Association of initial intracellular signalling pathway and cytokine level with early mortality in severe sepsis patients

Kc Lie,R Sinto,Eppy Eppy,D Widodo,S Lardo

doi:10.1186/cc14049

Abstract

Sepsis occurs as a result of systemic inflammatory process. The release of bacterial components to the systemic circulation leads to activation of inhibitor kappa B kinase (IKK)-β and nuclear factor kappa B (NF-κB) through phosphorylation and ubiquitination. Excessive inflammatory process with maladaptive host's immune response leads to organ dysfunctions and death [1,2]. This study was designed to investigate association of the initial level of intracellular signalling pathway and cytokine involved in sepsis pathophysiology (that is, IKK-β, NF-κB, tumour necrosis factor (TNF)α) and 72-hour (early) mortality in severe sepsis patients.

Highlights

During the course of systemic inflammation, most of the immune cell types get activated to a certain degree as part of, or contributing to, the cascade of physiopathological events
After the development of sepsis we detected in all patients significantly increased heart rate, respiratory rate per minute, leukocytosis, anemia, worse glucose metabolism and renal function (Table 1)
Free KDO in the used concentration was inactive in regulation of TLR4, CD11b and CD14 expression and did not induce tumor necrosis factor alpha (TNFa) release but its impact in biological activity was detected when KDO was applied as constituent of Re-LPS

Summary

Introduction

During the course of systemic inflammation, most of the immune cell types get activated to a certain degree as part of, or contributing to, the cascade of physiopathological events. This study aimed to find out whether mean differences of 6-hour, 12-hour, and 24-hour lactate clearance were observed between nonsurvivors and survivors of acute phase mortality in severe sepsis and septic shock patients. Conclusion: A two-phase retrospective chart review study demonstrated that the SSST utilized at a community hospital in Miami had a sensitivity value of 41.49% and a specificity value of 90.53% when evaluating medical surgical patients These results indicate the tool is accurate in detecting patients that are not septic; it is not reliable in identifying patients who are truly septic. This study was aimed to address the association of achieving either one or two targets of microcirculatory end point resuscitation and early mortality in severe sepsis and septic shock patients. Conclusion: Achieving both lactate clearance and ScvO2 targets in 6 hours after onset of resuscitation associates with lowest early mortality risk in severe sepsis and septic shock patients. Other blood samples were collected in blood culture tubes for culturing to verify septicemia depending on the clinical evidence

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