INTRODUCTION Chronic alcoholic patients have a threefold to fourfold increased risk for developing a severe infection or septic shock after surgery, which might be due to altered immune response. The aim of this outcome matched study was to investigate proinflammatory and anti-inflammatory immune parameters during the course of infection and subsequent septic shock in chronic alcoholic patients...

Volume infusion, to increase preload and to enhance ventricular performance, is accepted as initial management of septic shock. Recent evidence has demonstrated depressed myocardial function in human septic shock. We analyzed left ventricular performance during volume infusion using serial data from simultaneously obtained pulmonary artery catheter hemodynamic measurements and radionuclide cine...

INTRODUCTION ICU-acquired muscle weakness commonly occurs in patients with septic shock and is associated with poor outcome. Although atrophy is known to be involved, it is unclear whether ligands in plasma from these patients are responsible for initiating degradation of muscle proteins. The aim of the present study was to investigate if plasma from septic shock patients induces skeletal muscl...

OBJECTIVE To review the criteria for diagnosing and treating adrenal insufficiency in patients with septic shock. SOURCE OF DATA Articles published in Brazilian and foreign journals selected through these publicationś websites and Medline, as well as references cited in key articles. SUMMARY OF THE FINDINGS The literature reports a range betwen 17 and 54% for the finding of adrenal insuffic...

OBJECTIVES There is paucity of data on the magnitude of absolute or relative adrenal insufficiency in septic shock, especially in children. We conducted a prospective study to determine the prevalence of adrenal insufficiency in children with septic shock using a low-dose Synacthen (1 microg) stimulation test. DESIGN Cross-sectional study. SETTING Pediatric intensive care unit in a tertiary...

INTRODUCTION Severe sepsis and septic shock are associated with substantial mortality. However, few studies have assessed the risk of septic shock among patients who suffered from urinary tract infection (UTI). MATERIALS AND METHODS This retrospective study recruited UTI cases from an acute care hospital between January 2006 and October 2012 with prospective data collection. RESULTS Of the ...

In patients with sepsis and septic shock, the hemodynamic management in both early and later phases of these "organ dysfunction syndromes" is a key therapeutic component. It needs, however, to be differentiated between "early goal-directed therapy" (EGDT) as proposed for the first 6 hours of emergency department treatment by Rivers et al. in 2001 and "hemodynamic management" using advanced hemo...

Although shigellosis is a potentially fatal disease that may cause a number of extra-intestinal manifestations, intractable septic shock is an unusual complication. Here we describe a 6-month-old infant who developed severe septic shock and convulsions during an episode of dysentery caused by multidrug-resistant Shigella dysenteriae. The case presentation demonstrates how shigellosis can lead t...

BACKGROUND We aimed to investigate mortality trends in hospitalized patients with septic shock in the US. To achieve this objective, we tested hypothesis that mortality decreased in patients identified by the code of septic shock while mortality did not change in those with septic shock identified by vasopressor use. METHODS We conducted a serial cross-sectional analysis using Nationwide Inpa...

INTRODUCTION Experimental data from animal models of sepsis support a role for a transcription factor, nuclear erythroid-related factor 2 p45-related factor 2 (Nrf2), as a master regulator of antioxidant and detoxifying genes and intermediary metabolism during stress. Prior analysis of a pediatric septic shock transcriptomic database showed that the Nrf2 response is a top 5 upregulated signalin...