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
-
Mass casualty events (MCEs) generate a surge in severely injured bleeding casualties requiring rapid resuscitation primarily through high volume red blood cell (RBC) transfusion to maintain end organ perfusion. The significant RBC demand of these events threatens to overwhelm in-hospital RBC supplies. We investigated transfusion based strategies for managing RBC provision under these surge conditions using a computer simulation approach. ⋯ The use of restrictive transfusion protocols in instances of overwhelming RBC demand following an MCE appears to offer promising results for optimising overall outcomes from these events.
-
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.
-
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.
-
It has been demonstrated that sepsis is associated with aggravating immune suppression. T-peptide is one of tuftsin analogs, and it is characterized by its stable structure and long half life compared with tuftsin. The purpose of present study was to investigate the effect of tuftsin-derived T-peptide on cell-mediated immunity induced by lipopolysaccharides (LPS) and survival rate in septic mice. ⋯ These results suggest that tuftsin-derived T-peptide has the ability to modulate sepsis-induced immunosuppression and improve the outcome of septic mice.
-
Intra-abdominal sepsis is a common disease in India. Majority of the patients develop intra-abdominal infections due to secondary bacterial peritonitis. The spectrum of intra-abdominal infections in India is different from that in the West. ⋯ The spectrum of complicated intra-abdominal sepsis in India is considerably different from the west. The high mortality in our setting compared to west is probably due to late patient presentation, lack of ICU facilities and very high incidence of resistant bacteria, as compared to western literature.