Articles

Minimum quality threshold in pre-clinical sepsis studies (MQTiPSS): an international expert consensus initiative for improvement of animal modeling in sepsis

Pre-clinical animal studies precede the majority of clinical trials. While the clinical definitions of sepsis and recommended treatments are regularly updated, a systematic review of pre-clinical models of sep...

Authors: Marcin F. Osuchowski, Alfred Ayala, Soheyl Bahrami, Michael Bauer, Mihaly Boros, Jean-Marc Cavaillon, Irshad H. Chaudry, Craig M. Coopersmith, Clifford Deutschman, Susanne Drechsler, Philip Efron, Claes Frostell, Gerhard Fritsch, Waldemar Gozdzik, Judith Hellman, Markus Huber-Lang…

A mathematical model of CO₂, O₂ and N₂ exchange during venovenous extracorporeal membrane oxygenation

Venovenous extracorporeal membrane oxygenation (vv-ECMO) is an effective treatment for severe respiratory failure. The interaction between the cardiorespiratory system and the oxygenator can be explored with m...

Authors: Christopher John Joyce, Kiran Shekar and David Andrew Cook

Clinical-grade mesenchymal stem cells derived from umbilical cord improve septic shock in pigs

Septic shock is the leading cause of death in intensive care units. The pathophysiological complexity of this syndrome contributes to an absence of specific treatment. Several preclinical studies in murine mod...

Authors: Caroline Laroye, Jérémie Lemarié, Amir Boufenzer, Pierre Labroca, Lisiane Cunat, Corentine Alauzet, Frédérique Groubatch, Clémence Cailac, Lucie Jolly, Danièle Bensoussan, Loïc Reppel and Sébastien Gibot

Type 2 diabetes mellitus worsens neurological injury following cardiac arrest: an animal experimental study

Cardiac arrest carries a poor prognosis. The typical cardiac arrest patient is comorbid, and studies have shown that diabetes mellitus is an independent risk factor for increased mortality after cardiac arrest...

Authors: Lauge Vammen, Søren Rahbek, Niels Secher, Jonas Agerlund Povlsen, Niels Jessen, Bo Løfgren and Asger Granfeldt

Bioenergetic bypass using cell-permeable succinate, but not methylene blue, attenuates metformin-induced lactate production

Metformin is the most common pharmacological treatment for type 2 diabetes. It is considered safe but has been associated with the development of lactic acidosis under circumstances where plasma concentrations...

Authors: Sarah Piel, Johannes K. Ehinger, Imen Chamkha, Eleonor Åsander Frostner, Fredrik Sjövall, Eskil Elmér and Magnus J. Hansson

Evaluation of end-tidal carbon dioxide gradient as a predictor of volume responsiveness in spontaneously breathing healthy adults

Methods to guide fluid therapy in spontaneously breathing patients are scarce. No studies have reported the accuracy of end-tidal CO₂ (ET-CO₂) to predict volume responsiveness in these patients. We sought to eval...

Authors: María C. Arango-Granados, Virginia Zarama Córdoba, Andrés M. Castro Llanos and Luis A. Bustamante Cristancho

Body temperature and mouse scoring systems as surrogate markers of death in cecal ligation and puncture sepsis

Despite increasing ethical standards for conducting animal research, death is still often used as an endpoint in mouse sepsis studies. Recently, the Murine Sepsis Score (MSS), Mouse Clinical Assessment Score f...

Authors: Safiah H. C. Mai, Neha Sharma, Andrew C. Kwong, Dhruva J. Dwivedi, Momina Khan, Peter M. Grin, Alison E. Fox-Robichaud and Patricia C. Liaw

Ecological effects of cefepime use during antibiotic cycling on the Gram-negative enteric flora of ICU patients

This study examines the impact of cefepime and APP-β (antipseudomonal penicillin/ β-lactamase inhibitor combinations) on Gram-negative bacterial colonization and resistance in two Australian ICUs. While resist...

Authors: Carola Venturini, Andrew N. Ginn, Brooke E. Wilson, Guy Tsafnat, Ian Paulsen, Sally R. Partridge and Jonathan R. Iredell

A new way of monitoring mechanical ventilation by measurement of particle flow from the airways using Pexa method in vivo and during ex vivo lung perfusion in DCD lung transplantation

Different mechanical ventilation settings are known to affect lung preservation for lung transplantation. Measurement of particle flow in exhaled air may allow online assessment of the impact of ventilation be...

Authors: Ellen Broberg, Martiné Wlosinska, Lars Algotsson, Anna-Carin Olin, Darcy Wagner, Leif Pierre and Sandra Lindstedt

A research pathway for the study of the delivery and disposition of nebulised antibiotics: an incremental approach from in vitro to large animal models

Nebulised antibiotics are frequently used for the prevention or treatment of ventilator-associated pneumonia. Many factors may influence pulmonary drug concentrations with inaccurate dosing schedules potential...

Authors: Jayesh A. Dhanani, Jeremy Cohen, Suzanne L. Parker, Hak-Kim Chan, Patricia Tang, Benjamin J. Ahern, Adeel Khan, Manoj Bhatt, Steven Goodman, Sara Diab, Jivesh Chaudhary, Jeffrey Lipman, Steven C. Wallis, Adrian Barnett, Michelle Chew, John F. Fraser…

A vascular endothelial growth factor receptor gene variant is associated with susceptibility to acute respiratory distress syndrome

The acute respiratory distress syndrome (ARDS) is one of the main causes of mortality in adults admitted to intensive care units. Previous studies have demonstrated the existence of genetic variants involved i...

Authors: Natalia Hernandez-Pacheco, Beatriz Guillen-Guio, Marialbert Acosta-Herrera, Maria Pino-Yanes, Almudena Corrales, Alfonso Ambrós, Leonor Nogales, Arturo Muriel, Elena González-Higueras, Francisco J. Diaz-Dominguez, Elizabeth Zavala, Javier Belda, Shwu-Fan Ma, Jesús Villar and Carlos Flores

The endotoxin-induced pulmonary inflammatory response is enhanced during the acute phase of influenza infection

Influenza infections are often complicated by secondary infections, which are associated with high morbidity and mortality, suggesting that influenza profoundly influences the immune response towards a subsequ...

Authors: R. M. Koch, D. A. Diavatopoulos, G. Ferwerda, P. Pickkers, M. I. de Jonge and M. Kox

Esmolol indirectly stimulates vagal nerve activity in endotoxemic pigs

There is an increasing interest in beta-blockade as a therapeutic approach to sepsis following consistent experimental findings of attenuation of inflammation and improved survival with beta1 selective antagon...

Authors: Jerome Aboab, Louis Mayaud, Veronique Sebille, Rodrigo de Oliveira, Merce Jourdain and Djillali Annane

Allostasis and sedation practices in intensive care evaluation: an observational pilot study

A dysregulated stress response has been implicated in the pathogenesis of critical illness. Sedative agents utilised in the critically unwell patient may impact upon the stress response with a downstream negat...

Authors: John P. R. Moore, Chris Anstey, Lauren Murray, John F. Fraser and Mervyn Singer

In vitro comparison of the adsorption of inflammatory mediators by blood purification devices

Septic shock, a leading cause of acute kidney injury, induces release of pro-/anti-inflammatory mediators, leading to increased mortality and poor renal recovery. This is the first in vitro study directly comp...

Authors: Benjamin Malard, Corine Lambert and John A. Kellum

Bias flow rate and ventilation efficiency during adult high-frequency oscillatory ventilation: a lung model study

Bias flow (BF) is essential to maintain mean airway pressure (MAP) and to washout carbon dioxide (CO₂) from the oscillator circuit during high-frequency oscillatory ventilation (HFOV). If the BF rate is inadequat...

Authors: Osamu Nagano, Tetsuya Yumoto, Atsunori Nishimatsu, Shunsuke Kanazawa, Takahisa Fujita, Sunao Asaba and Hideo Yamanouchi

Serum chloride levels in critical illness—the hidden story

Chloride is the principal anion of the extracellular fluid and vital for both serum electroneutrality and acid-base homeostasis. The aim of this review is to investigate the relevance of dyschloremia in the cr...

Authors: Carmen Andrea Pfortmueller, Dominik Uehlinger, Stephan von Haehling and Joerg Christian Schefold

Positional effects on the distributions of ventilation and end-expiratory gas volume in the asymmetric chest—a quantitative lung computed tomographic analysis

Body positioning affects the configuration and dynamic properties of the chest wall and therefore may influence decisions made to increase or decrease ventilating pressures and tidal volume. We hypothesized th...

Authors: Gustavo A. Cortes-Puentes, Kenneth E. Gard, Alexander B. Adams, David J. Dries, Michael Quintel, Richard A. Oeckler, Luciano Gattinoni and John J. Marini

Preliminary experience on the safety and tolerability of mechanical “insufflation-exsufflation” in subjects with artificial airway

Catheter suctioning of respiratory secretions in intubated subjects is limited to the proximal airway and associated with traumatic lesions to the mucosa and poor tolerance. “Mechanical insufflation-exsufflati...

Authors: Miguel Sánchez-García, Passio Santos, Gema Rodríguez-Trigo, Fernando Martínez-Sagasti, Tomás Fariña-González, Ángela del Pino-Ramírez, Carlos Cardenal-Sánchez, Beatriz Busto-González, Mónica Requesens-Solera, Mercedes Nieto-Cabrera, Francisco Romero-Romero and Antonio Núñez-Reiz

A high-flow nasal cannula system with relatively low flow effectively washes out CO₂ from the anatomical dead space in a sophisticated respiratory model made by a 3D printer

Although clinical studies of the high-flow nasal cannula (HFNC) and its effect on positive end-expiratory pressure (PEEP) have been done, the washout effect has not been well evaluated. Therefore, we made an e...

Authors: Yu Onodera, Ryo Akimoto, Hiroto Suzuki, Masayuki Okada, Masaki Nakane and Kaneyuki Kawamae

Extracorporeal membrane oxygenation line-associated complications: in vitro testing of cyanoacrylate tissue adhesive and securement devices to prevent infection and dislodgement

Extracorporeal membrane oxygenation (ECMO) delivers cardiac and/or respiratory support to critically ill patients who have failed conventional medical therapies. If the large-bore cannulas used to deliver ECMO...

Authors: Taressa Bull, Amanda Corley, Danielle J. Smyth, David J. McMillan, Kimble R. Dunster and John F. Fraser

Intra-cellular lactate concentration in T lymphocytes from septic shock patients — a pilot study

Sepsis-associated hyperlactatemia is a widely used biomarker, associated with initial severity and poor outcomes. This increased circulating lactate concentration has been proposed to result in part from a mis...

Authors: Thibaut Girardot, Thomas Rimmelé, Guillaume Monneret, Julien Textoris and Fabienne Venet

Alterations in mitochondrial respiration and reactive oxygen species in patients poisoned with carbon monoxide treated with hyperbaric oxygen

Carbon monoxide (CO) poisoning is the leading cause of poisoning mortality and morbidity in the USA. Carboxyhemoglobin (COHb) levels are not predictive of severity or prognosis. At this time, the measurement o...

Authors: David H. Jang, Utsha G. Khatri, Brenna P. Shortal, Matthew Kelly, Kevin Hardy, David S. Lambert and David M. Eckmann

PEEP titration: the effect of prone position and abdominal pressure in an ARDS model

Prone position and PEEP can both improve oxygenation and other parameters, but their interaction has not been fully described. Limited data directly compare selection of mechanically “optimal” or “best” PEEP i...

Authors: Joseph C. Keenan, Gustavo A. Cortes-Puentes, Lei Zhang, Alex B. Adams, David J. Dries and John J. Marini

Fully automated life support: an implementation and feasibility pilot study in healthy pigs

Automated systems are available in various application areas all over the world for the purpose of reducing workload and increasing safety. However, such support systems that would aid caregivers are still lac...

Authors: Wilfried Klingert, Jörg Peter, Christian Thiel, Karolin Thiel, Wolfgang Rosenstiel, Kathrin Klingert, Christian Grasshoff, Alfred Königsrainer and Martin Schenk

HLA-DR expression in neonates after cardiac surgery under cardiopulmonary bypass: a pilot study

Monocyte HLA-DR expression has been reported as a marker of immunosuppression and a predictor of sepsis development. However, to date, there is no report on monocyte HLA-DR monitoring exclusively in neonates (...

Authors: Alexis Chenouard, Cécile Braudeau, Nicolas Cottron, Pierre Bourgoin, Nina Salabert, Antoine Roquilly, Régis Josien, Nicolas Joram and Karim Asehnoune

Volume-replacement ratio for crystalloids and colloids during bleeding and resuscitation: an animal experiment

Fluid resuscitation remains a cornerstone in the management of acute bleeding. According to Starling's “Three-compartment model”, four-times more crystalloids have the same volume effect as colloids. However, ...

Authors: Ildikó László, Gábor Demeter, Nándor Öveges, Dániel Érces, József Kaszaki, Krisztián Tánczos and Zsolt Molnár

Combinatorial therapy with two pro-coagulants and one osmotic agent reduces the extent of the lesion in the acute phase of spinal cord injury in the rat

Spinal cord injury (SCI) is a complex disease that leads to a motor, sensitive, and vegetative impairment. So far, single therapies are ineffective for treating SCI in humans and a multifactorial therapeutic a...

Authors: Mathieu Boutonnet, Elisabeth Laemmel, Eric Vicaut, Jacques Duranteau and Marc Soubeyrand

Effect of Ringer’s acetate in different doses on plasma volume in rat models of hypovolemia

Even though crystalloids are the first choice for fluid resuscitation in hemodynamically unstable patients, their potency as plasma volume expanders in hypovolemia of different etiologies is largely unknown. T...

Authors: Svajunas Statkevicius, Attila Frigyesi and Peter Bentzer

Assessment of immune organ dysfunction in critical illness: utility of innate immune response markers

In critically ill patients, organ dysfunctions are routinely assessed, monitored, and treated. Mounting data show that substantial critical illness-induced changes in the immune system can be observed in most ...

Authors: Carmen Andrea Pfortmueller, Christian Meisel, Michaela Fux and Joerg C. Schefold

Anthrax immune globulin improves hemodynamics and survival during B. anthracis toxin-induced shock in canines receiving titrated fluid and vasopressor support

Although anthrax immune globulin (AIG) improved survival in antibiotic-treated Bacillus anthracis-challenged animal models, whether it adds to the benefit of conventional hemodynamic support for B. anthracis toxi...

Authors: Dante A. Suffredini, Xizhong Cui, Dharmvir Jaswal, Kenneth E. Remy, Yan Li, Junfeng Sun, Steven B. Solomon, Yvonne Fitz, Mahtab Moayeri, Stephen Leppla and Peter Q. Eichacker

An experimental model to measure the ability of headphones with active noise control to reduce patient’s exposure to noise in an intensive care unit

Defining the association between excessive noise in intensive care units, sleep disturbance and morbidity, including delirium, is confounded by the difficulty of implementing successful strategies to reduce pa...

Authors: Stuart Gallacher, Doyo Enki, Sian Stevens and Mark J. Bennett

Effects of regional perfusion block in healthy and injured lungs

Severe hypoperfusion can cause lung damage. We studied the effects of regional perfusion block in normal lungs and in the lungs that had been conditioned by lavage with 500 ml saline and high V ...

Authors: Barbara Cambiaghi, Francesco Vasques, Onnen Mörer, Christian Ritter, Tommaso Mauri, Nils Kunze-Szikszay, Karin Holke, Francesca Collino, Giorgia Maiolo, Francesca Rapetti, Elias Schulze-Kalthoff, Tommaso Tonetti, Günter Hahn, Michael Quintel and Luciano Gattinoni

Cardiopulmonary bypass in the newborn: effects of circulatory cell-free hemoglobin and hyperoxia evaluated in a novel rat pup model

Infants with congenital heart defects (CHD) are at risk for white matter brain injury. This novel rat pup model characterizes the systemic effects of intravasal cell-free hemoglobin and hyperoxia, hypothesizin...

Authors: Åsa Jungner, Suvi Vallius, Matteo Bruschettini, Olga Romantsik, Magnus Gram and David Ley

ESICM LIVES 2017

Authors:

Myeloperoxidase can differentiate between sepsis and non-infectious SIRS and predicts mortality in intensive care patients with SIRS

Systemic inflammatory response syndrome (SIRS) is a clinical syndrome following inflammation. Clinically, it is difficult to distinguish SIRS following an infection, i.e., sepsis, from non-infectious SIRS. Mye...

Authors: Irene T. Schrijver, Hans Kemperman, Mark Roest, Jozef Kesecioglu and Dylan W. de Lange

Fluid loading and norepinephrine infusion mask the left ventricular preload decrease induced by pleural effusion

Pleural effusion (PLE) may lead to low blood pressure and reduced cardiac output. Low blood pressure and reduced cardiac output are often treated with fluid loading and vasopressors. This study aimed to determ...

Authors: Kristian Borup Wemmelund, Viktor Kromann Ringgård, Simon Tilma Vistisen, Janus Adler Hyldebrandt, Erik Sloth and Peter Juhl-Olsen

Sepsis 2017 Paris

Authors:

An extracorporeal carbon dioxide removal (ECCO₂R) device operating at hemodialysis blood flow rates

Extracorporeal carbon dioxide removal (ECCO₂R) systems have gained clinical appeal as supplemental therapy in the treatment of acute and chronic respiratory injuries with low tidal volume or non-invasive ventilat...

Authors: R. Garrett Jeffries, Laura Lund, Brian Frankowski and William J. Federspiel

Protective ventilation reduces Pseudomonas aeruginosa growth in lung tissue in a porcine pneumonia model

Mechanical ventilation with positive end expiratory pressure and low tidal volume, i.e. protective ventilation, is recommended in patients with acute respiratory distress syndrome. However, the effect of prote...

Authors: Jesper Sperber, Axel Nyberg, Miklos Lipcsey, Åsa Melhus, Anders Larsson, Jan Sjölin and Markus Castegren

Automated bedside flow cytometer for mHLA-DR expression measurement: a comparison study with reference protocol

In various ICU conditions, measurement of diminished expression of human leukocyte antigen-DR on circulating monocytes (mHLA-DR) by flow cytometry appears to be a reliable marker of acquired immunosuppression....

Authors: Mehdi Zouiouich, Morgane Gossez, Fabienne Venet, Thomas Rimmelé and Guillaume Monneret

Whole blood microRNA markers are associated with acute respiratory distress syndrome

MicroRNAs (miRNAs) can play important roles in inflammation and infection, which are common manifestations of acute respiratory distress syndrome (ARDS). We assessed if whole blood miRNAs were potential diagno...

Authors: Zhaozhong Zhu, Liming Liang, Ruyang Zhang, Yongyue Wei, Li Su, Paula Tejera, Yichen Guo, Zhaoxi Wang, Quan Lu, Andrea A. Baccarelli, Xi Zhu, Ednan K. Bajwa, B. Taylor Thompson, Guo-Ping Shi and David C. Christiani

Hemoadsorption corrects hyperresistinemia and restores anti-bacterial neutrophil function

Mounting evidence suggests that sepsis-induced morbidity and mortality are due to both immune activation and immunosuppression. Resistin is an inflammatory cytokine and uremic toxin. Septic hyperresistinemia (...

Authors: Anthony Bonavia, Lauren Miller, John A. Kellum and Kai Singbartl

Optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment

Esophageal pressure, used as a surrogate for pleural pressure, is commonly measured by air-filled balloon, and the accuracy of measurement depends on the proper balloon volume. It has been found that larger fi...

Authors: Yan-Lin Yang, Xuan He, Xiu-Mei Sun, Han Chen, Zhong-Hua Shi, Ming Xu, Guang-Qiang Chen and Jian-Xin Zhou

Impact of membrane lung surface area and blood flow on extracorporeal CO₂ removal during severe respiratory acidosis

Veno-venous extracorporeal CO₂ removal (vv-ECCO₂R) is increasingly being used in the setting of acute respiratory failure. Blood flow rates through the device range from 200 ml/min to more than 1500 ml/min, and t...

Authors: Christian Karagiannidis, Stephan Strassmann, Daniel Brodie, Philine Ritter, Anders Larsson, Ralf Borchardt and Wolfram Windisch

Heart rate variability in critical care medicine: a systematic review

Heart rate variability (HRV) has been used to assess cardiac autonomic activity in critically ill patients, driven by translational and biomarker research agendas. Several clinical and technical factors can in...

Authors: Shamir N. Karmali, Alberto Sciusco, Shaun M. May and Gareth L. Ackland

Sepsis prediction in critically ill patients by platelet activation markers on ICU admission: a prospective pilot study

Platelets have been involved in both immune surveillance and host defense against severe infection. To date, whether platelet phenotype or other hemostasis components could be associated with predisposition to...

Authors: Nathalie Layios, Céline Delierneux, Alexandre Hego, Justine Huart, Christian Gosset, Christelle Lecut, Nathalie Maes, Pierre Geurts, Arnaud Joly, Patrizio Lancellotti, Adelin Albert, Pierre Damas, André Gothot and Cécile Oury

Evaluation of an ADVanced Organ Support (ADVOS) system in a two-hit porcine model of liver failure plus endotoxemia

Novel extracorporeal procedures are constantly being developed and evaluated for use in patients with sepsis. Preclinical evaluation of such procedures usually requires testing in large animal models. In the p...

Authors: Ahmed Al-Chalabi, Edouard Matevossian, Anne von Thaden, Catherine Schreiber, Peter Radermacher, Wolfgang Huber, Aritz Perez Ruiz de Garibay and Bernhard Kreymann

Impact of hyperglycemia on cystathionine-γ-lyase expression during resuscitated murine septic shock

Cystathionine-γ-lyase (CSE) was shown to have a regulatory role in glucose metabolism. Circulatory shock can induce metabolic stress, thereby leading to hyperglycemia and mitochondrial dysfunction. In vitro da...

Authors: Tamara Merz, Josef A. Vogt, Ulrich Wachter, Enrico Calzia, Csaba Szabo, Rui Wang, Peter Radermacher and Oscar McCook

The novel nitric oxide donor PDNO attenuates ovine ischemia-reperfusion induced renal failure

Renal ischemia-reperfusion injury is a common cause of acute kidney injury in intensive care and surgery. Recently, novel organic mononitrites of 1,2-propanediol (PDNO) were synthesized and shown to rapidly an...

Authors: Kristofer F. Nilsson, John Sandin, Lars E. Gustafsson and Robert Frithiof