Septic Patients in Multiple Organ Failure Can Oxidize Infused Glucose, but Non-Oxidative Disposal (Storage) is Impaired

1995 ◽  
Vol 89 (6) ◽  
pp. 601-609 ◽  
Author(s):  
Ceri J. Green ◽  
I. T. Campbell ◽  
Ellen O'sullivan ◽  
S. Underhill ◽  
D. P. M. McLaren ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Glucose Oxidation ◽  
Glucose Utilization ◽  
Respiratory Exchange Ratio ◽  
Multiple Organ ◽  
Insulin Resistant ◽  
Control Subjects ◽  
Specific Time Point ◽  
Time Point

1. Patients suffering trauma and sepsis are insulin resistant, but no studies have specifically been made of patients suffering multiple organ failure. 2. We have studied exogenous glucose utilization in multiple organ failure using a combination of the hyperglycaemic glucose clamp and indirect calorimetry to quantify glucose utilization in multiple organ failure, partitioning it into oxidative and non-oxidative disposal (storage). 3. Fourteen septic patients with multiple organ failure were studied. APACHE II (Acute Physiological and Chronic Health Evaluation Mark II) scores on the day of the study ranged from 11 to 31 (median 16). Twenty percent d-glucose was infused and blood glucose was clamped at 12 mmol/l for 3 h. The results were compared with those obtained on seven healthy control subjects. 4. Glucose utilization and energy expenditure were similar in the two groups for the first 90 min of the clamp, after which glucose utilization and energy expenditure increased steadily in the control subjects but did not change in the patients. Respiratory exchange ratio rose in both groups; considered over the whole of the clamp period, respiratory exchange ratio was slightly lower in the patients than in the control subjects (P < 0.05) but not at any specific time point. Glucose oxidation rose in both groups but non-oxidative glucose disposal (storage) rose only in the control subjects. Glucose oxidation was slightly lower in the patients (P < 0.05) but not at any specific time point and there was no difference between the groups in the amount by which glucose oxidation increased. Non-oxidative disposal in the patients fell significantly (P < 0.01) over the course of the clamp and was significantly lower than in the control subjects (P < 0.01) 5. Growth hormone increased in response to glucose infusion in the patients but not in the control subjects. 6. Like patients suffering uncomplicated sepsis or trauma, patients with multiple organ failure are also insulin resistant. The defect appears to lie in an impairment of the ability to store glucose rather than oxidize it, and this may be due in part to the increase in growth hormone in patients with multiple organ failure.

Increased Whole Body Protein Breakdown Predominates over Increased Whole Body Protein Synthesis in Multiple Organ Failure

1993 ◽  
Vol 84 (6) ◽  
pp. 655-661 ◽  
Author(s):  
J. Arnold ◽  
I. T. Campbell ◽  
Therese A. Samuels ◽  
J. C. Devlin ◽  
Ceri J. Green ◽  
...  
Keyword(s):  
Protein Synthesis ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Protein Turnover ◽  
Multiple Organ ◽  
Whole Body ◽  
Protein Breakdown ◽  
Body Protein ◽  
Control Subjects ◽  
Healthy Control

1. Whole body protein turnover was measured using a primed-constant infusion of L-[1−13C]leucine with measurement of breath 13CO2 production and plasma 13C α-ketoisocaproate enrichment. Ten fasting patients, requiring mechanical ventilation and suffering from multiple organ failure, and six healthy control subjects were studied. 2. Protein breakdown and leucine removal from the plasma for protein synthesis were significantly higher in the patients than in the control subjects (P <0.01). In addition, leucine oxidation was almost 75% higher in the patients than in the healthy control subjects (P <0.05). 3. Plasma concentrations of glucose, insulin and growth hormone were not different between the two groups, but those of glucagon (not significant), noradrenaline (P <0.05) and cortisol (P <0.01) were almost two- and three-fold higher in the patients than in the control subjects. 4. Mean energy expenditure, measured by indirect calorimetry, was 30% higher in the patients than in the healthy control subjects (P <0.01). 5. Combining the data from both groups of subjects and using multiple regression analysis, cortisol was found to be the most significant predictor of (i) protein breakdown (48% of variance explained), (ii) leucine oxidation (69%) and (iii) hourly energy expenditure (54%). 6. The present investigation using [13C]leucine tracer methods demonstrated, in patients with multiple organ failure, that whole body protein breakdown and synthesis increased concomitantly and were twice as high as rates measured in healthy control subjects. Of the hormones measured in the present study, Cortisol appears to have the most significant effect on whole body protein turnover.

Clinical case of periostitis in pregnant women complicated by sepsis

2020 ◽  
pp. 61-63
Author(s):  
S. Sh. Kakvaeva ◽  
M. A. Magomedova ◽  
A. N. Dzhalilova
Keyword(s):  
Pregnant Woman ◽  
Multiple Organ Failure ◽  
Pregnant Women ◽  
Organ Failure ◽  
Clinical Case ◽  
Clinical Observation ◽  
Infectious Agent ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Number Of Patients

One of the most serious problems of modern medicine is sepsis. The number of patients undergoing this complication is 20–30 million (WHO) annually and has no tendency to decrease. Sepsis is characterized by severe multiple organ failure due to a violation of the response of the macroorganism to an infectious agent. Moreover, it is dangerous with high mortality. Sepsis often develops in patients with immunodeficiency conditions, which primarily include pregnant women. The article presents a clinical observation of a case of periostitis in a pregnant woman complicated by a septic state.

Failures of intensive treatment of multiple organ failure: pathophysiology and the need for personalization

2019 ◽  
pp. 48-57
Author(s):  
E.V. Grigoryev ◽  
◽  
D.L. Shukevich ◽  
G.P. Plotnikov ◽  
A.N. Kudryavtsev ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
Intensive Treatment

scholarly journals High-dose diquat poisoning: a case report

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110261
Author(s):  
Yanxia Huang ◽  
Renjing Zhang ◽  
Mei Meng ◽  
Dechang Chen ◽  
Yunxin Deng
Keyword(s):  
Renal Failure ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
High Dose ◽  
Severe Respiratory Failure ◽  
Aggressive Treatment ◽  
Lung Lesions ◽  
Pulmonary Lesions ◽  
New Treatment

Diquat is a widely used herbicide that is substituted for paraquat. With paraquat off the market, cases of diquat poisoning have been gradually increasing. The kidney is the most frequently impaired organ in diquat poisoning. Few cases of multiple organ failure caused by diquat have been reported. We herein describe a 30-year-old man who orally ingested about 160 mL of enriched diquat. Despite aggressive treatment, the patient’s condition progressed to multiple organ failure and death. The pulmonary lesions in this patient were different from those previously reported. This patient did not die of renal failure but of severe respiratory failure. He exhibited three different stages of pulmonary disease. The lung lesions in this case were unique. We hope that doctors will pay more attention to the lung lesions in patients with diquat poisoning in future and find new treatment methods to save the lives of such patients.

Endovascular treatment of an ilio-iliac arteriovenous fistula accompanied by venous thromboembolism presenting with multiple organ failure – A case report and literature review

Vascular ◽  
2021 ◽  
pp. 170853812199657
Author(s):  
Tiehao Wang ◽  
Jichun Zhao ◽  
Ding Yuan
Keyword(s):  
Multiple Organ Failure ◽  
Arteriovenous Fistula ◽  
Organ Failure ◽  
Iliac Artery ◽  
Vena Cava ◽  
Artery Aneurysm ◽  
Multiple Organ ◽  
High Rate ◽  
Type Ii ◽  
Type Ii Endoleak

Objectives Multiple organ failure is a rare manifestation of ilio-iliac arteriovenous fistula which can lead to a high rate of misdiagnosis and death. Methods We reported a 61-year-old man presenting with multiple organ failure rapidly after right lower limb swelling. Computed tomography angiography showed an ilio-iliac arteriovenous fistula caused by right common iliac artery aneurysm, and venous thrombosis of bilateral common iliac veins. A bifurcated stent-graft with coil embolization of right internal iliac artery was used for repair. Results The patient recovered rapidly and was discharged without complications. Although arteriovenous fistula persisted due to type II endoleak, aneurysm sac and inferior vena cava significantly shrunk at six months follow-up. Conclusions This report demonstrated that multiple organ failure may appear when the distal outflow tracts of arteriovenous fistula are obstructed. Moreover, endovascular repair is effective for reversal of multiple organ failure caused by arteriovenous fistula, even if arteriovenous fistula persists due to type II endoleak.

scholarly journals Post-COVID-19 Kawasaki-Like Syndrome

2021 ◽  
pp. 014556132110060
Author(s):  
Jérôme R. Lechien ◽  
Rémi Hervochon ◽  
Stéphane Hans
Keyword(s):  
Abdominal Pain ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Hepatitis A ◽  
Clinical Presentation ◽  
Multiple Organ ◽  
Mild Form ◽  
Severe Dysphagia ◽  
History Of ◽  
Inflammatory Syndrome

A 42-year-old man was referred for a week history of severe dysphagia, odynophagia, fever (39 °C), fatigue, abdominal pain, pharyngeal swelling, and multiple neck lymphadenopathies. The medical history reported a mild form of COVID-19 one month ago. The biology reported an unspecified inflammatory syndrome. The patient developed peritonitis, myocarditis, and hepatitis. A myocardium biopsy was performed. A diagnosis of Kawasaki-like disease (KLD) was performed. The occurrence of KLD in adults is rare but has to be known by otolaryngologists regarding the otolaryngological clinical presentation that may precede the multiple organ failure.

Epidemiology of post-injury multiple organ failure in an Australian trauma system

2009 ◽  
Vol 79 (6) ◽  
pp. 431-436 ◽  
Author(s):  
David C. Dewar ◽  
Peter Mackay ◽  
Zsolt Balogh
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Trauma System ◽  
Multiple Organ ◽  
Post Injury
Sign in / Sign up

Export Citation Format

Share Document