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Sepsis/Septic Shock
Published in Charles Theisler, Adjuvant Medical Care, 2023
Sepsis is a life-threatening medical emergency. It is often the consequence of bacteria in the bloodstream (bacteremia). The body's overwhelming and detrimental response to a blood infection can lead to tissue damage, organ failure, and death. For example, in attempting to fight the infection, the body sends inflammatory cytokines and nitric oxide into the blood stream which can lead to vasodilation (from smooth muscle relaxation), blood clots, and leaky blood vessels (vascular permeability). As a result, blood flow is impaired and organs are deprived of nutrients and oxygen, leading to organ damage.1 Sepsis occupies a continuum that ranges from mild to severe sepsis to septic shock and multiple organ dysfunction syndrome (MODS).2
Critical Care of the Trauma Patient
Published in Kenneth D Boffard, Manual of Definitive Surgical Trauma Care: Incorporating Definitive Anaesthetic Trauma Care, 2019
MODS is a clinical syndrome characterized by the progressive failure of multiple and interdependent organs. The ‘dysfunction’ identifies a phenomenon in which organ function is not capable of maintaining homeostasis, so it occurs along a continuum of progressive organ failure, rather than absolute failure. The lungs, liver, and kidneys are the principal target organs; however, failure of the cardiovascular and central nervous system may be prominent as well. The main inciting factors in trauma patients are haemorrhagic shock and infection. As life support and resuscitation techniques have improved, so the incidence of MODS has increased.
Cutaneous manifestations of sepsis
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Sepsis is defined as systemic inflammatory response syndrome (SIRS) secondary to a documented infection. The host response to infection leading to sepsis is a continuum that ranges from sepsis to severe sepsis to septic shock and multiple organ dysfunction syndrome (MODS) [1]. The symptoms of sepsis are often nonspecific and include fever with chills, confusion, anxiety, breathlessness, nausea, vomiting, malaise, and fatigue. But these symptoms are not universal or pathognomonic. Even though fever is a common symptom, some cases may have hypothermia in the presence of tachycardia and tachypnea. Like the other clinical features of sepsis, cutaneous manifestations are also not pathognomonic, but the presence of them may be extremely useful for the clinician to arrive at a diagnosis as well as to assess the severity of the condition.
Plantamajoside alleviates acute sepsis-induced organ dysfunction through inhibiting the TRAF6/NF-κB axis
Published in Pharmaceutical Biology, 2023
Daili Feng, Ruying Guo, Wei Liao, Jiancheng Li, Song Cao
Sepsis is a syndrome of uncontrolled systemic inflammation and often arises from infection, which has become a major lethal reason for patients in intensive care units (ICU) (van der Poll et al. 2021). On the basis of an epidemiological survey, there are about 48 million cases of sepsis worldwide (Gomanova and Brazhnikov 2021), and the mortality dynamics of sepsis have become increasingly prominent due to the diversified complications (Torres et al. 2022). Approximately 8.1 million patients died of sepsis with the mortality rate remaining at 25%–30% in 2021 (Fleischmann et al. 2016; Wong et al. 2021). Currently, sepsis remains an unresolved public health problem in many countries of the world. Organ damage is a principal feature of sepsis, which can further develop multiple organ dysfunction syndrome (MODS) (Sygitowicz and Sitkiewicz 2020). The dominating treatment strategies of sepsis rely on ventilator and continuous renal replacement therapy (CRRT) (Romagnoli et al. 2018; Lourbopoulos et al. 2021), but valid drugs for sepsis is still lacking. Therefore, the search for effective drugs for treatment of sepsis-induced organ damage is extremely important.
Combined radiation injury and its impacts on radiation countermeasures and biodosimetry
Published in International Journal of Radiation Biology, 2023
Juliann G. Kiang, William F. Blakely
In animal models of combined radiation injury (CI), there are rats (Alpen and Sheline 1954; Valeriote and Baker 1964), guinea pigs (Korlof 1956), dogs (Brooks et al. 1952), and swine (Baxter et al. 1953) with burns and wounds; they usually rise mortality after otherwise non-lethal radiation exposures. In 1970s, Armed Forces Radiobiology Research Institute (AFRRI) began CI investigations. In mice, radiation exposure followed by burns or other wounds further reduced survival compared to burns alone, wounds alone or radiation exposure alone (Ledney et al. 1992; Kiang and Ledney 2013), and radiation delays wound healing times (Ledney et al. 1981). Subsequently, CI resulted in acute suppression of myeloid, inhibition of the immune system, fluid imbalance, macro/microcirculation failure, massive cellular damage and death, and vital organ dysfunctions. Then, multiple organ dysfunction syndrome (MODS) occurs, which is the most frequent cause of death after CI (Koenig et al. 2005; Lausevic et al. 2008; Zou et al. 2008; Kiang and Olabisi 2019).
The role of artificial cells in the fight against COVID-19: deliver vaccine, hemoperfusion removes toxic cytokines, nanobiotherapeutics lower free radicals and pCO2 and replenish blood supply
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2022
Before the onset of COVID-19 this commercial device has been studied in other conditions with the elevation of systemic cytoklines [31–34]. For example, a detailed study in a porcine acute respiratory distress syndrome model shows that hemoperfusion cartridge (HA330), with a blood flow of 200–250 ml/min reduces the circulating and alveolar levels of proinflammatory cytokines, improves oxygenation and helps the recovery of lung injuries in the exudative phase [35]. Another study in patients with multiple organ dysfunction syndrome (MODS) shows the effectiveness of hemoperfusion [36]. Hemoperfusion significantly improves the biochemical indicators, inhibits the activation of NK-κB and significantly reduces the levels of inflammatory cytokines IL-6 and TNF-α in peripheral blood of the patients. A similar effect on the reduction of systemic cytokines are observed in patients with extrapulmonary sepsis-induced acute lung injury [37], Leptospirosis with acute respiratory failure and acute kidney injury [31] and septic shock patients [32].