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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reviewed 374 consecutive trauma patients over age 65 years to determine (1) if the emergency room Trauma Score (TS) could predict mortality, thereby improving ICU triage, and (2) the frequency of preventable complications in patients who died (n = 31). Fifty-two percent of deaths (n = 16) occurred in patients with TS = 15 or 16. Multiple organ failure/sepsis (MOF/S) was the most common cause of death overall (42%) and was also the most frequent cause of death in patients with a TS = 15-16 (63%). Nonsurvivors in the TS = 15-16 subgroup were older (80.9 +/- 2.0 vs. 74.9 +/- 0.5 years, p less than 0.02) and had greater ISSs (15.8 +/- 3.7 vs. 8.0 +/- 0.4, p = 0.001) than survivors. Patients with a TS less than 15 suffered high overall mortality (45%). Preventable complications contributed to mortality in 32% of all deaths and in 62% of MOF/S deaths. Aggressive care to prevent avoidable complications may improve survival in elderly trauma victims.
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PMID:Preventable complications and death from multiple organ failure among geriatric trauma victims. 140 16

Rabbits with MOF induced by intraabdominal sepsis were used to observe the effect of TPN with different amount of amino acid nitrogen on organ function, nitrogen balance and urine 3-MH excretion. The results showed that TPN support could improve the impaired organ function and reverse negative nitrogen balance. Low nitrogen burden was helpful to the lung, while high nitrogen appeared to be beneficial to the liver. Low nitrogen was more effective in increasing nitrogen balance and decreasing the urine 3-MH excretion. We conclude that excessive nitrogen burden results in significant thermic effect and an elevation of stress level, just as excessive glucose does.
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PMID:[Effect of total parenteral nutrition with different nitrogen burden on organ function and protein metabolism in multiple organ failure rabbits]. 181 12

PAF has been implicated as a mediator of shock, sepsis and MOF. The results of experimental data demonstrate that PAF induces changes characteristic of endotoxemia and sepsis, including systemic hypotension and diffuse microvascular leakage. These effects are prevented by PAF antagonists. PAF induces many of the characteristic changes of MOF, including functional impairment in the lung, kidney, gastrointestinal tract and heart. PAF antagonists will inhibit these adverse effects. PAF antagonists are now being manufactured by a number of pharmaceutical companies studying the beneficial effects of PAF antagonists in human disease. Data from these studies promise valuable information with significant clinical relevance to the practicing surgeon.
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PMID:The role of platelet activating factor and its antagonists in shock, sepsis and multiple organ failure. 185 37

A great variety of mediators and mediator systems are involved in the disturbance of the microcirculation and vascular permeability following polytrauma and sepsis. The locally accentuated, organ related activation and the cooperation of several of these mediators and mediator systems over a longer period of time seem to be responsible for the development of an acute organ failure in terms of ARDS and MOF. Cytokines from macrophages seem to be the determining factors converting a primarily functional and reversible systemic vascular reaction into organ related morphological lesions. This pathogenetic complexity has to be considered in future concepts for therapy and prophylaxis with regard to the hierarchical rank of the mediators involved.
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PMID:Actions and interactions of mediator systems and mediators in the pathogenesis of ARDS and multiorgan failure. 192 30

Current technology has prolonged the life support of patients with organ failures. The onset of MOF follows an inciting event and develops a clinical pattern of lung, liver, and kidney failure. Laboratory evidence of the syndrome includes hyperbilirubinemia, hyperglycemia, increased blood lactate, and reduced levels of hepatic proteins. Energy expenditure in MOF is increased and severe sepsis or septic shock can initiate the process of hypermetabolism and MOF. Current therapy is aimed at source control, restoration of oxygen transport, and metabolic support. Critical care nursing provides a technological and humanistic approach in developing a supportive environment for patients and families. Scientific study of the effects of nursing interventions on patient outcomes is needed to evaluate critical care nursing activities.
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PMID:The syndrome of multiple organ failure. 219 33

The course of 225 multiple traumatized patients in our ICU with a mean age of 35 +/- 16.8 years, a mean ISS of 30 +/- 8.3 and an overall mortality of 18.2% was evaluated retrospectively. For comparable ISS the mortality was higher in patients over 65 years, and increased further with age. The most common causes of death were MOF (41.5%), severe head injury (34.1%), and acute respiratory failure (ARF) (19.5%). The mortality increased when two or more organ failures were present. 105 patients had fractures of the long bones; in 28 of these all fractures were stabilized primarily (during the first 24 hours). Organ failure was seen less frequently in these patients compared to those with secondary stabilization: ARF 10.7% vs. 51.9% (p less than 0.0004), acute renal failure 3.6% vs. 11.7%, liver failure 3.6% vs. 11.7%, sepsis 14.3% vs. 29.9%. Mortality was significantly lower in the patient with primarily stabilized fractures (7.1% vs. 24.7%, p less than 0.05). The study demonstrates that early stabilization of long bone fractures results in a more favourable course, and that this should be carried out whenever feasible.
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PMID:[Organ failure in patients with multiple trauma. The effect of early osteosynthesis of fractures on complications]. 230 92

Inventarising the inflammatory capacities of the three types of inflammatory cells, PMN, macrophages and mast cells, each type seems able to induce a lethal whole body reaction. This whole body inflammation has hitherto largely escaped our attention, as in clinical studies inappropriate methods have been used such as counting peripheral leucocytes, and as monitoring key-mediators (IL-1, TNF, PGE-2, leukotrienes) and key-cells (activated PMN, macrophages and mast cells) hitherto was impossible. Presently a new set of methods is available, allowing a closer look at this whole body inflammation, such as elastase (monitoring PMN activity), neopterin (monitoring macrophage activity) and hopefully clinically practicable methods to monitor cytokines as well as endotoxin-levels. Only after such comprehensive studies have been performed, it might be concluded that--as in the experimental animal--sepsis and MOF may not necessarily be caused by bacteria or their endotoxins, but by an untoward autodestructive and self-sustaining activation of angry leucocytes and mad macrophages.
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PMID:Multiple organ failure: whole body inflammation? 265 70

To study the role of lysosomal protease released from polymorphonuclear leukocytes during MOF, plasma PMNE levels were measured serially in 38 patients. The patients were divided into two groups, 14 patients of MOF from sepsis (group 1), and 24 injured patients without MOF (group 2). The normal value of PMNE was from 21 to 165 micrograms/l. The PMNE levels of the group 1 elevated (831 +/- 241 micrograms/l) at the time of diagnosis of sepsis and remained high during MOF. On the contrary, those of the group 2 were high on admission (574 +/- 131 micrograms/l), but returned to normal within seven days. There was no relationship between the levels of PMNE and the number of neutrophils. However, the PMNE/neutrophils ratio was significantly higher in group 1. Correlations were demonstrated between the amount of PMNE and the decrease in the levels of platelet counts, fibronectin and coagulation factor XIII. It is suggested that PMNE might play a major role in the pathobiochemical changes and tissue injury during MOF.
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PMID:[Polymorphonuclear leukocyte elastase (PMNE) levels in sepsis; the effect of PMNE on multiple organ failure (MOF)]. 278 1

Pulmonary edema of sepsis is a consequence of increased transmural conductance for water and proteins at the level of lung microvessels induced by vasoactive endogenous mediators, liberated after activation of complement by bacterial endotoxins. Intermittent opening of interendothelial junctions at the level of post-capillary venules has been implicated as being the pathway for the leaking plasma proteins and water. Microvascular basement membranes and endothelial cell surfaces have fixed anionic charges (AS) which prevent the escape of plasma proteins from the circulation as well as the adhesion of blood cells to the luminal endothelium. The density distribution of these AS was substantially reduced in visceral and systemic microvessels during murine abdominal sepsis. This observation suggest that MOF secondary to sepsis is the consequence of a severe and generalized alteration of the microvascular electronegative charge, induced by liberation of inflammatory mediators.
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PMID:Decreased density distribution of mesenteric and diaphragmatic microvascular anionic charges during murine abdominal sepsis. 284 42

A retrospective study of 130 multiple trauma patients admitted to an intensive care unit is presented. Overall mortality was 33% for a mean ISS of 39.4. Craniocerebral trauma, multiple organ failure, sepsis and ARDS are the main causes of death, although there is no statistical difference for these between survivors and non-survivors. There is a good correlation between ISS and mortality (r = 0.86). Patients developing MOF, sepsis and ARDS have significantly higher ISS. Mortality from complications such as sepsis, MOF, ARDS and aspiration pneumonia seems more related to age.
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PMID:A retrospective study of 130 consecutive multiple trauma patients in an intensive care unit. 376 Mar 19


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