Journal of critical care
-
Journal of critical care · Feb 2018
Increased DNA damage and increased apoptosis and necrosis in patients with severe sepsis and septic shock.
Reactive oxygen species (ROS) has a key role in the pathogenesis of sepsis. We wanted to evaluate ROS-associated lymphocyte necrosis and apoptosis. ⋯ The level of 8-OHdG increased with severe sepsis or septic shock. There were significant differences between the pre- and post-treatment values for apoptotic cell frequency (4.21±3.15 vs. 3.82±3.07, P<0.05) and necrotic cell frequency (4.75±3.61 vs. 4.09±3.37, P<0.05). Apoptosis and necrosis was increased during severe sepsis and septic shock, and apoptosis increase also continued after recovery, but necrosis decreased following disease recovery. CONCLUSıONS: In patients with severe sepsis or septic shock, apoptosis and necrosis were increased along with increased 8-OHdG level.
-
Journal of critical care · Feb 2018
ReviewMetabolomic findings in sepsis as a damage of host-microbial metabolism integration.
Metabolomics globally evaluates the totality of the endogenous metabolites in patient's body, at the same time reflecting gene function, enzyme activity and degree of organ dysfunction in sepsis. The authors performed the analysis of the main chemical classes of low molecular weight compounds (amino acids, polyols, fatty acids, hydroxy acids, amines, nucleotides and their derivatives) that quantitatively distinguish patients with sepsis from healthy ones. The following keywords were used to find papers published in the Scopus and Web of Science databases from 2008 to 2015: (marker OR biomarker) AND (sepsis OR critical ill OR pneumonia OR hypoxia). ⋯ Thus, today, we should not limit ourselves studying eukaryotic cells while searching for new molecular mechanisms of sepsis-associated organ failure and septic shock. We should take into account and simulate in the experiments the changes of a human internal environment, which occur during the radical microbiome "restructuring" in critically ill patients. This approach opens up new prospects for an objective monitoring of diseases, carrying out an assessment of the integral metabolic profile in a given time on common metabolites (particularly aromatic), and in future will provide new targets for therapeutic effects.
-
Journal of critical care · Feb 2018
Multicenter Study Comparative StudyHealth-related quality of life after obstetric intensive care admission: Comparison with the general population.
To examine health-related quality of life (HRQoL) in obstetric patients after intensive care discharge, with comparison to age-appropriate reference values from the general Finnish female population. ⋯ The baseline HRQoL of study population was lower than that of the general population, but after six months, the mean values were comparable to reference value. However, one in five patients still experienced impaired QOL at follow-up.
-
Multi-organ dysfunction is seen in nearly 40-60% of all patients presenting with sepsis, including renal and cardiac dysfunction. Cardiorenal syndrome type-5 reflects concomitant cardiac and renal dysfunction secondary to a systemic condition that primarily affects both organs, such as sepsis. ⋯ Acute kidney injury is systematically evaluated using serum creatinine and urine output criteria. This review seeks to systematically describe the epidemiology, risk factors, pathogenesis, diagnosis and management of cardiorenal syndrome type-5 in the setting of sepsis.
-
Journal of critical care · Feb 2018
Multicenter Study Observational StudyPost-ICU psychological morbidity in very long ICU stay patients with ARDS and delirium.
We investigated the impact of delirium on illness severity, psychological state, and memory in acute respiratory distress syndrome patients with very long ICU stay. ⋯ Delirium was associated with memory impairment and PTSS-14 scores suggestive of PTSD, but not illness severity.