank p = 0.005). Elevated levels of exosomal CD63 were associated with the severity of organ failure and predictive of mortality in critically ill patients with sepsis.

scholarly journals Mortality of Pandrug-Resistant Klebsiella pneumoniae Bloodstream Infections in Critically Ill Patients: A Retrospective Cohort of 115 Episodes

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 76
Author(s):  
Matthaios Papadimitriou-Olivgeris ◽  
Christina Bartzavali ◽  
Alexandra Georgakopoulou ◽  
Fevronia Kolonitsiou ◽  
Chrisavgi Papamichail ◽  
...  
Keyword(s):  
Septic Shock ◽  
Klebsiella Pneumoniae ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Primary Outcome ◽  
Bloodstream Infections ◽  
Microdilution Method ◽  
Broth Microdilution Method ◽  
Carbapenemase Gene ◽  
Comorbidity Index

Background: The increased frequency of bacteraemias caused by pandrug-resistant Klebsiella pneumoniae (PDR-Kp) has significant implications. The aim of the present study was to identify predictors associated with mortality of PDR-Kp bacteraemias. Methods: Patients with monomicrobial bacteraemia due to PDR-Kp were included. K. pneumoniae was considered PDR if it showed resistance to all available groups of antibiotics. Primary outcome was 30-day mortality. Minimum inhibitory concentrations (MICs) of meropenem, tigecycline, fosfomycin, and ceftazidime/avibactam were determined by Etest, whereas for colistin, the broth microdilution method was applied. blaKPC, blaVIM, blaNDM, and blaOXA genes were detected by PCR. Results: Among 115 PDR-Kp bacteraemias, the majority of infections were primary bacteraemias (53; 46.1%), followed by catheter-related (35; 30.4%). All isolates were resistant to tested antimicrobials. blaKPC was the most prevalent carbapenemase gene (98 isolates; 85.2%). Thirty-day mortality was 39.1%; among 51 patients with septic shock, 30-day mortality was 54.9%. Multivariate analysis identified the development of septic shock, Charlson comorbidity index, and bacteraemia other than primary or catheter-related as independent predictors of mortality, while a combination of at least three antimicrobials was identified as an independent predictor of survival. Conclusions: Mortality of PDR-Kp bloodstream infections was high. Administration of at least three antimicrobials might be beneficial for infections in critically ill patients caused by such pathogens.

Glucocorticoid Sensitivity Is Highly Variable in Critically Ill Patients With Septic Shock and Is Associated With Disease Severity*

2016 ◽  
Vol 44 (6) ◽  
pp. 1034-1041 ◽  
Author(s):  
Jeremy Cohen ◽  
Carel J. Pretorius ◽  
Jacobus P. J. Ungerer ◽  
John Cardinal ◽  
Antje Blumenthal ◽  
...  
Keyword(s):  
Septic Shock ◽  
Disease Severity ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Glucocorticoid Sensitivity

scholarly journals Do Aspirin and Other Antiplatelet Drugs Reduce the Mortality in Critically Ill Patients?

Thrombosis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Wolfgang Lösche ◽  
Janina Boettel ◽  
Björn Kabisch ◽  
Johannes Winning ◽  
Ralf A. Claus ◽  
...  
Keyword(s):  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Therapeutic Option ◽  
Bleeding Risk ◽  
Antiplatelet Drugs ◽  
Beneficial Effects ◽  
Prospective Trials ◽  
High Bleeding Risk

Platelet activation has been implicated in microvascular thrombosis and organ failure in critically ill patients. In the first part the present paper summarises important data on the role of platelets in systemic inflammation and sepsis as well as on the beneficial effects of antiplatelet drugs in animal models of sepsis. In the second part the data of retrospective and prospective observational clinical studies on the effect of aspirin and other antiplatelet drugs in critically ill patients are reviewed. All of these studies have shown that aspirin and other antiplatelet drugs may reduce organ failure and mortality in these patients, even in case of high bleeding risk. From the data reviewed here interventional prospective trials are needed to test whether aspirin and other antiplatelet drugs might offer a novel therapeutic option to prevent organ failure in critically ill patients.

Evaluation of plasma levels of meropenem in septic patients during extracorporeal blood purification

2021 ◽  
Vol 20 (4) ◽  
pp. 81-94
Author(s):  
Artem V. Marukhov ◽  
Elena V. Murzina ◽  
Mikhail V. Zakharov ◽  
Genrikh A. Sofronov ◽  
Lyudmila V. Buryakova ◽  
...  
Keyword(s):  
Septic Shock ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Selective Adsorption ◽  
Plasma Concentrations ◽  
Blood Purification ◽  
Continuous Hemodiafiltration ◽  
Extracorporeal Blood ◽  
Extracorporeal Blood Purification ◽  
Extracorporeal Support

The relevance. Meropenem is a broad-spectrum carbapenem antibiotic widely used to treat patients with sepsis / septic shock. Critically ill patients are usually supported with one of the forms extracorporeal blood purification. However, data on the effect of various extracorporeal support techniques on the pharmacokinetics and pharmacodynamics of meropenem are insufficient or contradictory. Aim: To evaluate the effectiveness of meropenem dosage regimens in the treatment of septic patients during extracorporeal blood purification. Materials and methods. Plasma concentrations of meropenem were monitored in three critically ill patients with sepsis or septic shock. Patients were treated using various extracorporeal support techniques. Meropenem was used as empirical antibacterial mono- or complex therapy (1 g every 8 or 12 hours). Meropenem concentrations in plasma were determined by validated assay methods on Acquity ultraefficient liquid chromatography (UPLC) H-Class system. Results. It is shown that the meropenem plasma concentration in critically ill patients changes significantly. It was found that the standard meropenem dosing regimens in patients with sepsis / septic shock during continuous hemodiafiltration do not ensure the achievement of the PK/PD target of 100% TMIC for sensitive strains (MIC2 mg/L) and for intermediate resistance pathogens (2MIC8 mg/L). Continuous hemofiltration and selective adsorption of lipopolysaccharide have a less pronounced effect on the clearance of meropenem. Conclusion. To increase the effectiveness of antibacterial therapy, it is necessary to conduct research aimed at developing protocols for dosing antibacterial drugs for the treatment of sepsis during extracorporeal blood purification.

Metabolic encephalopathy in critically ill patients suffering from septic or nonseptic multiple organ failure

2000 ◽  
Vol 28 (5) ◽  
pp. 1310-1315 ◽  
Author(s):  
Christian Zauner ◽  
Alexandra Gendo ◽  
Ludwig Kramer ◽  
Alexander Kranz ◽  
Georg Grimm ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Metabolic Encephalopathy
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