Abstract
Acute kidney injury (AKI) is a frequent and serious complication of sepsis. Moreover, there is strong evidence that AKI in patients with severe sepsis is associated with a higher mortality rate. The devastating effects of Gram-negative sepsis are largely based on the effects of lipopolysaccharide (LPS), also known as endotoxin. Mitochondrial dysfunction has been suggested to contribute to the development of organ dysfunction and failure in sepsis. The mitochondrial electron transport chain consists of four complexes (CI to CIV) and its function can be assessed with different approaches. Statins, such as simvastatin and atorvastatin, are hypocholesterolemic drugs that possess pleiotropic effects, including antioxidant and anti-inflammatory properties, that are either dependent on or independent of 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase) inhibition. In addition, in vitro and in vivo studies have demonstrated that simvastatin has an anti-inflammatory effect in patients with predialytic chronic kidney disease, and may play an important role in counteracting the mechanisms involved in pathogenesis of inflammation. We aimed to investigate the effects of prior simvastatin on mitochondrial enzyme activities in kidney tissue of the early phase of sepsis.
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
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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