Tag: inflammation
The negative effect of initial high-dose methylprednisolone and tapering regimen for ARDS
The efficacy of corticosteroid use in acute respiratory distress syndrome (ARDS) remains controversial. Generally, short-term high-dose corticosteroid therapy is considered to be ineffective in ARDS. On the other hand, low-dose,... read more
Predictive Utility of DNI in Patients with MOF After Severe Traumatic Injury
Post-injury multiple organ failure (MOF) is the result of a systemic uncontrolled inflammatory response and it is the one of leading cause of late post-injury mortality. Delta neutrophil index (DNI) may serve useful marker... read more
Practical Management of Invasive Candidiasis in Critically Ill Patients
The heterogeneity of this patient population necessitated the creation of a mixed working group comprising experts in clinical microbiology, infectious diseases and intensive care medicine, all chosen on the basis of their... read more
Similar Metabolic, Innate Immunity, and Adipokine Profiles in Adult and Pediatric Sepsis vs. SIRS
Sepsis presents with similar profiles in adult and pediatric patients, characterized by enhanced inflammatory hormonal response and by repressed innate immunity, metabolism, and myocardial contractility. These features early... read more
Antibiotics, Immunosuppressive Drugs and the Downfall of the Human Immune System
Today I'll discuss two more factors that can debilitate the human immune system (allowing the microbiome to better cause disease). They are antibiotics (when used too frequently) and immunosuppressive drugs: two of the most... read more
Mechanical Ventilation Enhances Extrapulmonary Sepsis-induced Lung Injury
These data show for the first time that otherwise noninjurious mechanical ventilation can exacerbate acute lung injury (ALI) due to extrapulmonary sepsis underscoring a potential interactive contribution of common events... read more
A Positive Fluid Balance is an Independent Prognostic Factor in Patients with Sepsis
Intravenous fluid administration is an essential component of sepsis management, but a positive fluid balance has been associated with worse prognosis. We analyzed whether a positive fluid balance and its persistence over... read more
Why Most Diagnostic Procedures Aren’t Beneficial
We often assume that diagnostic procedures will help patients. A lot of training goes into learning how to do these procedures. Procedures are dramatic. We like performing them. Patients are impressed, perceiving that we... read more
Mortality and Cardiovascular and Respiratory Morbidity in Individuals with Impaired FEV1 (PURE)
The associations between the extent of forced expiratory volume in 1 s (FEV1) impairment and mortality, incident cardiovascular disease, and respiratory hospitalisations are unclear, and how these associations might vary... read more
CRRT for Sepsis-induced Acute Kidney Injury
Sepsis-induced acute kidney injury (SI-AKI) represents the first cause of AKI in ICUs, and renal replacement therapy (RRT) is frequently applied in advanced AKI stages. The debate between 'rescue' indications for RRT start... read more
Neutrophil Extracellular Traps (NETs) Exacerbate Severity of Infant Sepsis
Neutrophil extracellular traps (NETs) are innate defense mechanisms that are also implicated in the pathogenesis of organ dysfunction. However, the role of NETs in pediatric sepsis is unknown. This study reveals a hitherto... read more
Expanding the Differential for Hypotension in the Pediatric Patient
As many ED practitioners are aware, food allergies are common in the first 2 years of life, with a prevalence cited between 1-10% of the population. Most food allergies are IgE-mediated hypersensitivity reactions. Food protein-induced... read more
A Rare Group of White Blood Cells May Be the Secret to Prevent Sepsis
Basophils are evolutionarily conserved in vertebrates, despite their small numbers and short life span, suggesting that they have beneficial roles in maintaining health. However, these roles are not fully defined. Here we... read more
Vitamin C: Should We Supplement?
A short course of intravenous vitamin C in pharmacological dose seems a promising, well tolerated, and cheap adjuvant therapy to modulate the overwhelming oxidative stress in severe sepsis, trauma, and reperfusion after ischemia.... read more
Septic Shock: Innovative Treatment Options in the Wings
Vitamin C, angiotensin-II, and methylene blue are emerging options on the cutting edge of refractory septic shock treatment that require more investigation, but nevertheless appear promising, Rishi Rattan, MD, said at the... read more
Angiotensin converting enzyme defects in shock: implications for future therapy
Patients who develop vasodilatory shock, particularly when caused by an inflammatory condition like sepsis or pancreatitis, have evidence of significant endothelial injury as manifested by coagulation disorders and increased... read more
Effect of Human Recombinant Alkaline Phosphatase on 7-Day Creatinine Clearance in Patients With Sepsis-Associated AKI
In this randomized, double-blind, placebo-controlled, dose-finding adaptive phase 2a/2b trial enrolling 301 adults, the optimal therapeutic dose of recombinant alkaline phosphatase was 1.6 mg/kg. Treatment with this dose... read more
Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD
Among adults with COPD at high risk of exacerbation treated with inhaled corticosteroids, the addition of low-dose theophylline, compared with placebo, did not reduce the number COPD exacerbations over a 1-year period. The... read more
Doubling Down on Re-Expansion Pulmonary Edema: Treatment Approach and Ventilator Management
The treatment of choice for a pneumothorax is a chest tube, and when the small pig-tail catheter doesn’t do the job, the answer is to replace it with a larger bore – right? Not so fast. The exact mechanism of REPE is... read more
Early PREdiction of Sepsis Using Leukocyte Surface Biomarkers
From a large panel of leukocyte biomarkers, immunosuppression biomarkers were associated with subsequent sepsis in ED patients with suspected acute infection. Between January 2014 and February 2016, we recruited 272, 59 and... read more
Positive End-expiratory Pressure and Mechanical Power
Less than 7 cm H2O positive end-expiratory pressure reduced atelectrauma encountered at zero end-expiratory pressure. Above a defined power threshold, sustained positive end-expiratory pressure contributed to potentially... read more
Effect of Early vs Delayed Initiation of RRT on Mortality in Critically Ill Patients With AKI
Among critically ill patients with Acute Kidney Injury (AKI), early Renal Replacement Therapy (RRT) compared with delayed initiation of RRT reduced mortality over the first 90 days. Further multicenter trials of this intervention... read more
