scholarly journals Cytokines in Sepsis: Potent Immunoregulators and Potential Therapeutic Targets—An Updated View

2013 ◽  
Vol 2013 ◽  
pp. 1-16 ◽  
Author(s):  
Wibke Schulte ◽  
Jürgen Bernhagen ◽  
Richard Bucala
Keyword(s):  
Septic Shock ◽  
Immune Response ◽  
Intensive Care ◽  
Defense Mechanisms ◽  
Causes Of Death ◽  
Current Knowledge ◽  
The Other ◽  
Anti Inflammatory ◽  
Pleiotropic Regulators ◽  
Sepsis And Septic Shock

Sepsis and septic shock are among the leading causes of death in intensive care units worldwide. Numerous studies on their pathophysiology have revealed an imbalance in the inflammatory network leading to tissue damage, organ failure, and ultimately, death. Cytokines are important pleiotropic regulators of the immune response, which have a crucial role in the complex pathophysiology underlying sepsis. They have both pro- and anti-inflammatory functions and are capable of coordinating effective defense mechanisms against invading pathogens. On the other hand, cytokines may dysregulate the immune response and promote tissue-damaging inflammation. In this review, we address the current knowledge of the actions of pro- and anti-inflammatory cytokines in sepsis pathophysiology as well as how these cytokines and other important immunomodulating agents may be therapeutically targeted to improve the clinical outcome of sepsis.

scholarly journals EFFECT OF EXTRACORPORAL HEMOSORPTION ON ELIMINATION OF ANTIBACTERIAL DRUGS IN SEPSIS

2021 ◽  
Vol 19 (1) ◽  
pp. 10-15
Author(s):  
R. E. Yakubtsevich ◽  
◽  
N. V. Belyavsky ◽  
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
Adverse Effects ◽  
Blood Plasma ◽  
Intensive Care Units ◽  
Causes Of Death ◽  
Significant Proportion ◽  
Antibacterial Drugs ◽  
Sepsis Therapy ◽  
Sepsis And Septic Shock

Background. Sepsis and septic shock make a significant proportion of the causes of death in intensive care units. Hemosorption in combination with standard sepsis therapy reduces mortality by an average of 5-7% and significantly lowers the need for vasopressor support. Purpose of the study. Our aim is to investigate the data available about the effect of hemosorption on the dynamics of antibiotic levels in the blood plasma of patients. Material and methods. The results of more than 20 studies of the efficacy of various hemosorbents in the treatment of sepsis were analyzed. Results. Data on the significant effect of CytoSorb and Toraymyxin B sorbents on the pharmacokinetics of a number of antibiotics have been obtained. There are no data on the Belarusian sorbents Proteasosorb and LPS-hemo. Conclusions. The degree of elimination of antibacterial drugs during hemosorption depends on the specific characteristics of each sorbent. All potential adverse effects need to be carefully studied to maximize the use of hemosorption in the treatment of sepsis.

scholarly journals Rho-Proteins and Downstream Pathways as Potential Targets in Sepsis and Septic Shock: What Have We Learned from Basic Research

Cells ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1844
Author(s):  
Maria Luísa da Silveira Hahmeyer ◽  
José Eduardo da Silva-Santos
Keyword(s):  
Septic Shock ◽  
Actin Polymerization ◽  
Current Knowledge ◽  
Cecal Ligation ◽  
Experimental Models ◽  
Rho Proteins ◽  
Growing Cell ◽  
Sepsis And Septic Shock

Sepsis and septic shock are associated with acute and sustained impairment in the function of the cardiovascular system, kidneys, lungs, liver, and brain, among others. Despite the significant advances in prevention and treatment, sepsis and septic shock sepsis remain global health problems with elevated mortality rates. Rho proteins can interact with a considerable number of targets, directly affecting cellular contractility, actin filament assembly and growing, cell motility and migration, cytoskeleton rearrangement, and actin polymerization, physiological functions that are intensively impaired during inflammatory conditions, such as the one that occurs in sepsis. In the last few decades, Rho proteins and their downstream pathways have been investigated in sepsis-associated experimental models. The most frequently used experimental design included the exposure to bacterial lipopolysaccharide (LPS), in both in vitro and in vivo approaches, but experiments using the cecal ligation and puncture (CLP) model of sepsis have also been performed. The findings described in this review indicate that Rho proteins, mainly RhoA and Rac1, are associated with the development of crucial sepsis-associated dysfunction in different systems and cells, including the endothelium, vessels, and heart. Notably, the data found in the literature suggest that either the inhibition or activation of Rho proteins and associated pathways might be desirable in sepsis and septic shock, accordingly with the cellular system evaluated. This review included the main findings, relevance, and limitations of the current knowledge connecting Rho proteins and sepsis-associated experimental models.

scholarly journals Use of Gentamicin for Sepsis and Septic Shock in Anaesthesia-Intensive Care Unit: A Clinical Practice Evaluation

2020 ◽  
Vol 48 (5) ◽  
pp. 399-405
Author(s):  
Cyril Pernod ◽  
◽  
Antoine Lamblin ◽  
Andrei Cividjian ◽  
Patrick Gerome ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Clinical Practice ◽  
Sepsis And Septic Shock

scholarly journals Is Presepsin a Reliable Marker of Sepsis Diagnosis in Pediatric Intensive Care Unit?

2020 ◽  
Vol 8 (B) ◽  
pp. 66-70
Author(s):  
Hebat-Allah Algebaly ◽  
Hala M. Fouad ◽  
Maha M. Elkholy ◽  
Sally K. Ibrahim ◽  
Nermin M. Riad
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Consensus Conference ◽  
University Teaching ◽  
Control Group ◽  
Healthy Children ◽  
International Consensus ◽  
Critical Patients ◽  
Sepsis And Septic Shock

BACKGROUND: Sepsis is a major challenge in emergency departments and intensive care units (ICUs). Sepsis also mimics or interacts with many other disorders causing high mortality and morbidity. There is no accurate biomarker or test to diagnose or predict sepsis. The treatment of sepsis is often based on the clinician’s experience. AIM: We conducted this study to analyze the serum level of presepsin in pediatric critical patients with SIRS, sepsis, severe sepsis, and septic shock. METHODS: The study included 58 children, 32 septic pediatric patients admitted to the Pediatric ICU (PICU) of Cairo University Teaching Hospital and 26 healthy children who served as a control group. The aim was to estimate the diagnostic accuracy of presepsin in predicting sepsis in PICU. We classified the patients into systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock according to the international consensus conference criteria. RESULTS: In our study, we detected a positive correlation between C-reactive protein and presepsin levels at day 1 and day 3 of admission and a negative correlation between hemoglobin and presepsin levels at day 1. However, we found no difference in the serum presepsin between the children who had sepsis and the healthy ones (at day 1 [p = 0.430) and at day 3 [p = 0.845]). We also found that serum levels of presepsin were not significantly increased with the increasing severity of sepsis despite the higher median values with increasing sepsis severity. CONCLUSIONS: It was noted that presepsin levels increased in anemic critical patients, whereas presepsin had no role in differentiating the septic critical patients from healthy children. However, its level increased with increasing severity of sepsis grade.

Anti-inflammatory therapies in sepsis and septic shock

2000 ◽  
Vol 9 (7) ◽  
pp. 1651-1663 ◽  
Author(s):  
Bradley D Freeman ◽  
Charles Natanson
Keyword(s):  
Septic Shock ◽  
Anti Inflammatory ◽  
Sepsis And Septic Shock

Diagnostic Validity of Ratio between Differences of Central Venous to Arterial CO2 and Arterial to Central Venous O2 Content in Diagnosis of Anaerobic Metabolism among Septic Patients

2021 ◽  
Vol 8 (1) ◽  
pp. 34-38
Author(s):  
Subroto Kumar Sarker ◽  
Umme Kulsum Choudhury ◽  
Mohammad Mohsin ◽  
Subrata Kumar Mondal ◽  
Muslema Begum
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Anaerobic Metabolism ◽  
Venous Blood ◽  
Blood Gases ◽  
Serum Lactate ◽  
Central Venous ◽  
College Hospital ◽  
Sepsis And Septic Shock

Background: Detection of anaerobic metabolism is very crucial for the management of the septic patients. Objective: The purpose of the present study was to validate the ratio between differences of central venous to arterial CO2 and arterial to central venous O2 content in diagnosis of anaerobic metabolism among septic patients. Methodology: This prospective observational study was conducted in the Intensive Care Unit of the department of Anaesthesia Analgesia, Palliative and Intensive Care Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2016 to December 2016. All patients admitted to ICU with the features of severe sepsis and septic shock according to SSC guidelines with the age of more than or equal to 18 years in both sexes were included in this study. The arterial and central venous blood gases were measure simultaneously. At the same time serum lactate was measured. Result: Among the 69 patients, 31(44.9%) were of severe sepsis and 38(55%) were of septic shock patients. In the severe sepsis and septic shock patients the mean P(v-a)CO2/C(a-v)O2 is 1.39±0.41 and 1.11±0.40 respectively. Serum lactate in case of severe sepsis and septic shock patients is 2.85±1.40 and 3.85±1.04 respectively. The ROC analysis showed an area under curve 0.89 and P(v-a)CO2/C(a-v)O2 ratio cutoff value of 1.21 showed sensitivity 0.84 and specificity 0.94. Conclusion: The P(v-a)CO2/C(a-v)O2  ratio is also a another marker of global anaerobic metabolism and it would be used for diagnosis as well as management of septic patient.  Journal of Current and Advance Medical Research, January 2021;8(1):34-38

Sepsis

2020 ◽  
Author(s):  
Steven P LaRosa ◽  
Steven M. Opal
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Organ Dysfunction ◽  
Fluid Resuscitation ◽  
Multiorgan Failure ◽  
Sepsis Management ◽  
The Past ◽  
Sepsis And Septic Shock

Sepsis, along with the multiorgan failure that often accompanies this condition, is a leading cause of mortality in the intensive care unit. Although modest improvements in the prognosis have been made over the past two decades and promising new therapies continue to be investigated, innovations in the management of septic shock are still required. This chapter discusses the definitions, epidemiology, and pathogenesis (including microbial factors, host-derived mediators, and organ dysfunction) relating to sepsis. Management of severe sepsis and septic shock is also described.  This review contains 5 figures, 11 tables, and 99 references. Keywords:Organ dysfunction, sepsis, septic shock, infection, bacteremia, fluid resuscitation, vasopressor

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