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

Similar Metabolic, Innate Immunity, and Adipokine Profiles in Adult and Pediatric Sepsis vs. SIRS

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

Antibiotics, Immunosuppressive Drugs and the Downfall of the Human Immune System

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

Mechanical Ventilation Enhances Extrapulmonary Sepsis-induced Lung Injury

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

A Positive Fluid Balance is an Independent Prognostic Factor in Patients with Sepsis

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

Why Most Diagnostic Procedures Aren’t Beneficial

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

Mortality and Cardiovascular and Respiratory Morbidity in Individuals with Impaired FEV1 (PURE)

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

CRRT for Sepsis-induced Acute Kidney Injury

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

Neutrophil Extracellular Traps (NETs) Exacerbate Severity of Infant Sepsis

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

Expanding the Differential for Hypotension in the Pediatric Patient

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

A Rare Group of White Blood Cells May Be the Secret to Prevent Sepsis

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

Septic Shock: Innovative Treatment Options in the Wings

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

Angiotensin converting enzyme defects in shock: implications for future therapy

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 Human Recombinant Alkaline Phosphatase on 7-Day Creatinine Clearance in Patients With Sepsis-Associated AKI

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

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD

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

Doubling Down on Re-Expansion Pulmonary Edema: Treatment Approach and Ventilator Management

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

Early PREdiction of Sepsis Using Leukocyte Surface Biomarkers

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

Positive End-expiratory Pressure and Mechanical Power

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

Effect of Early vs Delayed Initiation of RRT on Mortality in Critically Ill Patients With AKI

Predicting the Requirement for RRT in Intensive Care Patients with Sepsis

Sepsis is one of the most frequent causes of acute kidney injury (AKI) in critically ill patients, with initial organ impairment often followed by dysfunction in other systems. Renal dysfunction may therefore represent one... read more

Predicting the Requirement for RRT in Intensive Care Patients with Sepsis

S1PR2 deficiency decreased macrophage pyroptosis and improved survival in E. coli sepsis

Sphingosine-1-phosphate receptor 2 (S1PR2) deficiency decreased macrophage pyroptosis and improved survival in E. coli sepsis. These beneficial effects were attributed to the decreased caspase-11 activation of S1PR2-deficient... read more

S1PR2 deficiency decreased macrophage pyroptosis and improved survival in E. coli sepsis

Initial Inflammatory Profile in Community-acquired Pneumonia Depends on Time since Onset of Symptoms

Time since symptom onset modifies the systemic inflammatory profile at Community-acquired Pneumonia (CAP) diagnosis. This information has relevant clinical implications for management, and it should be taken into account... read more

Initial Inflammatory Profile in Community-acquired Pneumonia Depends on Time since Onset of Symptoms