Articles

Increased glucocorticoid receptor expression in sepsis is related to heat shock proteins, cytokines, and cortisol and is associated with increased mortality

The purposes of this study are to examine if the human glucocorticoid receptor (hGR) isoform-α mRNA and hGR protein expressions are deficient in the acute phase of sepsis (S) compared to systemic inflammatory ...

Authors: Konstantinos Vardas, Stavroula Ilia, Amalia Sertedaki, Evangelia Charmandari, Efrossini Briassouli, Dimitris Goukos, Kleovoulos Apostolou, Katerina Psarra, Efthimia Botoula, Stylianos Tsagarakis, Eleni Magira, Christina Routsi, Constantine A. Stratakis, Serafim Nanas and George Briassoulis

‘In a dark place, we find ourselves’: light intensity in critical care units

Intensive care units provide specialised care for critically ill patients around the clock. However, intensive care unit patients have disrupted circadian rhythms. Furthermore, disrupted circadian rhythms are ...

Authors: Hannah J. Durrington, Richard Clark, Ruari Greer, Franck P. Martial, John Blaikley, Paul Dark, Robert J. Lucas and David W. Ray

Personalizing mechanical ventilation according to physiologic parameters to stabilize alveoli and minimize ventilator induced lung injury (VILI)

It has been shown that mechanical ventilation in patients with, or at high-risk for, the development of acute respiratory distress syndrome (ARDS) can be a double-edged sword. If the mechanical breath is impro...

Authors: Gary F. Nieman, Joshua Satalin, Penny Andrews, Hani Aiash, Nader M. Habashi and Louis A. Gatto

Baseline thrombospondin-1 concentrations are not associated with mortality in septic patients: a single-center cohort study on the intensive care unit

The initial phase of sepsis is characterized by hyperinflammation. Levels of thrombospondin-1 (TSP-1) rise rapidly during acute inflammation. The purpose of this clinical study was to study the association bet...

Authors: Ruben J. van der Wekken, Hans Kemperman, Mark Roest and Dylan W. de Lange

Erratum to: Heparin-binding protein is important for vascular leak in sepsis

Authors: Peter Bentzer, Jane Fisher, HyeJin Julia Kong, Mattias Mörgelin, John H. Boyd, Keith R. Walley, James A. Russell and Adam Linder

Resuscitation fluid composition affects hepatic inflammation in a murine model of early sepsis

Fluid resuscitation is a crucial therapy for sepsis, and the use of balanced fluids and/or isotonic albumin may improve patient survival. We have previously demonstrated that resuscitation with normal saline r...

Authors: Amanda L. Patrick, Peter M. Grin, Nicole Kraus, Michelle Gold, Matthew Berardocco, Patricia C. Liaw and Alison E. Fox-Robichaud

The impact of hydrocortisone treatment on neutrophil gelatinase-associated lipocalin release in porcine endotoxemic shock

A key feature of sepsis is systemic inflammatory activation that could be counteracted by steroids. In this experimental model of systemic inflammation, we sought to investigate whether septic neutrophil activ...

Authors: E. Söderberg, M. Eriksson, A. Larsson and M. Lipcsey

Deletion of Nlrp3 protects from inflammation-induced skeletal muscle atrophy

Critically ill patients develop atrophic muscle failure, which increases morbidity and mortality. Interleukin-1β (IL-1β) is activated early in sepsis. Whether IL-1β acts directly on muscle cells and whether it...

Authors: Nora Huang, Melanie Kny, Fabian Riediger, Katharina Busch, Sibylle Schmidt, Friedrich C. Luft, Hortense Slevogt and Jens Fielitz

Soluble Toll-like receptor 2 is a biomarker for sepsis in critically ill patients with multi-organ failure within 12 h of ICU admission

Soluble TLR2 levels are elevated in infective and inflammatory conditions, but its diagnostic value with sepsis-induced multi-organ failure has not been evaluated. 37 patients with a diagnosis of severe sepsis...

Authors: Benjamin Holst, Tamas Szakmany, Anne-Catherine Raby, Vincent Hamlyn, Kimberley Durno, Judith E. Hall and Mario O. Labéta

Neuroprotective effects of intravenous immunoglobulin are mediated through inhibition of complement activation and apoptosis in a rat model of sepsis

Intravenous (IV) immunoglobulin (Ig) treatment is known to alleviate behavioral deficits and increase survival in the experimentally induced model of sepsis. To delineate the mechanisms by which IVIg treatment...

Authors: Figen Esen, Gunseli Orhun, Perihan Ergin Ozcan, Evren Senturk, Melike Kucukerden, Murat Giris, Ugur Akcan, Canan Ugur Yilmaz, Nurcan Orhan, Nadir Arican, Mehmet Kaya, Sema Bilgic Gazioglu and Erdem Tuzun

From theory to bench confirmation or from bench to theory

In this commentary, the authors discuss two possible approaches in experimental studies. The first approach is to replicate an experimentation in order to confirm or not previously published results. The secon...

Authors: Julien Demiselle, Frauke Tillmans, Andreas Koch, Peter Radermacher and Pierre Asfar

Effects of volume resuscitation on the microcirculation in animal models of lipopolysaccharide sepsis: a systematic review

Recent research has identified an increased rate of mortality associated with fluid bolus therapy for severe sepsis and septic shock, but the mechanisms are still not well understood. Fluid resuscitation thera...

Authors: Nchafatso G. Obonyo, Jonathon P. Fanning, Angela S. Y. Ng, Leticia P. Pimenta, Kiran Shekar, David G. Platts, Kathryn Maitland and John F. Fraser

Comparison of an automatic analysis and a manual analysis of conjunctival microcirculation in a sheep model of haemorrhagic shock

Life-threatening diseases of critically ill patients are known to derange microcirculation. Automatic analysis of microcirculation would provide a bedside diagnostic tool for microcirculatory disorders and all...

Authors: Philip-Helge Arnemann, Michael Hessler, Tim Kampmeier, Andrea Morelli, Hugo Karel Van Aken, Martin Westphal, Sebastian Rehberg and Christian Ertmer

Critical role of endogenous histamine in promoting end-organ tissue injury in sepsis

Histamine assumes an important role as a major mediator in various pathologic disorders associated with inflammation and immune reactions. However, the involvement of histamine in the pathological conditions a...

Authors: Mizuki Hattori, Mitsuaki Yamazaki, Wakana Ohashi, Satoshi Tanaka, Kohshi Hattori, Kenichiro Todoroki, Toshio Fujimori, Hiroshi Ohtsu, Naoyuki Matsuda and Yuichi Hattori

Comparison between effects of pressure support and pressure-controlled ventilation on lung and diaphragmatic damage in experimental emphysema

In patients with emphysema, invasive mechanical ventilation settings should be adjusted to minimize hyperinflation while reducing respiratory effort and providing adequate gas exchange. We evaluated the impact...

Authors: Gisele de A. Padilha, Lucas F. B. Horta, Lillian Moraes, Cassia L. Braga, Milena V. Oliveira, Cíntia L. Santos, Isalira P. Ramos, Marcelo M. Morales, Vera Luiza Capelozzi, Regina C. S. Goldenberg, Marcelo Gama de Abreu, Paolo Pelosi, Pedro L. Silva and Patricia R. M. Rocco

Exploring alternative routes for oxygen administration

Hypoxemia may compromise cell metabolism and organ function. Supplemental oxygen (O₂) at high concentrations may prove ineffective, and issues relating to hyperoxia, barotrauma, mechanical ventilation, and extrac...

Authors: Elisa Damiani, Alex Dyson, Lucia Zacchetti, Abele Donati and Mervyn Singer

Heparin-binding protein is important for vascular leak in sepsis

Elevated plasma levels of heparin-binding protein (HBP) are associated with risk of organ dysfunction and mortality in sepsis, but little is known about causality and mechanisms of action of HBP. The objective...

Authors: Peter Bentzer, Jane Fisher, HyeJin Julia Kong, Mattias Mörgelin, John H. Boyd, Keith R. Walley, James A. Russell and Adam Linder

ESICM LIVES 2016: part one

Authors: L. Bos, L. Schouten, L. van Vught, M. Wiewel, D. Ong, O. Cremer, A. Artigas, I. Martin-Loeches, A. Hoogendijk, T. van der Poll, J. Horn, N. Juffermans, M. Schultz, N. de Prost, T. Pham, G. Carteaux…

A new approach to selective brain cooling by a Ranque-Hilsch vortex tube

Target temperature management is the single most effective intervention and the gold standard in post-resuscitation care today. However, cooling the whole body below 33–34 °C can cause severe complications. Th...

Authors: Mohammad Fazel Bakhsheshi, Yong Wang, Lynn Keenliside and Ting-Yim Lee

Plasmadiafiltration ameliorating gut mucosal barrier dysfunction and improving survival in porcine sepsis models

The object of this study is to explore whether the plasmadiafiltration (PDF) is more effective in improving the intestinal mucosal barrier function by removing more key large molecular inflammatory mediators a...

Authors: Ming Xin Li, Jun Feng Liu, Jian Da Lu, Ying Zhu, Ding Wei Kuang, Jian Bing Xiang, Peng Sun, Wei Wang, Jun Xue, Yong Gu and Chuan Ming Hao

ESICM LIVES 2016: part two

Authors: S. Sivakumar, F. S. Taccone, K. A. Desai, C. Lazaridis, M. Skarzynski, M. Sekhon, W. Henderson, D. Griesdale, L. Chapple, A. Deane, L. Williams, R. Strickland, K. Lange, D. Heyland, M. Chapman, M. J. Rowland…

ESICM LIVES 2016: part three

Authors: T. Velasquez, G. Mackey, J. Lusk, U. G. Kyle, T. Fontenot, P. Marshall, L. S. Shekerdemian, J. A. Coss-Bu, A. Nishigaki, T. Yatabe, T. Tamura, K. Yamashita, M. Yokoyama, J. C. Ruiz-Rodriguez, B. Encina, R. Belmonte…

Effects of N-acetylcysteine (NAC) supplementation in resuscitation fluids on renal microcirculatory oxygenation, inflammation, and function in a rat model of endotoxemia

Modulation of inflammation and oxidative stress appears to limit sepsis-induced damage in experimental models. The kidney is one of the most sensitive organs to injury during septic shock. In this study, we ev...

Authors: Bulent Ergin, Philippe Guerci, Lara Zafrani, Frank Nocken, Asli Kandil, Ebru Gurel-Gurevin, Cihan Demirci-Tansel and Can Ince

Transpulmonary and pleural pressure in a respiratory system model with an elastic recoiling lung and an expanding chest wall

We have shown in acute lung injury patients that lung elastance can be determined by a positive end-expiratory pressure (PEEP) step procedure and proposed that this is explained by the spring-out force of the ...

Authors: Per Persson, Stefan Lundin and Ola Stenqvist

The effects of early high-volume hemofiltration on prolonged cardiac arrest in rats with reperfusion by cardiopulmonary bypass: a randomized controlled animal study

It is not yet clear whether hemofiltration can reduce blood cytokine levels sufficiently to benefit patients who suffer prolonged cardiac arrest (CA) treated with cardiopulmonary bypass (CPB). We sought to ass...

Authors: Koichiro Shinozaki, Joshua W. Lampe, Junhwan Kim, Tai Yin, Tong Da, Shigeto Oda, Hiroyuki Hirasawa and Lance B. Becker

Gentisic acid sodium salt, a phenolic compound, is superior to norepinephrine in reversing cardiovascular collapse, hepatic mitochondrial dysfunction and lactic acidemia in Pseudomonas aeruginosa septic shock in dogs

The development of lactic acidemia (LA) in septic shock (SS) is associated with an ominous prognosis. We previously showed that the mechanism of LA in SS may relate to impaired hepatic uptake of lactate, but t...

Authors: Steven Mink, Subir K. Roy Chowdhury, Jose Gotes, Zhao-Qin Cheng, Krika Kasian and Paul Fernyhough

Endothelial bioreactor system ameliorates multiple organ dysfunction in septic rats

The endothelium is a potentially valuable target for sepsis therapy. We have previously studied an extracorporeal endothelial cell therapy system, called the endothelial bioreactor (EBR), which prolonged the s...

Authors: Shuai Ma, Yuli Lin, Bo Deng, Yin Zheng, Chuanming Hao, Rui He and Feng Ding

Sepsis modeling in mice: ligation length is a major severity factor in cecal ligation and puncture

The cecal ligation and puncture (CLP) model, a gold standard in sepsis research, is associated with an important variability in mortality. While the number of punctures and needle size is well described in CLP...

Authors: Stéphanie Ruiz, Fanny Vardon-Bounes, Virginie Merlet-Dupuy, Jean-Marie Conil, Marie Buléon, Olivier Fourcade, Ivan Tack and Vincent Minville

Transcriptional reprogramming of metabolic pathways in critically ill patients

Critical illness causes a shift away from mitochondrial metabolism towards a greater dependence on glycolysis. This metabolic shift is thought to be associated with lactic acidosis, organ dysfunction and poor ...

Authors: Marek Nalos, Grant Parnell, Robert Robergs, David Booth, Anthony S. McLean and Benjamin M. Tang

The effect of plasma from septic ICU patients on healthy rat muscle mitochondria

Although sepsis-induced organ failure is a major cause of death in ICU worldwide, the associated mitochondrial dysfunction is not fully characterized and there is presently no evidence of causality. In this st...

Authors: Jonathan Grip, Towe Jakobsson, Nicolas Tardif and Olav Rooyackers

Modulatory effects of vagal stimulation on neurophysiological parameters and the cellular immune response in the rat brain during systemic inflammation

Stimulation of the vagus nerve has modulating, anti-inflammatory effects on the cellular immune response in the blood and the spleen, stabilizing brain function. Here, we aimed to investigate its potential eff...

Authors: Hanna Schweighöfer, Christoph Rummel, Joachim Roth and Bernhard Rosengarten

Erratum to: Left ventricular function during porcine-resuscitated septic shock with pre-existing atherosclerosis

Authors: Benedikt L. Nußbaum, Oscar McCook, Clair Hartmann, José Matallo, Martin Wepler, Elena Antonucci, Miriam Kalbitz, Markus Huber-Lang, Michael Georgieff, Enrico Calzia, Peter Radermacher and Sebastian Hafner

Microcirculatory perfusion shows wide inter-individual variation and is important in determining shock reversal during resuscitation in a porcine experimental model of complex traumatic hemorrhagic shock

Traumatic hemorrhagic shock (THS) is a leading cause of preventable death following severe traumatic injury. Resuscitation of THS is typically targeted at blood pressure, but the effects of such a strategy on ...

Authors: Sam D. Hutchings, David N. Naumann, Sarah Watts, Callie Wilson, Clare Burton, Julia Wendon and Emrys Kirkman

Lung stress, strain, and energy load: engineering concepts to understand the mechanism of ventilator-induced lung injury (VILI)

It was recently shown that acute respiratory distress syndrome (ARDS) mortality has not been reduced in over 15 years and remains ~40 %, even with protective low tidal volume (LVt) ventilation. Thus, there is ...

Authors: Gary F. Nieman, Joshua Satalin, Penny Andrews, Nader M. Habashi and Louis A. Gatto

Erratum to: Comparison of the evolution of mechanical ventilation associated pneumonia (VAP) before the implantation of selective digestive decontamination (DDS) and after implantation of pneumonia zero program (NZ)

Authors: R. Fernández Fernández, M. Herreros Gonzalo, L. Serrano Fernández, L. Camacho Peinado, N. Cruza Leganés, M. Á. Taberna Izquierdo, F. Alba García and F. Árbol Linde

Left ventricular function during porcine-resuscitated septic shock with pre-existing atherosclerosis

Reversible, depressed cardiac function is frequently encountered during septic shock and commonly called septic cardiomyopathy. Previous studies demonstrated reduced ejection fraction and left ventricular dila...

Authors: Benedikt L. Nußbaum, Oscar McCook, Clair Hartmann, José Matallo, Martin Wepler, Elena Antonucci, Miriam Kalbitz, Markus Huber-Lang, Michael Georgieff, Enrico Calzia, Peter Radermacher and Sebastian Hafner

Comparison between pressure-recording analytical method (PRAM) and femoral arterial thermodilution method (FATD) cardiac output monitoring in an infant animal model of cardiac arrest

The pressure-recording analytical method is a new semi-invasive method for cardiac output measurement (PRAM). There are no studies comparing this technique with femoral artery thermodilution (FATD) in an infan...

Authors: Javier Urbano, Jorge López, Rafael González, Sarah N. Fernández, María José Solana, Blanca Toledo, Ángel Carrillo and Jesús López-Herce

Cross-species validation of cell cycle arrest markers for acute kidney injury in the rat during sepsis

The recent discovery of cell cycle arrest biomarkers, tissue inhibitor of metalloproteinases (TIMP)-2 and insulin-like growth factor binding protein 7 (IGFBP7), has led to a newly available clinical test for a...

Authors: Zhi-Yong Peng, Feihu Zhou and John A. Kellum

The 30-year evolution of airway pressure release ventilation (APRV)

Airway pressure release ventilation (APRV) was first described in 1987 and defined as continuous positive airway pressure (CPAP) with a brief release while allowing the patient to spontaneously breathe through...

Authors: Sumeet V. Jain, Michaela Kollisch-Singule, Benjamin Sadowitz, Luke Dombert, Josh Satalin, Penny Andrews, Louis A. Gatto, Gary F. Nieman and Nader M. Habashi

Critical illness polyneuropathy in ICU patients is related to reduced motor nerve excitability caused by reduced sodium permeability

Reduced motor and sensory nerve amplitudes in critical illness polyneuropathy (CIP) are characteristic features described in electrophysiological studies and due to dysfunction of voltage-gated sodium channels...

Authors: Susanne Koch, Jeffrey Bierbrauer, Kurt Haas, Simone Wolter, Julian Grosskreutz, Friedrich C. Luft, Claudia D. Spies, Jens Fielitz and Steffen Weber-Carstens

Serum proteomics as a strategy to identify novel biomarkers of neurologic recovery after cardiac arrest: a feasibility study

Serum biomarkers may play a role in prognostication after cardiac arrest. This study was designed to assess the feasibility of using two-dimensional gel electrophoresis (2D-GE) coupled with mass spectrometry (...

Authors: J. Gordon Boyd, Laura J. Smithson, Daniel Howes, John Muscedere and Michael D. Kawaja

Hypercapnic acidosis attenuates pulmonary epithelial stretch-induced injury via inhibition of the canonical NF-κB pathway

Hypercapnia, with its associated acidosis (HCA), is a consequence of respiratory failure and is also seen in critically ill patients managed with conventional “protective” ventilation strategies. Nuclear facto...

Authors: Shahd Horie, Bilal Ansari, Claire Masterson, James Devaney, Michael Scully, Daniel O’Toole and John G. Laffey

Quantification of perflutren microsphere contrast destruction during transit through an ex vivo extracorporeal membrane oxygenation circuit

Echocardiography is a key investigation in the management of patients on extracorporeal membrane oxygenation (ECMO). However, echocardiographic images are often non-diagnostic in this patient population. Contr...

Authors: David G. Platts, Charles McDonald, Kiran Shekar, Darryl J. Burstow, Daniel Mullany, Marc Ziegenfuss, Sara Diab and John F. Fraser

Effects of fresh frozen plasma, Ringer’s acetate and albumin on plasma volume and on circulating glycocalyx components following haemorrhagic shock in rats

Early use of fresh frozen plasma (FFP) in haemorrhagic shock is associated with improved outcome. This effect may partly be due to protection of the endothelial glycocalyx and/or secondary to a superior effica...

Authors: Axel Nelson, Svajunas Statkevicius, Ulf Schött, Pär I. Johansson and Peter Bentzer

Modulation of monocytes in septic patients: preserved phagocytic activity, increased ROS and NO generation, and decreased production of inflammatory cytokines

The nature of the inflammatory response underscoring the pathophysiology of sepsis has been extensively studied. We hypothesized that different cell functions would be differentially regulated in a patient wit...

Authors: Sidnéia S. Santos, Amanda M. Carmo, Milena K. C. Brunialti, Flavia R. Machado, Luciano C. Azevedo, Murillo Assunção, Sílvia C. Trevelin, Fernando Q. Cunha and Reinaldo Salomao

Cost of surviving sepsis: a novel model of recovery from sepsis in Drosophila melanogaster

Multiple organ failure, wasting, increased morbidity, and mortality following acute illness complicates the health span of patients surviving sepsis. Persistent inflammation has been implicated, and it is prop...

Authors: Ata Murat Kaynar, Veli Bakalov, Silvia Martinez Laverde, Amélie I. F. Cambriel, Byoung-Hoon Lee, Atif Towheed, Alyssa D. Gregory, Steven A. R. Webb, Michael J. Palladino, Fernando A. Bozza, Steven D. Shapiro and Derek C. Angus

A technique for continuous bedside monitoring of global cerebral energy state

Cerebral cytoplasmatic redox state is a sensitive indicator of cerebral oxidative metabolism and is conventionally evaluated from the extracellular lactate/pyruvate (LP) ratio. In the present experimental stud...

Authors: Rasmus Jakobsen, Troels Halfeld Nielsen, Asger Granfeldt, Palle Toft and Carl-Henrik Nordström

Carbon dioxide dialysis in a swine model utilizing systemic and regional anticoagulation

Extracorporeal carbon dioxide removal (ECCO₂R) has been gaining interest to potentially facilitate gas transfer and equilibrate mild to moderate hypercapnic acidosis, when standard therapy with non-invasive venti...

Authors: A. S. Sharma, P. W. Weerwind, O. Bekers, E. M. Wouters and J. G. Maessen

Kinetics of arterial carbon dioxide during veno-venous extracorporeal membrane oxygenation support in an apnoeic porcine model

Extracorporeal membrane oxygenation (ECMO) is a technique widely used worldwide to improve gas exchange. Changes in ECMO settings affect both oxygen and carbon dioxide. The impact on oxygenation can be followe...

Authors: Pedro Vitale Mendes, Marcelo Park, Alexandre Toledo Maciel, Débora Prudêncio e Silva, Natalia Friedrich, Edzangela Vasconcelos Santos Barbosa, Adriana Sayuri Hirota, Guilherme Pinto Paula Schettino, Luciano Cesar Pontes Azevedo and Eduardo Leite Vieira Costa

Heparins attenuated histone-mediated cytotoxicity in vitro and improved the survival in a rat model of histone-induced organ dysfunction

The beneficial effects of heparin in the treatment of severe sepsis, septic shock, and sepsis-associated disseminated intravascular coagulation (DIC) have recently been reported. However, the mechanisms underl...

Authors: Toshiaki Iba, Naoyuki Hashiguchi, Isao Nagaoka, Yoko Tabe, Katsuhiko Kadota and Koichi Sato