Shock : molecular, cellular, and systemic pathobiological aspects and therapeutic approaches : the official journal the Shock Society, the European Shock Society, the Brazilian Shock Society, the International Federation of Shock Societies
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Excessive release of inflammatory cytokines that induces hematopoietic progenitor cell apoptosis lead to the persistent anaemia which results delay recovery of patients with trauma hemorrhagic shock (T/HS). Therefore, aim was to investigate of the correlation of serum cytokines on in-vitro hematopoietic progenitor cells growth among T/HS patients. This study investigates the serum cytokines levels in patients with trauma hemorrhagic shock and correlation with hematopoietic stem cell growth/differentiation. ⋯ Our studies suggested hematopoietic stem cell growth suppressed by serum levels of cytokines TNF-α, and IL6. Further studies need to be undertaken to evaluate potential therapeutic strategies for TNF-α and IL-6 in the given setting.
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Systemic inflammation is a well-known risk factor for respiratory muscle weakness. Studies using animal models of inflammation have shown that endotoxin administration induces diaphragm dysfunction. However, the effects of in vivo endotoxin administration on diaphragm function in humans have not been studied. Our aim was to evaluate diaphragm function in a model of systemic inflammation in healthy subjects. ⋯ This study shows that, in contrast to diaphragm dysfunction observed in animal models of inflammation, in vivo diaphragm contractility is augmented in the early phase after low-dose endotoxin administration in humans.
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Early detection and management of post-traumatic haemorrhage and coagulopathy have been associated with improved outcomes but local infrastructures, logistics and clinical strategies may differ. ⋯ This study confirms differences in infrastructure, logistics and clinical practice for the detection.
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Observational Study
CT-proAVP is Not a Good Predictor of Vasopressor Need in Septic Shock.
Septic shock features a high hospital mortality. Improving our ability to risk stratify these patients at admission may help better define management strategies and design studies. The primary objective of this study was to determine if patients dead or with sustained vasopressor need at day 7 had a relative arginine vasopressin (AVP) deficiency as compared with vasopressor-free patients at day 7. Another objective was to explore if plasma CT-proAVP (C terminal part of preprovasopressin) measured within 24 h of sepsis onset could predict patient severity. ⋯ Patients with septic shock and sustained need of vasopressors do not seem to present a relative AVP deficiency. In sepsis, the subgroup of patients that may benefit from AVP supplementation still needs to be identified. Our study further confirms previous data on the ability of the CT-proAVP to predict patient severity in severe sepsis and septic shock.
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Septic deaths occur in a deranged environment featuring both hyperinflammatory and immunosuppressive responses. At present, there is no approved immune-modulatory drug able to restore this imbalance. This study aimed to test a newly developed blood cell secretome preparation (APOSEC) upon outcome in the acute mouse model of polymicrobial sepsis. ⋯ This study demonstrated that deregulation of immuno-inflammatory responses and organ/cellular homeostasis caused by a relatively severe CLP insult was too rapid/strong to be effectively modified by APOSEC.