Systemic Inflammatory Response Syndrome, Sepsis, and Multiple Organ Dysfunction Syndrome

Sharp, Claire R.

doi:10.1002/9781119028994.ch159

Cited by 11 publications

(19 citation statements)

References 30 publications

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“…These Sepsis-3 definitions incorporate a rapid organ failure assessment score (92), that has yet to be robustly examined in veterinary medicine. An equivalent redefinition of sepsis in veterinary medicine had not been undertaken and hence the SIRS criteria remain the best available strategy (93), and have been used in multiple studies of canine sepsis and of septic peritonitis specifically (6, 14, 94, 95). As such, they were considered to be a necessary component of the identification of the SP and NSA populations in the present study.…”

Section: Discussionmentioning

confidence: 99%

Biomarker Guided Diagnosis of Septic Peritonitis in Dogs

Martiny

Goggs

2019

Front. Vet. Sci.

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Septic peritonitis (SP) is common in dogs and is associated with high mortality. Early recognition is essential to maximizing survival and may be aided by biomarker measurement. The present study aimed to evaluate the ability of biomarkers to discriminate septic peritonitis from non-septic ascites (NSA). Eighteen dogs with SP and 19 age-matched controls with NSA were enrolled. Contemporaneous blood and peritoneal effusion samples were obtained. Concentrations of cell-free DNA (cfDNA), cytokines, glucose, lactate, N-terminal pro-C-type natriuretic peptide (NT-proCNP), nucleosomes, and procalcitonin (PCT) were measured using commercial reagents and assays. Paired biomarker concentrations were compared with the Wilcoxon matched-pairs signed rank test, and biomarker concentrations between groups were compared with the Mann-Whitney U -test. P -values were adjusted for multiple comparisons using the Bonferroni correction. Receiver operating characteristic curves were generated to assess the ability of the above biomarkers to discriminate SP from NSA. Dogs with SP had significantly greater blood CCL2 concentrations than dogs with NSA ( P = 0.032). Dogs with SP had significantly greater effusion CCL2, IL-6, IL-10, and lactate concentrations than dogs with NSA ( P ≤ 0.0121). Blood-effusion concentration gradients of CCL2, glucose, IL-6, IL-10, and lactate were significantly different in dogs with SP compared to dogs with NSA ( P ≤ 0.0165). Effusion lactate concentration had the highest AUROC value (0.866, 95% CI 0.751–0.980, P = 0.0001), although other biomarkers performed similarly. An effusion lactate concentration of 4.2 mmol/L was 72.2% (95% CI 46.5–90.3%) sensitive and 84.2% (95% CI 60.4–96.6%) specific for the diagnosis of SP.

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Section: Discussionmentioning

confidence: 99%

Biomarker Guided Diagnosis of Septic Peritonitis in Dogs

Martiny

Goggs

2019

Front. Vet. Sci.

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“…As a result, the recent redefinition of sepsis in human medicine used a data-driven approach to derive novel clinical criteria for sepsis identification (23). An equivalent redefinition of sepsis in veterinary medicine had not been undertaken and hence the SIRS criteria remained the best available strategy (41). The SIRS criteria in cats have not been as thoroughly evaluated as those for dogs (42), however.…”

Section: Discussionmentioning

confidence: 99%

Cytokine and Chemokine Profiling in Cats With Sepsis and Septic Shock

et al. 2020

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Background: Sepsis is a life-threatening condition associated with an exacerbated production of both pro-and anti-inflammatory cytokines that can promote a hyperactive response to infection or induce immunoparalysis. Data regarding the immune response to sepsis in cats are scarce. Establishing the profiles of cytokines and chemokines in feline sepsis to characterize the nature of the immune responses to sepsis might enable individualized treatments to be developed and targeted. Objective: To evaluate the cytokine and chemokine network in cats with sepsis and septic shock, and to investigate the associations of these analytes with disease severity and outcome. Methods: Blood samples prospectively collected at presentation of cats with sepsis and septic shock to two veterinary teaching hospitals were analyzed. Forty healthy cats were included as controls. A 19-plex feline cytokine/chemokine magnetic bead assay system was used to measure analytes in citrated plasma samples. Cytokine concentrations were compared between groups using the Kruskal-Wallis test with Dunn's post-hoc correction for multiple comparisons. Cytokine concentrations were compared between survivors and non-survivors with the Mann-Whitney U test. Odds ratios were calculated using logistic regression. A multivariable logistic regression model for prediction of septic shock was constructed. Results: The study enrolled 35 septic cats. Many cytokines were undetectable in both sick and healthy control cats and were excluded from subsequent analyses. Comparisons of cytokine concentrations among healthy controls, cats with sepsis (n = 12) and cats with septic shock (n = 23) revealed that sick cats (sepsis or septic shock) had significantly higher plasma concentrations of IL-6, IL-8, KC-like, and RANTES compared to healthy controls. The combination of MCP-1, Flt-3L, and IL-12 was predictive of septic shock. None of the cytokines analyzed was predictive of outcome in this study population. Conclusion: Plasma concentrations of IL-6, IL-8, KC-like, and RANTES are increased in cats with sepsis and may play important roles in pathogenesis. Multivariable modeling suggested that analysis of cytokines might aid differentiation of septic shock from sepsis. None of the cytokines analyzed was predictive of outcome. Measurement of these cytokines might enable future studies to better diagnose and characterize feline sepsis and septic shock.

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“…However, in veterinary medicine, the definitions remain consistent with the initial 1991 definition, which defines sepsis as SIRS with an infectious nidus (Kenney et al . 2010, Boller & Otto 2014, Sharp 2019).…”

Section: Introductionmentioning

confidence: 99%

“…The most current definition, Sepsis 3.0, defines it as a life-threatening organ dysfunction due to a dysregulated host response to infection and has eliminated the term "severe sepsis" (Singer et al 2016). However, in veterinary medicine, the definitions remain consistent with the initial 1991 definition, which defines sepsis as SIRS with an infectious nidus (Kenney et al 2010, Boller & Otto 2014, Sharp 2019.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of quick sequential organ failure scores in dogs with severe sepsis and septic shock

Osgood

Hollenbeck

Yankin

2022

J of Small Animal Practice

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To evaluate the prognostic utility of the quick sequential organ failure assessment score in dogs with severe sepsis and septic shock presenting to an emergency service, and evaluate the clinical value of the quick sequential organ failure assessment score to predict severe sepsis and septic shock. Materials and MethOds:The quick sequential organ failure assessment score was calculated by evaluating respiratory rate (>22 breaths per minute), arterial systolic blood pressure (≤100 mmHg) and altered mentation. The quick sequential organ failure assessment scores with respiratory rate cut-offs of greater than 22, greater than 30 and greater than 40 were compared. Cases were defined as dogs presented to the emergency room and met at least 2 systemic inflammatory response syndrome criteria, had documented infection, and at least one organ dysfunction. A control population of dogs included animals with non-infectious systemic inflammatory response syndrome.results: Forty-five dogs with severe sepsis and septic shock and 45 dogs with non-infectious systemic inflammatory response syndrome were included in the final analysis. The quick sequential organ failure assessment provided poor discrimination between survivors and non-survivors for severe sepsis and septic shock (area under receiving operating characteristic curve, 0.51; 95% confidence interval, 0.35 to 0.67). Discrimination remained poor when quick sequential organ failure assessment greater than 30 and quick sequential organ failure assessment greater than 40 scores were calculated (area under receiving operating characteristic curve, 0.56; 95% confidence interval, 0.39 to 0.72, and 0.54; 95% confidence interval, 0.36 to 0.71). The quick sequential organ failure assessment of at least 2, quick sequential organ failure assessment greater than 30 of at least 2 and quick sequential organ failure assessment greater than 40 of at least 2 produced sensitivity and specificity to detect severe sepsis and septic shock of 66. 7% and 64.5%, 62.2% and 71.1%, 44.4% and 80%, respectively. cOnclusiOn and clinical significance: Scoring systems utilised in emergency rooms should have high sensitivity to reduce missed sepsis cases and treatment delays. The use of the quick sequential organ failure assessment for severe sepsis and septic shock demonstrated poor mortality prediction and low sensitivity to detect canine patients with severe sepsis and septic shock and should not be used alone when screening for sepsis.

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Systemic Inflammatory Response Syndrome, Sepsis, and Multiple Organ Dysfunction Syndrome

Cited by 11 publications

References 30 publications

Biomarker Guided Diagnosis of Septic Peritonitis in Dogs

Biomarker Guided Diagnosis of Septic Peritonitis in Dogs

Cytokine and Chemokine Profiling in Cats With Sepsis and Septic Shock

Evaluation of quick sequential organ failure scores in dogs with severe sepsis and septic shock

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