Articles

Elevated plasma glypicans are associated with organ failure in patients with infection

Increased vascular permeability is a key feature in the pathophysiology of sepsis and the development of organ failure. Shedding of the endothelial glycocalyx is increasingly being recognized as an important p...

Authors: Jane Fisher, Adam Linder and Peter Bentzer

Correction to: Amino acid loss during CVVH in critically ill patients

After publication of this supplement [1], it was brought to our attention that abstract A333 contains a serious error.

Authors: S. N. Stapel, R. de Boer and H. M. Oudemans

Fluid sparing and norepinephrine use in a rat model of resuscitated haemorrhagic shock: end-organ impact

Haemostasis and correction of hypovolemia are the pillars of early haemorrhage shock (HS) management. Vasopressors, which are not recommended as first-line therapy, are an alternative to aggressive fluid resus...

Authors: Sophie Dunberry-Poissant, Kim Gilbert, Caroline Bouchard, Frédérique Baril, Anne-Marie Cardinal, Sydnée L’Ecuyer, Mathieu Hylands, François Lamontagne, Guy Rousseau and Emmanuel Charbonney

The effects of normovolemic anemia and blood transfusion on cerebral microcirculation after severe head injury

Cerebral regional microcirculation is altered following severe head injury. In addition to tissue disruption, partial pressure of tissue oxygenation is impaired due to an increase in the oxygen tissue gradient...

Authors: Judith Bellapart, Kylie Cuthbertson, Kimble Dunster, Sara Diab, David G. Platts, Christopher Raffel, Levon Gabrielian, Adrian Barnett, Jennifer Paratz, Rob Boots and John F. Fraser

A novel selective cooling system for the brain: feasibility study in rabbits vs piglets

Selective brain cooling (SBC) methods could alleviate the complications associated with systemic hypothermia. The authors (MFB, LK, and T-YL) have developed a simple and an effective nasopharyngeal SBC method ...

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

Intravenous hydrogen sulfide does not induce neuroprotection after aortic balloon occlusion-induced spinal cord ischemia/reperfusion injury in a human-like porcine model of ubiquitous arteriosclerosis

In rodents, intravenous sulfide protected against spinal cord ischemia/reperfusion (I/R) injury during aortic balloon occlusion. We investigated the effect of intravenous sulfide on aortic occlusion-induced po...

Authors: Andre Bredthauer, Karla Lehle, Angelika Scheuerle, Hubert Schelzig, Oscar McCook, Peter Radermacher, Csaba Szabo, Martin Wepler and Florian Simon

Cystathionine-γ-lyase expression is associated with mitochondrial respiration during sepsis-induced acute kidney injury in swine with atherosclerosis

Sepsis is associated with disturbed glucose metabolism and reduced mitochondrial activity and biogenesis, ultimately leading to multiple organ dysfunction, e.g., acute kidney injury (AKI). Cystathionine-γ-lyas...

Authors: Tamara Merz, Martin Wepler, Benedikt Nußbaum, Josef Vogt, Enrico Calzia, Rui Wang, Csaba Szabo, Peter Radermacher and Oscar McCook

Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP: secondary analysis from a study on novel preventive strategies

We previously evaluated the efficacy of a ventilatory strategy to achieve expiratory flow bias and positive end-expiratory pressure (EFB + PEEP) or the Trendelenburg position (TP) for the prevention of ventila...

Authors: Gianluigi Li Bassi, Raquel Guillamat Prats, Antonio Artigas, Eli Aguilera Xiol, Joan-Daniel Marti, Otavio T. Ranzani, Montserrat Rigol, Laia Fernandez, Andrea Meli, Denise Battaglini, Nestor Luque, Miguel Ferrer, Ignacio Martin-Loeches, Pedro Póvoa, Davide Chiumello, Paolo Pelosi…

Interaction of the hydrogen sulfide system with the oxytocin system in the injured mouse heart

Both the hydrogen sulfide/cystathionine-γ-lyase (H₂S/CSE) and oxytocin/oxytocin receptor (OT/OTR) systems have been reported to be cardioprotective. H₂S can stimulate OT release, thereby affecting blood volume an...

Authors: Tamara Merz, Britta Lukaschewski, Daniela Wigger, Aileen Rupprecht, Martin Wepler, Michael Gröger, Clair Hartmann, Matthew Whiteman, Csaba Szabo, Rui Wang, Christiane Waller, Peter Radermacher and Oscar McCook

ESICM LIVES 2018

Authors:

A novel approach to assess cerebral and coronary perfusion after cardiac arrest

Several indices exist to assess cerebral perfusion after cardiac arrest (CA). We aimed to investigate a new approach allowing absolute flow and microvascular resistance measurement based on selective arterial ...

Authors: Julien Adjedj, Fabien Picard, Maarten Vanhaverbeke, Bernard De Bruyne, Alain Cariou, Ming Wu, Stefan Janssens and Olivier Varenne

Analysis of particulate exposure during continuous drug infusion in critically ill adult patients: a preliminary proof-of-concept in vitro study

In critically ill patients, drug incompatibilities frequently occur because of the number of drugs to be administered through a limited number of infusion lines. These are among the main causes of particulate ...

Authors: Malik Benlabed, Anthony Martin Mena, Romain Gaudy, Maxime Perez, Stéphanie Genay, Jean-Daniel Hecq, Pascal Odou, Gilles Lebuffe and Bertrand Décaudin

Sepsis 2018

Authors:

Tight junction structure, function, and assessment in the critically ill: a systematic review

Epithelial and endothelial barrier integrity, essential for homeostasis, is maintained by cellular boarder structures known as tight junctions (TJs). In critical illness, TJs may become disrupted, resulting in...

Authors: David Vermette, Pamela Hu, Michael F Canarie, Melissa Funaro, Janis Glover and Richard W Pierce

Validation of new marker of fluid responsiveness based on Doppler assessment of blood flow velocity in superior vena cava in mechanically ventilated pigs

We studied a novel approach for the evaluation and management of volemia: minimally invasive monitoring of respiratory blood flow variations in the superior vena cava (SVC). We performed an experiment with 10 ...

Authors: Tomas Kovarnik, Miroslav Navratil, Jan Belohlavek, Mikulas Mlcek, Martin Chval, Zhi Chen, Stepan Jerabek, Otomar Kittnar and Ales Linhart

Succinate and the shortcut to the cure of metformin-induced lactic acidosis

Inhibition of the respiratory chain complex I plays a key role in the pathogenesis of metformin-induced lactic acidosis. In a work recently published in this journal, a novel cell-permeable succinate prodrug (...

Authors: Alessandro Protti

Bench Validation of a Compact Low-Flow CO₂ Removal Device

There is increasing evidence demonstrating the value of partial extracorporeal CO₂ removal (ECCO₂R) for the treatment of hypercapnia in patients with acute exacerbations of chronic obstructive pulmonary disease a...

Authors: Alexandra G. May, R. Garrett Jeffries, Brian J. Frankowski, Greg W. Burgreen and William J. Federspiel

Heparin-binding protein in ventilator-induced lung injury

Although mechanical ventilation is often lifesaving, it can also cause injury to the lungs. The lung injury is caused by not only high pressure and mechanical forces but also by inflammatory processes that are...

Authors: Jonas Tydén, N. Larsson, S. Lehtipalo, H. Herwald, M. Hultin, J. Walldén, A. F. Behndig and J. Johansson

Time course of liver mitochondrial function and intrinsic changes in oxidative phosphorylation in a rat model of sepsis

Tissue ATP depletion and oxidative stress have been associated with the severe outcomes of septic shock. One of the compensatory mechanisms to alleviate the sepsis-induced mitochondrial dysfunction could be th...

Authors: Pierre Eyenga, Damien Roussel, Jerome Morel, Benjamin Rey, Caroline Romestaing, Virginie Gueguen-Chaignon, Shey-Shing Sheu and Jean Paul Viale

Advanced modes of mechanical ventilation and optimal targeting schemes

Recent research results provide new incentives to recognize and prevent ventilator-induced lung injury (VILI) and create targeting schemes for new modes of mechanical ventilation. For example, minimization of ...

Authors: Matthias van der Staay and Robert L. Chatburn

Correction to: Esmolol indirectly stimulates vagal nerve activity in endotoxemic pigs

Following publication of the original article [1], the author reported these required corrections to Fig. 5 and Fig. 6:

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

Heart rate elevations during early sepsis predict death in fluid-resuscitated rats with fecal peritonitis

In sepsis, early outcome prediction would allow investigation of both adaptive mechanisms underlying survival and maladaptive mechanisms resulting in death. The aim of this study was to test whether early chan...

Authors: Alain Rudiger, Victor Jeger, Mattia Arrigo, Christian A. Schaer, Florian F. Hildenbrand, Margarete Arras, Burkhardt Seifert, Mervyn Singer, Gabriele Schoedon, Donat R. Spahn and Dominique Bettex

Peptide binding to cleaved CD31 dampens ischemia/reperfusion-induced intestinal injury

CD31 is a key transmembrane neutrophil immunoregulatory receptor. Mesenteric ischemia/reperfusion-induced neutrophil activation leads to a massive cleavage and shedding of the most extracellular domains of CD3...

Authors: Quoc Thang Hoang, Alexandre Nuzzo, Liliane Louedec, Sandrine Delbosc, Francesco Andreata, Jamila Khallou-Laschet, Maksud Assadi, Philippe Montravers, Dan Longrois, Olivier Corcos, Giuseppina Caligiuri, Antonino Nicoletti, Jean-Baptiste Michel and Alexy Tran-Dinh

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