Ubiquitous protective effects of cyclosporine A in preventing cardiac arrest-induced multiple organ failure

2014 ◽  
Vol 117 (8) ◽  
pp. 930-936 ◽  
Author(s):  
Martin Cour ◽  
Maryline Abrial ◽  
Vincent Jahandiez ◽  
Joseph Loufouat ◽  
Elise Belaïdi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Brain Damage ◽  
Cyclosporine A ◽  
Myocardial Dysfunction ◽  
Permeability Transition ◽  
Multiple Organ ◽  
Term Survival ◽  
Kidney Liver

Opening of the mitochondrial permeability transition pore (mPTP) appears to be a pivotal event in myocardial ischemia-reperfusion (I/R) injury. Resuscitated cardiac arrest (CA) leads to the post-CA syndrome that encompasses, not only myocardial dysfunction, but also brain injury, failure of other organs (kidney, liver, or lung), and systemic response to I/R. We aimed to determine whether cyclosporine A (CsA) might prevent multiple organ failure following CA through a ubiquitous mPTP inhibition in each distant vital organ. Anesthetized New Zealand White rabbits were subjected to 15 min of CA and 120 min of reperfusion. At the onset of resuscitation, the rabbits received CsA, its non-immunosuppressive derivative NIM811, or vehicle (controls). Survival, hemodynamics, brain damage, organ injuries, and systemic I/R response were analyzed. Fresh mitochondria were isolated from the brain, heart, kidney, liver, and lung to assess both oxidative phosphorylation and permeability transition. CsA analogs significantly improved short-term survival and prevented multiple organ failure, including brain damage and myocardial dysfunction ( P < 0.05 vs. controls). Susceptibility of mPTP opening was significantly increased in heart, brain, kidney, and liver mitochondria isolated from controls, while mitochondrial respiration was impaired ( P < 0.05 vs. sham). CsA analogs prevented these mitochondrial dysfunctions ( P < 0.05 vs. controls). These results suggest that CsA and NIM811 can prevent the post-CA syndrome through a ubiquitous mitochondrial protective effect at the level of each major distant organ.

scholarly journals Blood platelets in the development of sepsis, septic shock and multiple organ failure syndrome

2021 ◽  
Vol 22 (6) ◽  
pp. 1085-1096 ◽  
Author(s):  
N. B. Serebryanaya ◽  
P. P. Yakutseni
Keyword(s):  
Septic Shock ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Myocardial Dysfunction ◽  
Blood Platelets ◽  
Clinical Manifestations ◽  
Multiple Organ ◽  
Patient Death ◽  
Platelet Counts

Participation of blood platelets in the development of sepsis is clearly illustrated by hemocoagulation disorders and frequently observed thrombocytopenia. In the patients with sepsis, thrombocytopenia develops rapidly, with minimal platelet counts registered on the fourth day of observation, after which the platelet counts usually rise. Continuous thrombocytopenia and absence of a relative increase in platelets are considered predictors of patient death. The mechanisms of thrombocytopenia developing in sepsis are quite diverse, but the processes in periphery are prevailing, e.g., the so-called “platelet consumption” which is determined by their activation, chemotaxis and isolation in the microvasculature. Recently, a mechanism has been identified for the accelerated removal of platelets with desialized surface glycoproteins from the circulation. Sialidases, also known as neuraminidases, are widely present in viruses and bacteria, and pharmacological inhibition of sialidases is able to withstand thrombocytopenia in the infectious process. The key role of platelets in the development of septic shock was revealed. Sequestration of platelets in the microvessels of the lungs and brain (manifesting as thrombocytopenia) is accompanied by rapid serotonin release, thus underlying the main clinical manifestations, e.g., decreased blood pressure, heart rate and increased capillary permeability. To counteract sharp release of this mediator, pharmacological attempts are made to inhibit the SERT transporter by means of selective serotonin reuptake inhibitors. Blood platelets are key participants in the pathogenesis of multiple organ failure syndromes, such as acute renal damage, acute respiratory distress syndrome, myocardial dysfunction, and sepsis-associated encephalopathy. To restore impaired vascular permeability in these conditions, in particular, sepsis-associated encephalopathy, a pharmacological S1P receptor mimetic is under study. The review specifies possible pathogenetically significant targets that can be used to perform pharmacological correction of conditions associated with sepsis and concomitant thrombocytopenia.

COAGULOPATHY AND MULTIPLE ORGAN FAILURE AFTER TRAUMATIC EXSANGUINATION CARDIAC ARREST (CA) OF 60 MIN IN DOGS

2002 ◽  
Vol 30 (Supplement) ◽  
pp. A120 ◽  
Author(s):  
A Nozari ◽  
F Bontempo ◽  
P Safar ◽  
X Wu ◽  
S W Stezoski ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ

scholarly journals Long-term survival of chronic dialysis patients following survival from an episode of multiple-organ failure

Critical Care ◽  
2009 ◽  
Vol 13 (3) ◽  
pp. R65 ◽  
Author(s):  
Richard J Chapman ◽  
Maie Templeton ◽  
Simon Ashworth ◽  
Robert Broomhead ◽  
Adam McLean ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
Chronic Dialysis ◽  
Dialysis Patients ◽  
Term Survival ◽  
Long Term Survival

scholarly journals On-the-Scene Hyaluronan and Syndecan-1 Serum Concentrations and Outcome after Cardiac Arrest and Resuscitation

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
V. Bogner-Flatz ◽  
M. Braunstein ◽  
L. E. Ocker ◽  
T. Kusmenkov ◽  
J. Tschoep ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Ischemia Reperfusion ◽  
Serum Markers ◽  
Multiple Organ ◽  
Endothelial Glycocalyx ◽  
Whole Body ◽  
Serum Samples ◽  
Inflammatory Reactions

Background. It is not predictable which patients will develop a severe inflammatory response after successful cardiopulmonary resuscitation (CPR), also known as “postcardiac arrest syndrome.” This pathology affects only a subgroup of cardiac arrest victims. Whole body ischemia/reperfusion and prolonged shock states after return of spontaneous circulation (ROSC) may both contribute to this devastating condition. The vascular endothelium with its glycocalyx is especially susceptible to initial ischemic damage and may play a detrimental role in the initiation of postischemic inflammatory reactions. It is not known to date if an immediate early damage to the endothelial glycocalyx, detected by on-the-scene blood sampling and measurement of soluble components (hyaluronan and syndecan-1), precedes and predicts multiple organ failure (MOF) and survival after ROSC. Methods. 15 patients after prehospital resuscitation were included in the study. Serum samples were collected on the scene immediately after ROSC and after 6 h, 12 h, 24 h, and 48 h. Hyaluronan and syndecan-1 were measured by ELISA. We associated the development of multiple organ failure and 30-day survival rates with these serum markers of early glycocalyx damage. Results. Immediate serum hyaluronan concentrations show significant differences depending on 30-day survival. Further, the hyaluronan level is significantly higher in patients developing MOF during the initial and intermediate resuscitation period. Also, the syndecan-1 levels are significantly different according to MOF occurrence. Conclusion. Serum markers of glycocalyx shedding taken immediately on the scene after ROSC can predict the occurrence of multiple organ failure and adverse clinical outcome in patients after cardiac arrest.

scholarly journals Multiple organ failure after trauma affects even long-term survival and functional status

Critical Care ◽  
2007 ◽  
Vol 11 (5) ◽  
pp. R95 ◽  
Author(s):  
Atle Ulvik ◽  
Reidar Kvåle ◽  
Tore Wentzel-Larsen ◽  
Hans Flaatten
Keyword(s):  
Multiple Organ Failure ◽  
Functional Status ◽  
Organ Failure ◽  
Multiple Organ ◽  
Term Survival ◽  
Long Term Survival

Multiple organ failure after spontaneous return of circulation in cardiac arrest in children

2017 ◽  
Vol 87 (1) ◽  
pp. 34-41
Author(s):  
Tania Carbayo ◽  
Alba de la Mata ◽  
Marina Sánchez ◽  
Jesús López-Herce ◽  
Jimena del Castillo ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ

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.

Sign in / Sign up

Export Citation Format

Share Document