Treatment of anaerobic phlegmon of the upper extremity induced by Clostridium perfringens via application of an oxygenated pharmaceutical

At the present time, cases of gas infection are extremely rarely encountered. The incidence of anaerobic gas infection totals 0.1-1.0 cases in 1,000,000 of the population per year. The clinical case presented describes peculiarities in clinical progression of the disease, of its surgical and complex treatment. The dynamics of multiple organ dysfunction markers has been shown. On admission, the predicted lethal outcome rate totalled 66.7% to 82%. The treatment included local and peroral application of an oxygenated pharmaceutical. Tissue oximetry revealed elevation of blood oxygen saturation 30 and 60 minutes after the oxygenated pharmaceutical intake. The surgical tactics employed and the pathogenetic therapy combined with local and peroral application of the oxygenated pharmaceutical made it possible to achieve a positive treatment outcome

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Snoring: The Case for Molecular Tissue Oximetry

10.20944/preprints201903.0087.v1 ◽

2019 ◽

Author(s):

Guy M. Hatch ◽

Liza Ashbrook ◽

Aric A. Prather ◽

Andrew D. Krystal

Keyword(s):

Oxygen Saturation ◽

Pulse Oximetry ◽

Sleep Disturbance ◽

Oxygen Supply ◽

Blood Oxygen ◽

Blood Oxygen Saturation ◽

Primary Snoring ◽

Arterial Blood ◽

Obstructive Sleep ◽

Tissue Oximetry

Snoring gets no respect.  It also gets little to no medical therapy.  Why is this?  How can something that is clearly pathological based on epidemiologic research not be diagnosed and treated with effective therapy?  The problem is the lack of a credible, objective index of pathology during snoring.  Pulse oximetry detects drops in arterial blood oxygen saturation (SpO2) associated with obstructive sleep apnea and hypopnea events in polysomnographic (PSG) testing.  When no desaturation is present, evidence of sleep disturbance is required to indicate the presence of pathology.  However, obstruction at the mild end of the continuum of sleep disordered breathing (SDB) can occur without producing a drop in SpO2 or sleep disturbance; in which case it is referred to as ‘primary snoring.’ Although statistically associated with co-morbidities of SDB, without there being a drop in SpO2 or sleep disturbance, primary snoring is not thought to be pathologic enough to warrant diagnosis or treatment.  One promising means of detecting the pathological processes associated with primary snoring is molecular tissue oximetry, which detects skin tissue oxygen need, vs. oxygen supply.   In cases of hypoxic challenge, regulatory mechanisms restrict blood flow to the skin to preferentially maintain blood oxygen supply to more vital organs.  As a result, molecular tissue oximetry of the skin is a more sensitive measure of inadequate breathing than pulse oximetry measuring blood oxygen saturation.  In this article we review molecular tissue oximetry technology and methodology and make the case that it is a promising tool for identifying pathology occurring in association with primary snoring.

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Prevention and treatment of progressive multiple organ disfunction in acute pancreatitis

Acta chirurgica iugoslavica ◽

10.2298/aci0302114b ◽

2003 ◽

Vol 50 (2) ◽

pp. 115-125 ◽

Cited By ~ 1

Author(s):

Vladimir Bumbasirevic ◽

Miroslav Milicevic ◽

V. Bukumirovic ◽

Vitomir Rankovic ◽

A. Pavlovic ◽

...

Keyword(s):

Acute Pancreatitis ◽

Organ Dysfunction ◽

Multiple Organ Dysfunction Syndrome ◽

Multiple Organ ◽

Multiple Organ Dysfunction ◽

Lethal Outcome ◽

Treatment Protocols ◽

Course Of Illness ◽

Improve Outcome ◽

Prevention And Treatment

Acute pancreatitis is illness with unpredictable outcome. In some patients course of illness is progressive and leading to multiple organ dysfunction syndrome often resulting with lethal outcome. During last decade the treatment protocols have changed. Basic patophysiologic mechanisms leading to progression of the illness, as well as, contemporary diagnostic and treatment possibilities that can prevent occurrence of severe consequences and improve outcome are presented.

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New System For Predicting The Outcome Of Secondary Peritonitis

Russian Open Medical Journal ◽

10.15275/rusomj.2021.0315 ◽

2021 ◽

Vol 10 (3) ◽

Author(s):

Nikolay V. Lebedev ◽

Sariya B. Agrba ◽

Vasily S. Popov ◽

Alexey E. Klimov ◽

Giorgy T. Svanadze

Keyword(s):

Statistical Analysis ◽

Abdominal Sepsis ◽

Multiple Organ ◽

Secondary Peritonitis ◽

Apache Ii ◽

Diffuse Peritonitis ◽

Multiple Organ Dysfunction ◽

Toxic Shock ◽

Lethal Outcome ◽

New System

Despite improvements in the methods of diagnostics, surgical interventions and intensive care, the problem of treating patients with diffuse peritonitis remains relevant. Diffuse peritonitis is a major contributor to mortality in all urgent care settings and the second leading cause of sepsis in critically ill patients. At the same time, even in developed countries, the number of patients with peritonitis does not tend to decrease, and mortality rates remain high, reaching 90-93% with the development of abdominal sepsis and toxic shock syndrome. One of the ways to reduce mortality in peritonitis is the use of objective systems for prognosis of the peritonitis outcome, allowing to compare the results of patient treatment and to choose the optimal treatment tactics for each particular patient. The objective — To develop a new system for predicting the outcome of secondary peritonitis (survival or death) focused on the criteria of abdominal sepsis and multiple organ dysfunction syndrome (associated or not associated with peritonitis), and to analyze its accuracy versus the most common comparable systems. Material and Methods — Our study was based on analyzing the treatment outcomes in 352 patients with secondary diffuse peritonitis. On admission, sepsis was diagnosed in 15 (4.3%), and toxic shock in 4 (1.1%) patients. The main causes of death were purulent intoxication and/or sepsis (51 cases or 87.9%), cancer intoxication (4 cases or 6.9%), and acute cardiac failure (3 cases or 5.2%). We analyzed the effectiveness of several systems of predicting the peritonitis outcomes: the Mannheim’s Peritoneal Index (MPI), World Society for Emergency Surgery Sepsis Severity Score (WSES SSS), Acute Physiology and Chronic Health Evaluation II (APACHE II) system, general Sequential Organ Failure Assessment Score (gSOFA), as well as the Peritonitis Prognosis System (PPS) developed by the authors. The probability of the effect of 40 clinical and laboratory parameters on the outcome of patients with secondary peritonitis was analyzed via using parametric and nonparametric methods of statistical analysis (Fisher’s test, Mann-Whitney U test, Chi-squared test with Yates’s continuity correction). The criteria were selected that had a predictive power for the lethal outcome (p <0.05), and they were included in the PPS system. To compare the predictive value of the PPS, ROC analysis was conducted with construction of receiver operating characteristic curves for each analyzed system of predicting the peritonitis outcome. The STATISTICA 8 software was used for performing the statistical analysis. Results — The following criteria were of greatest importance in predicting the lethal outcome: a patient’s age, a presence of a malignant neoplasm, a nature of the exudate, the development of sepsis (toxic shock), as well as multiple organ dysfunction not associated with the developed peritonitis. PPS exhibited the greatest accuracy in terms of predicting mortality in patients with secondary diffuse peritonitis (AUC=0.942) versus minimal in APACHE II (AUC=0.840). Conclusion — APACHE II, MPI, WSES SSS and PPS can be considered reliable in terms of mortality prognosis in peritonitis patients. PPS has the greatest accuracy of predicting the mortality in patients with secondary diffuse peritonitis (94%).

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Disseminated intravascular coagulation in meningococcal sepsis

Hämostaseologie ◽

10.1055/s-0037-1619581 ◽

2003 ◽

Vol 23 (03) ◽

pp. 125-130 ◽

Cited By ~ 2

Author(s):

S. Zeerleder ◽

R. Zürcher Zenklusen ◽

C. E. Hack ◽

W. A. Wuillemin

Keyword(s):

Organ Dysfunction ◽

Disseminated Intravascular Coagulation ◽

Skin Necrosis ◽

Multiple Organ ◽

Meningococcal Sepsis ◽

Multiple Organ Dysfunction ◽

Intravascular Coagulation ◽

Therapeutic Concepts ◽

New Therapeutic Concepts ◽

Coagulation And Fibrinolysis

SummaryWe report on a man (age: 49 years), who died from severe meningococcal sepsis with disseminated intravascular coagulation (DIC), multiple organ dysfunction syndrome and extended skin necrosis. We discuss in detail the pathophysiology of the activation of coagulation and fibrinolysis during sepsis. The article discusses new therapeutic concepts in the treatment of disseminated intravascular coagulation in meningococcal sepsis, too.

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Multiple Organ Dysfunction Syndrome of Alcoholic Origin in an 18-Year-Old Patient

The International Annals of Medicine ◽

10.24087/iam.2018.2.12.712 ◽

2018 ◽

Vol 2 (12) ◽

Author(s):

Francesco Gazia ◽

Giacomo De Luca ◽

Imbalzano Gabriele ◽

Vincenzo Pellicanò

Keyword(s):

Organ Dysfunction ◽

Multiple Organ Dysfunction Syndrome ◽

Multiple Organ ◽

Multiple Organ Dysfunction

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IMPACT probability of poor outcome and plasma cytokine concentrations are associated with multiple organ dysfunction syndrome following traumatic brain injury

Journal of Neurosurgery ◽

10.3171/2018.8.jns18676 ◽

2019 ◽

Vol 131 (6) ◽

pp. 1931-1937 ◽

Cited By ~ 2

Author(s):

Sungho Lee ◽

Hyunsoo Hwang ◽

Jose-Miguel Yamal ◽

J. Clay Goodman ◽

Imoigele P. Aisiku ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Organ Dysfunction ◽

Multiple Organ Dysfunction Syndrome ◽

Sofa Score ◽

Plasma Concentrations ◽

Multiple Organ ◽

Multiple Organ Dysfunction ◽

Poor Outcome ◽

Initial Plasma

OBJECTIVETraumatic brain injury (TBI) is a major cause of morbidity and mortality. Multiple organ dysfunction syndrome (MODS) occurs frequently after TBI and independently worsens outcome. The present study aimed to identify potential admission characteristics associated with post-TBI MODS.METHODSThe authors performed a secondary analysis of a recent randomized clinical trial studying the effects of erythropoietin and blood transfusion threshold on neurological recovery after TBI. Admission clinical, demographic, laboratory, and imaging parameters were used in a multivariable Cox regression analysis to identify independent risk factors for MODS following TBI, defined as maximum total Sequential Organ Failure Assessment (SOFA) score > 7 within 10 days of TBI.RESULTSTwo hundred patients were initially recruited and 166 were included in the final analysis. Respiratory dysfunction was the most common nonneurological organ system dysfunction, occurring in 62% of the patients. International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) probability of poor outcome at admission was significantly associated with MODS following TBI (odds ratio [OR] 8.88, 95% confidence interval [CI] 1.94–42.68, p < 0.05). However, more commonly used measures of TBI severity, such as the Glasgow Coma Scale, Injury Severity Scale, and Marshall classification, were not associated with post-TBI MODS. In addition, initial plasma concentrations of interleukin (IL)–6, IL-8, and IL-10 were significantly associated with the development of MODS (OR 1.47, 95% CI 1.20–1.80, p < 0.001 for IL-6; OR 1.26, 95% CI 1.01–1.58, p = 0.042 for IL-8; OR 1.77, 95% CI 1.24–2.53, p = 0.002 for IL-10) as well as individual organ dysfunction (SOFA component score ≥ 1). Finally, MODS following TBI was significantly associated with mortality (OR 5.95, 95% CI 2.18–19.14, p = 0.001), and SOFA score was significantly associated with poor outcome at 6 months (Glasgow Outcome Scale score < 4) when analyzed as a continuous variable (OR 1.21, 95% CI 1.06–1.40, p = 0.006).CONCLUSIONSAdmission IMPACT probability of poor outcome and initial plasma concentrations of IL-6, IL-8, and IL-10 were associated with MODS following TBI.

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A novel ITPA variant causes epileptic encephalopathy with multiple-organ dysfunction

Journal of Human Genetics ◽

10.1038/s10038-020-0765-3 ◽

2020 ◽

Vol 65 (9) ◽

pp. 751-757 ◽

Cited By ~ 1

Author(s):

Masamune Sakamoto ◽

Den Kouhei ◽

Muzhirah Haniffa ◽

Sebastián Silva ◽

Mónica Troncoso ◽

...

Keyword(s):

Organ Dysfunction ◽

Epileptic Encephalopathy ◽

Multiple Organ ◽

Multiple Organ Dysfunction

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PSIX-9 Impacts of bunk management on feedlot performance, carcass characteristics, hydrogen sulfide concentration and blood oxygen saturation in steers fed 25 or 50% modified distillers grains plus solubles

Journal of Animal Science ◽

10.1093/jas/skaa278.735 ◽

2020 ◽

Vol 98 (Supplement_4) ◽

pp. 422-422

Author(s):

Rebecca L Moore ◽

Cierrah J Kassetas ◽

Leslie A LeKatz ◽

Bryan W Neville

Keyword(s):

Hydrogen Sulfide ◽

Oxygen Saturation ◽

Management Strategy ◽

Distillers Grains ◽

Feed Ratio ◽

Sulfide Concentration ◽

Blood Oxygen ◽

Blood Oxygen Saturation ◽

Feedlot Performance ◽

Arterial Blood

Abstract One hundred and twenty-six yearling angus steers (initial body weight 445.87 ± 7.13 kg) were utilized in a 2 x 2 factorial design to evaluate the impacts of bunk management and modified distillers grains plus solubles (mDGS) inclusion on feedlot performance, hydrogen sulfide concentrations and blood oxygen saturation. Treatments included bunk management strategy either control bunk management (CON; clean bunks at the time of next day’s feeding) or long bunk management (LONG; feed remaining at time of next day’s feeding), and two inclusion rates of mDGS either 25% or 50% (DM Basis). On d 0, 7, 14, 21, 28 and 35 rumen gas samples were collected via rumenocentesis, and arterial blood samples were collected on two steers from each pen. No differences (P ≥ 0.09) were observed for dry matter intake, average daily gain and gain-to-feed ratio for bunk management or mDGS inclusion. Hot carcass weight, ribeye area, marbling score and quality grade were not affected (P ≥ 0.48) by either bunk management or mDGS inclusion. Back fat was greater (P = 0.04) for CON steers compared to LONG (1.30 vs 1.12 ± 0.05cm, respectively), but was not affected (P = 0.59) by mDGS inclusion. Steers on CON had greater (P = 0.03) yield grades compared to LONG (3.21 vs 2.96 ± 0.11, respectively). Bunk management strategy did not impact hydrogen sulfide concentrations or blood oxygen saturation (P = 0.82). Hydrogen sulfide concentrations increased (P < 0.001) with increasing mDGS inclusion. Blood oxygen saturation was influenced by day of sampling (P = 0.01). Blood oxygen saturation was not affected (P = 0.07) by mDGS inclusion. The fact that ruminal hydrogen sulfide concentrations increased while blood oxygen saturation remained similar raises questions about the quantity of hydrogen sulfide and metabolic fate of excess hydrogen sulfide in the blood of ruminant animals.

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