Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy

Perner, Anders; Gordon, Anthony; Backer, Daniel De; Dimοpoulos, George; Russell, James A.; Lipman, Jeffrey; Jensen, Jens Ulrik Stæhr; Myburgh, John; Singer, Mervyn; Bellomo, Rinaldo; Walsh, Timothy

doi:10.1007/s00134-016-4577-z

Cited by 170 publications

(123 citation statements)

References 96 publications

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“…In the case of severe hypoxemia, invasive mechanical ventilation is the mainstay of supportive therapy in ICU worldwide [65]. Patients with influenza are commonly affected by the inherent virulence of the virus, and the major feature is the early development of ARDS characterized by lung injury and primary viral pneumonia.…”

Section: Supportive Treatment Including Ecmomentioning

confidence: 99%

Severe flu management: a point of view

et al. 2020

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Annual flu seasons are typically characterized by changes in types and subtypes of influenza, with variations in terms of severity. Despite remarkable improvements in the prevention and management of patients with suspected or laboratory-confirmed diagnosis of influenza, annual seasonal influenza continues to be associated with a high morbidity and mortality. Admission to the intensive care unit is required for patients with severe forms of seasonal influenza infection, with primary pneumonia being present in most of the cases. This review summarizes the most recent knowledge on the diagnosis and treatment strategies in critically ill patients with influenza, focused on diagnostic testing methods, antiviral therapy, use of corticosteroids, antibacterial and antifungal therapy, and supportive measures. The review focuses on diagnostic testing methods, antiviral therapy, use of corticosteroids, antibacterial and antifungal therapy, supportive measures and relevant existing evidence, in order to provide the non-expert clinician a useful overview. An enhanced understanding of current diagnostic and treatment aspects of influenza infection can contribute to improve outcomes and reduce mortality among ICU patients with influenza.

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Section: Supportive Treatment Including Ecmomentioning

confidence: 99%

Severe flu management: a point of view

et al. 2020

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“…In the context of an increasing incidence of sepsis [60,61] and fast-emerging antibiotic resistance [62], this weak evidence base is disappointing and arguably unacceptable. We must rapidly determine how to prescribe antibiotics optimally for both efficacy and safety [63].…”

Section: Antibioticsmentioning

confidence: 99%

The intensive care medicine research agenda on septic shock

et al. 2017

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“…Sepsis is progressively believed to represent the ultimate general cause of mortality from infection . In a view of the globally expanding antibiotic resistance, the occurrence and frequency of sepsis is anticipated to rise . This will also enhance the burden of sepsis management for the healthcare economics emphasizing the importance of exploiting new approaches for treatment and prevention of sepsis.…”

Section: Introductionmentioning

confidence: 99%

Disaccharide‐Based Anionic Amphiphiles as Potent Inhibitors of Lipopolysaccharide‐Induced Inflammation

et al. 2018

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Despite significant advances made in the last decade in the understanding of molecular mechanisms of sepsis and in the development of clinically relevant therapies, sepsis remains the leading cause of mortality in intensive care units with increasing incidence worldwide. Toll‐like receptor 4 (TLR4)—a transmembrane pattern‐recognition receptor responsible for propagating the immediate immune response to Gram‐negative bacterial infection—plays a central role in the pathogenesis of sepsis and chronic inflammation‐related disorders. TLR4 is complexed with the lipopolysaccharide (LPS)‐sensing protein myeloid differentiation‐2 (MD‐2) which represents a preferred target for establishing new anti‐inflammatory treatment strategies. Herein we report the development, facile synthesis, and biological evaluation of novel disaccharide‐based TLR4⋅MD‐2 antagonists with potent anti‐endotoxic activity at micromolar concentrations. A series of synthetic anionic glycolipids entailing amide‐linked β‐ketoacyl lipid residues was prepared in a straightforward manner by using a single orthogonally protected nonreducing diglucosamine scaffold. Suppression of the LPS‐induced release of interleukin‐6 and tumor necrosis factor was monitored and confirmed in human immune cells (MNC and THP1) and mouse macrophages. Structure–activity relationship studies and molecular dynamics simulations revealed the structural basis for the high‐affinity interaction between anionic glycolipids and MD‐2, and highlighted two compounds as leads for the development of potential anti‐inflammatory therapeutics.

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Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy

Cited by 170 publications

References 96 publications

Severe flu management: a point of view

Severe flu management: a point of view

The intensive care medicine research agenda on septic shock

Disaccharide‐Based Anionic Amphiphiles as Potent Inhibitors of Lipopolysaccharide‐Induced Inflammation

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