Articles: sepsis.
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Intensive care medicine · Jan 2025
Multicenter Study Observational StudyLeft ventricular diastolic dysfunction is prevalent but not associated with mortality in patients with septic shock.
Prognostic impact of left ventricular diastolic dysfunction (LVDD) in septic shock patients has not been determined using current diagnostic guidelines. We assessed the relation between LVDD during the first 3 days following intensive care unit (ICU) admission for septic shock and Day-28 mortality. ⋯ LVDD was highly prevalent in patients with septic shock but not associated with mortality. It appeared improving in one-third of survivors.
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Review Case Reports
Brucella as a cause of severe sepsis: Case series and brief review.
Brucellosis is a serious public health problem worldwide and can affect any organ system. Due to brucellosis's variable clinical presentation, ranging from subclinical to fully symptomatic, and limited available information, it poses a diagnostic challenge. ⋯ These case presentations will be valuable in increasing the awareness of physicians. A prompt diagnosis is crucial, as detecting some clues of the infection in its early stages can help avoid misdiagnoses.
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Sepsis is a life-threatening organ dysfunction that occurs due to a dysregulated host response to infection. Septic-associated liver injury (SALI) has been closely linked to the prognosis and mortality of sepsis. Recent investigations have delved into the gut-liver axis and its association with SALI, identifying its pivotal role in the gut microbiota. ⋯ Moreover, their metabolites might exacerbate or initiate SALI by modulating immune responses. Nevertheless, interventions to restore the balance of the gut microbiota, such as the administration of probiotics, fecal microbiota transplantation, or dietary adjustments, may ameliorate SALI and enhance the prognosis and survival rates of septic patients. This review aimed to elucidate the function of the gut microbiota in the genesis and procession of SALI and its potential therapeutic value, offering a deeper understanding of the pathogenesis and therapeutic avenues for SALI.
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Intensive care medicine · Jan 2025
Randomized Controlled TrialSepsis subtypes and differential treatment response to vitamin C: biological sub-study of the LOVIT trial.
We hypothesised that the biological heterogeneity of sepsis may highlight sepsis subtypes with differences in response to intravenous vitamin C treatment in the Lessening Organ Dysfunction with VITamin C (LOVIT) trial. Our aims were to identify sepsis subtypes and to test whether sepsis subtypes have differences in treatment effect to vitamin C and describe putative biological effects of vitamin C treatment. ⋯ We report three sepsis subtypes based on inflammatory response profile. No subtype benefitted from vitamin C treatment in the LOVIT trial, with heterogeneity of treatment effect in the magnitude of harm.
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Observational Study
Cardiopulmonary Ultrasound to Predict Care Escalation in Early Sepsis: A Pilot Study.
It is challenging to identify emergency department (ED) patients with sepsis who will require resources such as positive-pressure ventilation, vasopressors, or intensive care unit (ICU) admission. ⋯ In patients with concern for sepsis early findings of ≥4 B-lines is associated with care escalation. Combining this finding with LVF and RV size assessment improves the positive predictive power and may be useful in rapid identification of patients likely to require care escalation.