SHOCK最新文献

{"title":"PRE-ADMISSION BARIATRIC SURGERY IS ASSOCIATED WITH REDUCED MORTALITY IN SURGICAL PATIENTS WITH SEPSIS.","authors":"Anahita Jalilvand, Patrick J Kennedy, John Loftus, Courtney Collins, Whitney Kellett, Wendy Wahl, Jon Wisler","doi":"10.1097/SHK.0000000000002568","DOIUrl":"10.1097/SHK.0000000000002568","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Obesity is associated with higher 90-day mortality compared to nonobese surgical patients. Bariatric surgery (BS) can reduce obesity-related comorbidities, even in those with persistent obesity. Objective: Evaluate the impact of prior BS on sepsis outcomes in surgical patients with obesity. Setting: University Hospital, United States. Methods: A single-institution retrospective review of all surgical patients with sepsis (SOFA≥2) was conducted. Patients were grouped into people with obesity and prior BS (OB/BS; n = 48), people with obesity without BS (OB; n = 717), nonobese (NOB; n = 574), and nonobese with prior BS (NOB/BS; n = 27). Demographic data, comorbidities, and sepsis presentation were compared. The primary outcome was cumulative 90-day mortality and survival. Results: Most OB/BS patients underwent gastric bypass <5 years from admission (61%). The OB/BS group was younger, more likely to be female, and transferred from an outside hospital. The mean BMI was highest in the OB/BS group (46.3± 14.7 kg/m 2 , P < 0.0005). Charlson Comorbidity Index was lower in the OB/BS and NOB/BS groups (2 (1-4) and 2 (2-4), respectively, P = 0.0033). Cumulative 90-day mortality was significantly lower in the OB/BS cohort (20.8%, P = 0.002). The OB/BS cohort was more likely to die from intra-abdominal sepsis not amenable to source control (60% vs. 22.5% vs. 22.8% vs. 37.5%, P = 0.04). Compared to the other groups, 90-day survival was highest in the OB/BS cohort (log-rank P < 0.009). Conclusions: This study demonstrated improvement in 90-day survival in OB/BS patients despite higher BMIs. However, this group was more likely to die from intra-abdominal sources, likely reflecting surgical complexity in the setting of prior bypasses.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"844-850"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"METHANE ADMINISTRATION DURING OXYGENATION MITIGATES ACUTE KIDNEY INJURY IN A PIG MODEL OF 24-H VENO-VENOUS EXTRACORPOREAL MEMBRANE OXYGENATION.","authors":"Noémi Vida, Zoltán Varga, Antal Szabó-Biczók, Gábor Bari, Gyöngyvér Vigyikán, Ádám Hodoniczki, Ámos Gajda, Attila Rutai, László Juhász, Szabolcs Péter Tallósy, Sándor Turkevi-Nagy, Anett Bársony, Nándor Öveges, Andrea Szabó, Mihály Boros, Gabriella Varga, Dániel Érces","doi":"10.1097/SHK.0000000000002586","DOIUrl":"10.1097/SHK.0000000000002586","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Severe respiratory failure often requires veno-venous extracorporeal membrane oxygenation (v-v ECMO) treatment, a procedure frequently associated with acute kidney injury (AKI). Preclinical studies have demonstrated the anti-inflammatory properties of inhaled methane (CH 4 ). This experimental protocol aimed to investigate whether CH 4 gas administration could mitigate the development of AKI in a clinically relevant large animal model of v-v ECMO. Methods: Anesthetized miniature pigs were divided into three groups (n = 6 each). Following cannulation of the right femoral and internal jugular veins, v-v ECMO was initiated and maintained for 24 h, followed by a 6-h post-ECMO observation. The control group underwent cannulation without ECMO, while the v-v ECMO+CH 4 group received a 2% CH 4 -air mixture via the oxygenator. Urine output was recorded, and kidney injury was assessed using plasma and urine neutrophil gelatinase-associated lipocalin levels. Inflammatory activation was evaluated through plasma interleukin-1β (IL-1β) and interleukin-8 (IL-8) levels. Kidney tissue samples were analyzed for histopathological changes, xanthine oxidoreductase and myeloperoxidase activities, and nitrite/nitrate levels. Results: The CH 4 -treated group exhibited significantly higher post-ECMO renal arterial flow (244.7 ± 70 vs. 96.3 ± 21 mL/min) and increased average urine output (5.75 ± 1.6 vs. 3.25 ± 0.4 mL/h/kg) compared to the v-v ECMO group. CH 4 administration reduced urine and plasma neutrophil gelatinase-associated lipocalin levels and demonstrated lower histological damage scores (0.8 ± 0.3 vs. 3.3 ± 0.8). Furthermore, CH 4 treatment decreased xanthine oxidoreductase and myeloperoxidase activities and reduced inflammatory mediators, including IL-1β, IL-8, and nitrite/nitrate. Conclusion: CH 4 admixture significantly mitigates inflammatory activation and renal injury associated with v-v ECMO. These findings suggest that CH 4 may serve as an effective adjunctive means to reduce renal complications of v-v ECMO therapy.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"935-943"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"QUESTIONS REGARDING SAMPLING AND VALIDATION METHODS.","authors":"Tyler Zander, Melissa A Kendall, Rachel L Wolansky, Joseph Sujka, Paul C Kuo","doi":"10.1097/SHK.0000000000002580","DOIUrl":"10.1097/SHK.0000000000002580","url":null,"abstract":"","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"947"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NEUTROPHIL PERCENTAGE-TO-ALBUMIN RATIO IS ASSOCIATED WITH 30-DAY ALL-CAUSE MORTALITY IN SEPTIC CHOLANGITIS PATIENTS: A COHORT STUDY.","authors":"Jie Liu, Pengfei Wang, Jiajun Ji","doi":"10.1097/SHK.0000000000002574","DOIUrl":"10.1097/SHK.0000000000002574","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Neutrophil percentage-to-albumin ratio (NPAR) has been proven to correlate with the poor prognosis of various diseases. This study aims at investigating the prognostic value of NPAR for septic cholangitis patients from Medical Information Mart Intensive Care IV database. Methods: Overall, 329 adult septic cholangitis patients were retrospectively included, of whom 82 experienced deaths within 30 days. Cox regression, restricted cubic spline, and Kaplan-Meier curves were employed to evaluate the association between NPAR and 30-day mortality. Hazard ratio (HR) and 95% confidential interval (95% CI) were calculated. Receiver operating characteristic curves and integrated discrimination improvement analysis were utilized to assess the predictive efficacy of NPAR. Results: NPAR was significantly associated with 30-day mortality in multivariable Cox analysis (HR = 1.52, 95% CI = 1.16-1.99, P = 0.003). Kaplan-Meier curves indicated NPAR in the second quartile (range from 2.55-2.93) demonstrated the lowest mortality (log-rank test: P < 0.001). RCS curves showed a U-shaped relationship between NPAR and 30-day mortality, and an inflection point of appropriately 2.73 was discovered. HRs and 95% CIs on the left and right sides of the inflection point, were 0.299 (0.114-0.781, P = 0.014) and 1.955 (1.362-2.807, P < 0.001), respectively. NPAR exhibited a moderate Receiver operating characteristic (0.668) for the prediction of 30-day mortality. Importantly, addition of the NPAR into illness score models can significantly improve the predictive ability. Conclusions: A U-shaped nonlinear association was observed between NPAR and 30-day all-cause mortality in septic cholangitis patients. NPAR emerged as a potential marker for the prognosis of critical cholangitis patients.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"863-869"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXPLORING THE POTENTIAL OF BEND7 AS AN IMMUNOMODULATORY BIOMARKER IN SEPSIS THROUGH INTEGRATIVE GENOMIC AND TRANSCRIPTOMIC ANALYSIS.","authors":"Chao Ren, Yuyang Liu, Zhangna Ding, Zhanyu Yang, Tao Wan, Ning Zhang, Junyi Chen, Hui Feng, Qi Liu","doi":"10.1097/SHK.0000000000002529","DOIUrl":"10.1097/SHK.0000000000002529","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Sepsis is a life-threatening condition driven by a dysregulated immune response to infection. Identifying the genetic factors underlying sepsis pathogenesis remains a major challenge in developing effective treatments. Methods: The Summary data-based Mendelian Randomization method was used to integrate Genome-Wide Association Studies and expression quantitative trait loci data to identify sepsis-related genes. These genes were intersected with prognostic gene sets from Gene Expression Omnibus transcriptomic datasets and validated using an independent dataset. Comprehensive single-cell RNA sequencing analysis, including cell clustering, differential expression analysis, cell-cell communication mapping, and pseudotime trajectory analysis, was performed to explore the roles of the identified genes within the sepsis microenvironment. Results: Intersection of Summary data-based Mendelian Randomization and Gene Expression Omnibus gene sets, followed by validation, identified two risk genes and five protective genes as significantly differentially expressed. The risk gene BEND7, predominantly expressed in platelets, was further analyzed using single-cell RNA sequencing, revealing strong interactions with immune cells, particularly monocytes and neutrophils, via the intercellular adhesion molecule signaling pathway. Functional enrichment analysis suggested that BEND7-positive platelets play a role in immune modulation and platelet activation. Conclusion: BEND7 was identified as a platelet-specific gene involved in immune regulation during sepsis. Targeting BEND7-positive platelets may present new therapeutic opportunities in sepsis management.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"826-835"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TRANSPLANTATION OF VIABLE ALLOGENEIC MITOCHONDRIA PROTECTS KIDNEY FUNCTION IN A MOUSE MODEL OF HEMORRHAGIC SHOCK AND RHABDOMYOLYSIS-INDUCED ACUTE RENAL INJURY.","authors":"Yu-Li Pang, Shi-Yuan Fang, Chien-Chi Huang, Ming-Wei Lin, Jun-Neng Roan, Kuen-Jer Tsai, Chen-Fuh Lam","doi":"10.1097/SHK.0000000000002579","DOIUrl":"10.1097/SHK.0000000000002579","url":null,"abstract":"<p><strong>Abstract: </strong>Background and Aims: Acute kidney injury (AKI) is independently associated with high mortality after major trauma. Because mitochondrial dysfunction in renal tubular cells is a critical early subcellular change in AKI, this study proposed that administration of freshly harvested viable mitochondria could ameliorate renal tubular injury in a mouse model of two-hit rhabdomyolysis-related AKI. Methods: Mice were subjected to acute hemorrhagic shock and rhabdomyolysis through blood withdrawal and intramuscular glycerol injection. Mitochondria (100 μg) were freshly isolated from the soleus muscles of naïve mice. Mitochondria or placebo solution was randomly delivered into arterial catheter 1 h after the induction of AKI. The mice were euthanized 36 h later, and blood samples and kidneys were collected for analysis. Results: IVIS imaging confirmed increased expression of fluorescence-labeled allogeneic mitochondrial accumulation in AKI kidneys. Mitochondrial transplantation significantly decreased the elevated serum levels of urea nitrogen, creatinine and potassium. The protein expression of endogenous antioxidant molecules (Nrf-2, heme oxygenase-1 and superoxide dismutases) was significantly increased. The BAX-to-Bcl-2 ratio and expression of cleaved caspace-3 were also reduced in the mitochondrial-transplanted animals, indicating the attenuation of mitochondrial-mediated apoptosis in the kidney tissues of AKI mice. Histopathological examination confirmed that degrees of renal tubular injury were improved following mitochondrial transplantation. Conclusions: Transplantation of freshly isolated mitochondria augments endogenous antioxidant capacity and ameliorates mitochondrial apoptosis in the injured kidney tissues after hemorrhagic shock and rhabdomyolysis-induced AKI. Allogeneic mitochondrial transplantation could be a potential and feasible therapeutic option for prevention and management of AKI secondary to major trauma.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"929-934"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RIGHT VENTRICULAR DYSFUNCTION AS A MORTALITY DETERMINANT FOR PATIENTS WITH CARDIOGENIC SHOCK INDUCED BY ACUTE MYOCARDIAL INFARCTION.","authors":"Amin Daoulah, Shaber Seraj, Ahmed Elmahrouk, Nooraldaem Yousif, Prashanth Panduranga, Wael Almahmeed, Abdulrahman Arabi, Mohammed Alshehri, Hatem M Aloui, Amr A Arafat, Mohammed A Qutub, Waleed Alharbi, Rajesh Rajan, Mokhtar Abdirahman Kahin, Abdullah Alenezi, Said Al Maashani, Taher Hassan, Jassim Alswuaidi, Awad Alqahtani, Mubarak Abdulhadi Aldossari, Mohammed Al Jarallah, Ali Alshehri, Abdelmaksoud Elganady, Badr Alzahrani, Abdulrahman M Alqahtani, Faisal Omar M Al Nasser, Haitham Amin, Mohamed N Alama, Alaa Aldossari, Sultan Al Obaikan, Alsayed Ali Almarghany, Omar Kanbr, Ahmed Jamjoom, Youssef Elmahrouk, Ibrahim A M Abdulhabeeb, Mohammed Balghith, Ahmad S Hersi, Abeer Said Mohamed Al Rawahi, Marwa Abd Elghany Albasiouny Alkholy, Adnan Fathey Hussien, Abdulrahman Almoghairi, Mohamed Mohammednabil A Alama, Mohamed Ajaz Ghani, Ayman Uthman Alhussini, Ayman Basardah, Bandar Alshehri, Laura AlObaid, Sara Shawki Saati, Seraj Abualnaja, Tarique Shahzad Chachar, Hassan Khan, Shahrukh Hashmani, Ahmed A Ghonim, Khalid Almerri, Razan W Alsofayan, Abeer M Shawky, Amir Lotfi","doi":"10.1097/SHK.0000000000002583","DOIUrl":"10.1097/SHK.0000000000002583","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Cardiogenic shock (CS) secondary to acute myocardial infarction (AMI) is a major cause of in-hospital mortality. With the addition of right ventricular dysfunction (RVD), it is associated with poorer outcomes. This study examines the impact of RVD on mortality in CS-AMI patients, highlighting the importance of early RVD identification and tailored management. Methods: Data from the Gulf Cardiogenic Shock (Gulf-CS) registry-a multicenter registry of CS-AMI patients from six Gulf countries-were analyzed to compare in-hospital and long-term outcomes for patients with and without RVD. RVD was defined by echocardiographic criteria: tricuspid annular plane systolic excursion <17 mm, S' wave <12 cm/s, and tricuspid annular plane systolic excursion/ pulmonary artery systolic pressure ratio <0.34. Multivariable logistic and Cox regression models were used to identify in-hospital and follow-up mortality predictors. Results: Among 1,513 CS-AMI patients, RVD was independently associated with higher in-hospital mortality (55.87% vs. 42.89%, P < 0.001) and lower survival at 6, 12, 18, and 24 months (58%, 35%, 18%, and 6% vs. 73%, 53%, 38%, and 30%; P < 0.001). Predictors of in-hospital mortality included advanced Society for Cardiovascular Angiography and Interventions shock stage, cardiac arrest, age, non-ST-elevation myocardial infarction, number of vessels affected, and elevated creatinine, while follow-up mortality was associated with advanced Society for Cardiovascular Angiography and Interventions stage, reduced left ventricular ejection fraction, elevated blood urea nitrogen, history of CABG and comorbidities including chronic obstructive pulmonary disease and prior cerebrovascular accident. Conclusion: RVD is a significant independent predictor of both in-hospital and long-term mortality in CS-AMI, highlighting the need for early RVD assessment and specific interventions. This study's findings support the integration of RV-focused management strategies to improve survival outcomes in this high-risk population.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"885-892"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PREDICTING IN-HOSPITAL MORTALITY IN CRITICAL ORTHOPEDIC TRAUMA PATIENTS WITH SEPSIS USING MACHINE LEARNING MODELS.","authors":"Ze Long, Shengzhi Tan, Baisheng Sun, Yong Qin, Shengjie Wang, Zhencan Han, Tao Han, Feng Lin, Mingxing Lei","doi":"10.1097/SHK.0000000000002516","DOIUrl":"10.1097/SHK.0000000000002516","url":null,"abstract":"<p><strong>Abstract: </strong>Purpose: This study aims to establish and validate machine learning-based models to predict death in hospital among critical orthopedic trauma patients with sepsis or respiratory failure. Methods: This study collected 523 patients from the Medical Information Mart for Intensive Care database. All patients were randomly classified into a training cohort and a validation cohort. Six algorithms, including logistic regression (LR), extreme gradient boosting machine (eXGBM), support vector machine (SVM), random forest (RF), neural network (NN), and decision tree (DT), were used to develop and optimize models in the training cohort, and internal validation of these models were conducted in the validation cohort. Based on a comprehensive scoring system, which incorporated 10 evaluation metrics, the optimal model was obtained with the highest scores. An artificial intelligence (AI) application was deployed based on the optimal model in the study. Results: The in-hospital mortality was 19.69%. Among all developed models, the eXGBM had the highest area under the curve (AUC) value (0.951, 95% CI: 0.934-0.967), and it also showed the highest accuracy (0.902), precise (0.893), recall (0.915), and F1 score (0.904). Based on the scoring system, the eXGBM had the highest score of 53, followed by the RF model (43) and the NN model (39). The scores for the LR, SVM, and DT were 22, 36, and 17, respectively. The decision curve analysis confirmed that both the eXGBM and RF models provided substantial clinical net benefits. However, the eXGBM model consistently outperformed the RF model across multiple evaluation metrics, establishing itself as the superior option for predictive modeling in this scenario, with the RF model as a strong secondary choice. The Shapley Additive Explanation analysis revealed that Simplified Acute Physiology Score II, age, respiratory rate, Oxford Acute Severity of Illness Score, and temperature were the most important five features contributing to the outcome. Conclusions: This study develops an artificial intelligence application to predict in-hospital mortality among critical orthopedic trauma patients with sepsis or respiratory failure.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"815-825"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE ROLE OF ULTRASONIC CARDIAC OUTPUT MONITOR IN EVALUATING STROKE VOLUME VARIATION TO DETERMINE FLUID RESPONSIVENESS IN PATIENTS WITH SHOCK.","authors":"Seval Orman, Pervin Hancı, Serdar Efe, Volkan İnal","doi":"10.1097/SHK.0000000000002584","DOIUrl":"10.1097/SHK.0000000000002584","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Dynamic assessment of cardiac output (CO) with passive leg raise (PLR), stroke volume variation (SVV), and pulse pressure variation (PPV) offer effective and safe methods to predict fluid responsiveness in patients with shock. The primary aim of this study was to evaluate the reliability of CO and SVV readings with the ultrasonic cardiac output monitor (USCOM) 1A device compared to PPV measurements in determining fluid responsiveness of patients in shock. Materials and Method: Intubated and mechanically ventilated patients aged 18-95 with shock admitted to the medical intensive care unit from June 2019 to December 2020 were included in the study. Fluid responsiveness was assessed using PPV from arterial monitoring and CO/SVV using the USCOM 1A device. CO, PPV, and SVV data were recorded before and after PLR. Results: Out of 145 shock patients, 92 were included. Before the PLR maneuver, 67 patients had PPV values above 12% and were stated as fluid responsive. The SVV index measured by the USCOM device demonstrated good sensitivity (85%) and specificity (96%) in identifying fluid responsiveness. The agreement with PPV was substantial (Cronbach's alpha reliability: 0.718 [ P < 0.001]), and the index was internally consistent (kappa agreement: 0.707 [ P < 0.001]). The SVV index moderately correlated with PPV (R: 0.588 [ P = 0.001]). Regarding fluid responsiveness determined by PPV, the AUC value of SVV was 0.797 (0.701-0.894) (p: 0.001). Conclusion: SVV measured by the USCOM device is a reliable and practical tool for hemodynamic assessment in clinical practice, particularly when invasive methods are unsuitable.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"893-899"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CREATINE KINASE IS ELEVATED BY THE SUBMANDIBULAR VEIN BLEED TECHNIQUE, OBSCURING THE MEASUREMENT OF MUSCLE DAMAGE IN SEPSIS.","authors":"Taniah Ali, Daniela Rodarte, Luiz F Garcia, Sydney Ligon, Chander Khatri, Wendy E Walker","doi":"10.1097/SHK.0000000000002585","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002585","url":null,"abstract":"","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":"63 6","pages":"944-946"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}