Abstract
Sepsis remains a leading cause of mortality in our ICUs. Ileus, defined as the inhibition of the propulsive motility in the gastrointestinal (GI) tract, together with mucosal barrier dysfunction will maintain sepsis by the translocation of intestinal bacteria. Preliminary data in our group showed that the administration of GTS-21, a selective alpha7 nicotinic acetylcholine receptor (α7nAChR) agonist, ameliorates inflammation and GI motility disturbances during sepsis [1]. Activation of the α7nAChR is the final step in the vagal anti-inflammatory pathway, a spleen-dependent and macrophage-dependent pathway that dampens inflammation. We aimed to study the effects of splenectomy (SPLX) combined with GTS-21 on GI motility and on local colonic and systemic inflammation, as the role of the spleen in the vagal anti-inflammatory pathway is currently under debate.
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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