Early Management of Severe Sepsis

Marik, Paul E.

doi:10.1378/chest.13-2104

Cited by 78 publications

(68 citation statements)

References 155 publications

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“…[14,15]. Crystalloid fluid may be given in 500 mL challenges adding up to an initial resuscitation of 20-30 mL kg −1 , measuring responsiveness by an increase in stroke volume [15,16]. Some authors suggest evaluating the inferior vena cava with an ultrasound to assess fluid benefit to help avoid over-resuscitation [15,17].…”

Section: Sepsismentioning

confidence: 99%

BTreatment review of hospital acquired infections

Bailey¹,

Udeani²,

Surani³

2018

Fighting Antimicrobial Resistance

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Section: Sepsismentioning

confidence: 99%

BTreatment review of hospital acquired infections

Bailey¹,

Udeani²,

Surani³

2018

Fighting Antimicrobial Resistance

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“…11 With the destruction of the glycocalyx, the integrity of the endothelium that was already damaged becomes further compromised since it became exposed to the inflammatory cytokines and white blood cells. 12 This process, along with the venodilation induced by the inappropriate release of nitric oxide, contributes to the significant capillary leak present in sepsis. 13 This capillary leakage and migration of intravascular fluid to interstitial space lead to relative hypovolemia, tissue hypoperfusion, and organ dysfunction.…”

Section: Sepsis and Glycocalyxmentioning

confidence: 99%

“…During severe sepsis and septic shock, these capillary leakages are exacerbated because of compromised vascular integrity, and this has been linked with worsened tissue perfusion, worsened cardiac contractility, worsened oxygenation, and increased mortality. 12 Fluid overloading a patient compounds the compromised vasculature by causing atrial and ventricular stretching of the heart which, in turn, releases atrial natriuretic peptide and brain natriuretic peptide, both of which have been found to further destroy the endothelial glycocalyx. 2 It has been shown that higher brain natriuretic peptide during sepsis is correlated with increased mortality and that positive fluid balance to be an independent risk of mortality in patients with sepsis.…”

Section: Overresuscitation and The Destruction Of The Glycocalyxmentioning

confidence: 99%

“…18 Of note, theoretical advantages of infusing albumin for resuscitation include anti-inflammatory effect and less volume required. 12 In addition, infusion of hypertonic albumin may help restore glycocalyx integrity and prevent further capillary leak. These benefits may explain the mortality benefit seen in the subset of patients with septic shock in the ALBIOS (Albumin Replacement in Patients with Severe Sepsis or Septic Shock) trial.…”

Section: Overresuscitation and The Destruction Of The Glycocalyxmentioning

confidence: 99%

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Glycocalyx in Sepsis Resuscitation

Chen

2016

Critical Care Nursing Quarterly

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Starling's forces are fundamental to our understanding of physiology. Based on his findings, hydrostatic pressure and oncotic pressure are crucial factors in the movement of intravascular and extravascular fluid. However, new literatures on endothelial glycocalyx, a layer of protective glycoprotein within the vasculature that was first discovered in the 1980s, are reshaping our standard models of Starling's forces. This article examines the nature of the endothelial glycocalyx and why understanding it may change the way we resuscitate patients with sepsis.

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“…Current treatments for sepsis are typically supportive and often ineffective, despite the fact that the number of deaths per year is around eight million (2). Moreover, more than 30% of survivors suffer from long-term functional disabilities and persistent critical illness (3).…”

Section: Introductionmentioning

confidence: 99%

The Fab Fragment of a Human Anti-Siglec-9 Monoclonal Antibody Suppresses LPS-Induced Inflammatory Responses in Human Macrophages

et al. 2016

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Sepsis is a major cause of death for hospitalized patients and is characterized by massive overreaction of immune responses to invading pathogens which is mediated by cytokines. For decades, there has been no effective treatment for sepsis. Sialic acid-binding, Ig-like lectin-9 (Siglec-9), is an immunomodulatory receptor expressed primarily on hematopoietic cells which is involved in various aspects of inflammatory responses and is a potential target for treatment of sepsis. The aim of the present study was to develop a human anti-Siglec-9 Fab fragment, which was named hS9-Fab03 and investigate its immune activity in human macrophages. We began by constructing the hS9-Fab03 prokaryotic expression vector from human antibody library and phage display. Then, we utilized a multitude of assays, including SDS-PAGE, Western blotting, ELISA, affinity, and kinetics assay to evaluate the binding affinity and specificity of hS9-Fab03. Results demonstrated that hS9-Fab03 specifically bind to Siglec-9 antigen with high affinity, and pretreatment with hS9-Fab03 could attenuate lipopolysaccharide (LPS)-induced TNF-α, IL-6, IL-1β, IL-8, and IFN-β production in human PBMC-derived macrophages, but slightly increased IL-10 production in an early time point. We also observed similar results in human THP-1-differentiated macrophages. Collectively, we prepared the hS9-Fab03 with efficient activity for blocking LPS-induced pro-inflammatory cytokines production in human macrophages. These results indicated that ligation of Siglec-9 with hS9-Fab03 might be a novel anti-inflammatory therapeutic strategy for sepsis.

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Early Management of Severe Sepsis

Cited by 78 publications

References 155 publications

BTreatment review of hospital acquired infections

BTreatment review of hospital acquired infections

Glycocalyx in Sepsis Resuscitation

The Fab Fragment of a Human Anti-Siglec-9 Monoclonal Antibody Suppresses LPS-Induced Inflammatory Responses in Human Macrophages

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