Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of the present study was to determine whether hearts that demonstrate depressed myocardial reserves as a result of sustained hypermetabolic sepsis would show a potentiation of the dysfunction after an infusion of high doses of alcohol. We have previously shown that myocardial depression is present in hearts removed from hypermetabolic septic rats. Acute alcohol administration has also been shown to have a negative inotropic effect on the heart. In this study, myocardial function was assessed under in vitro conditions in which preload could be varied and aortic outflow resistance controlled and thus heart function could be determined under both low and high workloads. The alcohol-infused group increased cardiac performance as a function of increasing preload similarly to the controls. Heart rate, however, was significantly elevated compared with control. Isolated hearts from septic, saline-infused animals showed depressed cardiac performance both in terms of stroke volume and myocardial work over a range of preloads. The septic, alcohol-infused animals did not show this depression. Thus, a loss of myocardial reserve was demonstrable in hearts isolated from septic, saline-infused rats but not in septic, alcohol-infused rats. Alcohol, at least acutely, seemed to reverse or ameliorate the loss of myocardial reserve induced by sepsis possibly by increasing the ability of the heart to fill during diastole and thus perform volume work.
 ...
PMID:Function of isolated hearts from septic, saline-infused, and septic, alcohol-infused rats. 178 83

The primary function of the cardio-respiratory system is to meet the oxygen demands of the various organs and tissues and to remove metabolic wastes. The cellular O2 supply in the critically ill patient afflicted with severe infection, sepsis or ARDS is impaired not only by reduced O2 transport to the tissue due to myocardial depression caused by inadequate preloading and depressed contractility, but also by inadequate blood flow at the regional and microcirculatory levels. To obtain adequate tissue oxygenation despite derangements of the microcirculation, it is useful to aim for a hyperdynamic circulatory state that provides a supramaximal O2 transport. The best way to achieve this goal is first to optimize cardiac filling pressures, i.e. to the upper range of normal, and then to improve cardiac output using inotropic support. Only when the arterial pressure remains too low despite these measures is the use of vasopressors indicated.
 ...
PMID:[Oxygen transport and tissue oxygenation in critically ill patients--value of volumes and vasoactive substances]. 181 5

Little is known of the endorphins' role in sepsis-induced respiratory distress and naloxone's effect as a treatment of it. Thirteen piglets were infused with live Escherichia coli at a rate of 2 to 10 x 10(8) colony-forming units per hour for six hours or until death and were divided into two groups: the septic control group (n = 8), and the naloxone-treated group (n = 5), which received 8 mg/kg/h of naloxone by continuous infusion. The results showed a significant reduction of QS/QT, VD/VT, and arterial carbon dioxide pressure at one hour and a significant increase of arterial carbon dioxide pressure and minute ventilation at 1, 3, and 4 hours in the naloxone-treated group, compared with the untreated septic group. None of the piglets in the naloxone-treated group developed ventilatory depression, while 75% of those in the untreated septic group did. Among the latter ficial effects of naloxone are likely related to its action on the central and peripheral respiratory regulatory mechanisms. A transient protection of the cardiac output and relatively decreased extravascular lung water with naloxone treatment may also, in part, improve the ventilation-perfusion maldistribution and secondarily reduce QS/QT and VD/VT.
 ...
PMID:[Prevention of septic ventilatory depression with naloxone]. 181 74

So-called "Postoperative Erythroderma" was experienced in a 68 year-old man who received CABG for unstable angina. After a seemingly uneventful recovery, he revealed high grade fever on 13th post operative day (POD), rashes over the whole body on 15th POD and pancytopenia on 20th POD. He died of sepsis, multiple organ failure and DIC on 21st POD. Blood transfusion (concentrated red cell: 3 units) was done on operation. In this case, the rate of premature and atypical lymphocytes increased, and the ratio of OKT4 (helper)/OKT8 (suppressor) decreased. These findings of the examination suggested that there was a possibility of cell-mediated immunological depression. We considered this to be acute GVHD after blood transfusion.
 ...
PMID:[A case of "postoperative erythroderma" following coronary artery bypass grafting operation]. 183 33

Myelosuppression in patients with cancer is usually the result of tumor invasion of the bone marrow, cytotoxic chemotherapy, or radiation therapy, all of which suppress bone marrow function. Anemia, thrombocytopenia, and neutropenia are the three most clinically significant complications that result from bone marrow depression. Although anemia and thrombocytopenia can produce serious clinical problems, blood-component transfusions--despite having inherent problems of their own--usually are successful in correcting or minimizing these complications. Although neutropenia is manageable in most situations, it remains a serious problem that, at its worst, can progress to life-threatening septicemia. The longer neutrophil counts remain low, the more susceptible patients become to infection by endogenous and exogenous microbial flora. Accordingly, the oncology nurse increases the frequency of patient assessment and monitoring for infection. Control measures are introduced to minimize environmental contaminants. These measures attempt to reduce the incidence of opportunistic infections that frequently occur in patients with severe or prolonged neutropenia and for which antimicrobial therapy is indicated. Implementing specific infection-control interventions and thoroughly educating the patient and his/her family help to limit the clinical problems associated with myelosuppression for most patients.
 ...
PMID:Current strategies for managing myelosuppression in patients with cancer. 190 77

An outbreak of salmonellosis in foals occurred on a large Thoroughbred farm in California. Only foals less than 8 days of age exhibited clinical signs, which included depression, anorexia, and diarrhea. Three foals died from septicemia. The agent responsible was Salmonella ohio, which is rarely involved in salmonellosis in horses. During the course of the outbreak, S. ohio was isolated from 27 of 97 mares (27.8%) and 34 of 97 foals (35.1%). Mares were the presumed source of infection for foals. The absence of clinical signs in mares allowed for increased exposure of foals through environmental contamination. Although foals continued to become infected after strict control measures were adopted, none became ill. Salmonella serotypes of seemingly low virulence can produce serious disease outbreaks.
 ...
PMID:An outbreak of equine neonatal salmonellosis. 191 93

The quality of analgesia and incidence of side effects when using a continuous subarachnoid infusion of diamorphine were assessed in 28 postoperative patients who had undergone major abdominal or lower limb surgery. Excellent pain relief was obtained without depression of the respiratory rate. Four patients complained of headache, and 50% of those patients not already catheterized preoperatively subsequently required it for urinary retention. There was no evidence of sepsis related to the indwelling subarachnoid catheter.
 ...
PMID:Initial experience of continuous subarachnoid diamorphine infusion for postoperative pain relief. 195

Since the sepsis syndrome is associated with depressed vascular reactivity, it may be incorrect to assume that pharmacologically mediated changes in cardiac output will be proportionately distributed at the regional level of the circulation. We examined the effect of hyperdynamic sepsis and the concurrent administration of the vasodilatory prostaglandin (PGE1) on the regional distribution of blood flows (Q) in unanesthetized sheep rendered septic by cecal ligation and perforation. Systemic Q progressively increased throughout a 48-h study period after cecal ligation and perforation. Simultaneously, organ Q, measured by the radioactive microsphere technique, was depressed to the pancreas, but increased to the heart, gallbladder, brain, and colon; the increased Q to both heart and gallbladder was greater than the simultaneous increase in systemic Q in this septic study. With the infusion of PGE1 (1 microgram/kg/min), mean arterial perfusing pressures fell, while the cardiac index increased further over that recorded during the 48-h septic study. Despite this depression in arterial pressures, the only significant effect of PGE1 on the interorgan distribution of Q was in the renal circulation, where it was demonstrated that kidney Q fell. We conclude that (1) hyperdynamic and normotensive sepsis exerted nonhomogeneous effects on the distribution of organ Q, and (2) an increased systemic Q during PGE1 infusion was proportionately distributed to all organs, except the kidneys, where Q paradoxically fell. The latter finding suggests that the regulation of kidney Q may be depressed across the normal range of arterial perfusing pressures in the sepsis syndrome. Further investigation is essential to understand the effect of clinical interventions on the control of tissue O2 flux at both the regional and microregional levels of the circulation.
 ...
PMID:Effect of PGE1 on altered distribution of regional blood flows in hyperdynamic sepsis. 195 17

The study objective was to describe the clinical, biologic, and hemodynamic features of adult overwhelming meningococcal purpura and to examine the prognostic factors by multivariate analysis at the time of admission to the intensive care unit. Thirty-five patients (greater than or equal to 13 years of age) with meningococcal infection, circulatory shock, and generalized purpuric lesions of abrupt onset were recorded in eight intensive care units from 1977 to 1989. The patients were young (mean age, 26.6 years; range, 13 to 68 years) and had been previously healthy. The female-to-male ratio was 3:1. Mortality was 54.3%, with most deaths occurring within the first 48 hours, usually secondary to irreversible shock with multiple organ failure. Ischemic complications (eight cases), prolonged heart failure (seven cases), and secondary septicemia (five cases) were the chief complications among survivors. Initial hemodynamic study after volume loading showed low stroke volume index (mean +/- SD, 29.4 +/- 13 mL/m2) and tachycardia (mean +/- SD, 138 +/- 16 beats per minute), a profile suggesting a greater myocardial depression than usually observed in gram-negative bacillary septic shock. Univariate prognostic analysis showed that four variables at the time of admission were associated with fatal outcome: a plasma fibrinogen level of 1.5 g/L or less, a factor V concentration of 0.20 or less, a platelet count lower than 80 x 10(9)/L, and a cerebrospinal fluid leukocyte count of 20 x 10(6)/L or less. Stepwise regression analysis showed that low fibrinogen level (less than or equal to 1.5 g/L) was the sole adverse prognostic variable (odds ratio = 2, 95% confidence interval, 1.5 to 2.7). Adult overwhelming meningococcal purpura is still associated with high mortality and morbidity. Low fibrinogen level at time of admission may permit early recognition of the most severely ill patients.
 ...
PMID:Adult overwhelming meningococcal purpura. A study of 35 cases, 1977-1989. 199 58

Although active hepatocellular function is depressed during sepsis, it is not known whether this occurs in the very early stages of sepsis and whether it is due to depressed cardiac output or hepatic blood flow. To study this, rats were subjected to sepsis by cecal ligation and puncture and hepatocellular function was determined at various intervals thereafter by assessing the ability of the liver to clear different doses of indocyanine green. The indocyanine green concentration was continuously measured in vivo with a fiberoptic catheter and an in vivo hemoreflectometer. Maximal velocity and kinetic constant of the clearance of indocyanine green, hepatic blood flow, and cardiac output were determined in experimental and sham-operated rats. The results demonstrate that hepatic blood flow and cardiac output increased 2 to 10 hours after cecal ligation and puncture, while hepatocellular function (maximum velocity and kinetic constant) was decreased even 2 hours following cecal ligation and puncture. No linear correlation between hepatocellular function and hepatic blood flow or cardiac output was found under such conditions. The extremely early depression in active hepatocellular function, despite the increased hepatic blood flow and cardiac output, may form the basis for cellular dysfunctions leading to multiple organ failure during sepsis.
 ...
PMID:Hepatic extraction of indocyanine green is depressed early in sepsis despite increased hepatic blood flow and cardiac output. 199 97


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>