Articles: sepsis.
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Sepsis and septic shock remain all too frequent syndromes in modern medicine with unacceptably high mortality rates. Physicians must be aware of the many ways in which sepsis and septic shock may present and the multiple differential diagnoses. ⋯ Our current limited understanding of the pathophysiology of sepsis and septic shock significantly limits our ability to treat this syndrome effectively and thus substantively alter mortality. New developments in immunology and metabolism seem promising in furthering our understanding and improving our therapy of this complex multisystem disorder.
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Critical care clinics · Oct 1986
ReviewThe cardiopulmonary effects of sepsis on the trauma patient.
The cardiopulmonary effects of acute infection are inflammation-induced. Inflammatory mediators can both initiate and perpetuate the characteristic hyperdynamic, hypermetabolic state.
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Comparative Study
Selective elevation of systemic blood pressure by epinephrine during sepsis-induced pulmonary hypertension in piglets.
In a piglet model of group B beta Streptococci (GBS)-induced pulmonary hypertension, we have determined hemodynamic responses to epinephrine (EPI) infusion in both the systemic and pulmonary circulations. Three groups of piglets (GBS + EPI, n = 6; GBS + placebo, n = 6; placebo, n = 6) were studied. GBS, infused intravenously at approximately 5 X 10(7) organisms/kg/min, reduced cardiac index and stroke volume index while elevating pulmonary artery pressure and pulmonary vascular resistance index. ⋯ Systemic acid/base status and PaO2 did not differ among piglets who received GBS + EPI, GBS alone, or placebo. Extrapolation of these data to human infants must be approached with extreme caution. However, selective elevation of systemic blood pressure may be a feasible strategy for some infants to impede right-to-left shunting of blood often associated with sepsis-induced pulmonary hypertension.
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Case Reports
Angioneurotic edema, agranulocytosis, and fatal septicemia following captopril therapy.
Captopril, an angiotensin converting enzyme inhibitor used in the treatment of hypertension, has been associated with hematologic as well as dermatologic side effects. Two patients with captopril-induced angioneurotic edema, one of whom had fatal granulocytopenia and overwhelming polymicrobial sepsis, are presented.