Seminars in respiratory and critical care medicine最新文献_第2页

How to Survive Sepsis: Patient Testimonial. 如何度过败血症：患者感言。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-08-01 Epub Date: 2024-07-11 DOI: 10.1055/s-0044-1787874

Krista Bracke

{"title":"How to Survive Sepsis: Patient Testimonial.","authors":"Krista Bracke","doi":"10.1055/s-0044-1787874","DOIUrl":"10.1055/s-0044-1787874","url":null,"abstract":"Leaving university I started working for the Belgian National Radio as a journalist. I used to travel a lot and produce radio features about life abroad and how people all over the world dealt with the different challenges in society. A privileged job that I enjoyed doing for many years. In the meantime, I got married and became a mother of two sons. Nothing to worry about, so it seemed, until January 30, 2009. I had been fighting the symptoms of flu for some days. Instead of recovering, I began to feel worse and worse: I had a high fever, was asleep most of the time, could barely eat or drink, and had to cough a lot. The general practitioner sent me to hospital. A few hours later, I had to be reanimated. It was a close call: I was infected by the Streptococcus pyogenes bacteria. My blood started thickening, my organs stopped functioning, and I went into a septic shock, followed by a cardiac arrest. I was successfully reanimated, but still not stable. For 10 days, I was fighting to survive at the intensive care unit (ICU), with several cardiac arrests and reanimations, some of which were long-lasting. The Head of the ICU informed my husband that there was less than 5% chance to survive and if so, he could not predict what kind of damage there would be: the amount of drugs that I had been given, including noradrenaline, was so extremely high, that it became very unclear how my body would respond to it. And if, as by miracle, I would survive: what kind of damage would there be? Physical? Mental? Physical and mental? No specialist could answer those questions. But both the health care professionals and my family fought to keep me alive.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591269","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}

引用次数: 0

Definition and Epidemiology of Sepsis. 败血症的定义和流行病学。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-08-01 Epub Date: 2024-07-05 DOI: 10.1055/s-0044-1787990

Pietro Arina, Daniel A Hofmaenner, Mervyn Singer

引用次数: 0

Management of Sepsis in the First 24 Hours: Bundles of Care and Individualized Approach. 败血症最初 24 小时的管理：一揽子护理和个性化方法。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-08-01 Epub Date: 2024-08-29 DOI: 10.1055/s-0044-1789185

Irene Coloretti, Martina Tosi, Emanuela Biagioni, Stefano Busani, Massimo Girardis

{"title":"Management of Sepsis in the First 24 Hours: Bundles of Care and Individualized Approach.","authors":"Irene Coloretti, Martina Tosi, Emanuela Biagioni, Stefano Busani, Massimo Girardis","doi":"10.1055/s-0044-1789185","DOIUrl":"https://doi.org/10.1055/s-0044-1789185","url":null,"abstract":"Early diagnosis and prompt management are essential to enhance the outcomes of patients with sepsis and septic shock. Over the past two decades, evidence-based guidelines have guided appropriate treatment and recommended the implementation of a bundle strategy to deliver fundamental treatments within the initial hours of care. Shortly after its introduction, the implementation of a bundle strategy has led to a substantial decrease in mortality rates across various health care settings. The primary advantage of these bundles is their universality, making them applicable to all patients with sepsis. However, this same quality also represents their primary disadvantage as it fails to account for the significant heterogeneity within the septic patient population. Recently, the individualization of treatments included in the bundle has been suggested as a potential strategy for further improving the prognosis of patients with sepsis. New strategies for the early identification of microorganisms and their resistance patterns, advanced knowledge of antibiotic kinetics in critically ill patients, more conservative fluid therapy in specific patient populations, and early use of alternative vasopressors to catecholamines, as well as tailored source control based on patient conditions and site of infection, are potential approaches to personalize initial care for specific subgroups of patients. These innovative methodologies have the potential to improve the management of septic shock. However, their implementation in clinical practice should be guided by solid evidence. Therefore, it is imperative that future research evaluate the safety, efficacy, and cost-effectiveness of these strategies.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111912","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}

引用次数: 0

Early Diagnosis of Sepsis: The Role of Biomarkers and Rapid Microbiological Tests. 败血症的早期诊断：生物标志物和快速微生物检验的作用。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-08-01 Epub Date: 2024-07-01 DOI: 10.1055/s-0044-1787270

Erika P Plata-Menchaca, Juan Carlos Ruiz-Rodríguez, Ricard Ferrer

引用次数: 0

Informative Subtyping of Patients with Sepsis. 对败血症患者进行信息亚型分类。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-08-01 Epub Date: 2024-07-08 DOI: 10.1055/s-0044-1787992

John Cafferkey, Manu Shankar-Hari

引用次数: 0

Dysregulation of Host-Pathogen Interactions in Sepsis: Host-Related Factors. 败血症中宿主与病原体相互作用的失调：与宿主相关的因素。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-08-01 Epub Date: 2024-07-01 DOI: 10.1055/s-0044-1787554

Sebastiaan C M Joosten, Willem J Wiersinga, Tom van der Poll

引用次数: 0

Acute Management of Sepsis beyond 24 Hours. 败血症 24 小时后的急性处理。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-08-01 Epub Date: 2024-07-05 DOI: 10.1055/s-0044-1787991

Antoine Premachandra, Nicholas Heming

{"title":"Acute Management of Sepsis beyond 24 Hours.","authors":"Antoine Premachandra, Nicholas Heming","doi":"10.1055/s-0044-1787991","DOIUrl":"10.1055/s-0044-1787991","url":null,"abstract":"Sepsis manifests as a dysregulated immune response to an infection, leading to tissue damage, organ failure, and potentially death or long-term health issues. Sepsis remains a major health challenge globally, causing approximately 50 million cases and 11 million deaths annually. Early management of sepsis focuses on source control, antimicrobial treatment, and supporting vital organ function. Subsequent care includes metabolic, nutritional, and immune therapies to address the complex needs of septic patients. Metabolic management is based on obtaining moderate glucose targets. Nutritional support aims to mitigate hypercatabolism and muscle wasting, but aggressive early nutrition does not improve outcomes and could even be harmful. Immune modulation is crucial due to the dual nature of sepsis-induced immune responses. Corticosteroids have shown benefits in shock and organ dysfunction reversal and in mortality reduction with current guidelines recommending them in vasopressor therapy-dependent patients. In conclusion, sepsis management beyond the initial hours requires a multifaceted approach, focusing on metabolic, nutritional, and immune system support tailored to individual patient needs to enhance survival and recovery.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538551","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}

引用次数: 0

Epigenetic Mechanisms in Sepsis-Associated Acute Kidney Injury. 败血症相关急性肾损伤的表观遗传机制

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-08-01 Epub Date: 2024-08-29 DOI: 10.1055/s-0044-1789240

Marco Fiorentino, Reginald Philippe, Carmen A Palumbo, Stefania Prenna, Vincenzo Cantaluppi, Silva De Rosa

{"title":"Epigenetic Mechanisms in Sepsis-Associated Acute Kidney Injury.","authors":"Marco Fiorentino, Reginald Philippe, Carmen A Palumbo, Stefania Prenna, Vincenzo Cantaluppi, Silva De Rosa","doi":"10.1055/s-0044-1789240","DOIUrl":"https://doi.org/10.1055/s-0044-1789240","url":null,"abstract":"Sepsis, the dysregulated immune response of the host to infections, leads to numerous complications, including multiple organ dysfunction with sepsis-associated acute kidney injury (SA-AKI) being a frequent complication associated with increased risk of mortality and the progression toward chronic kidney disease (CKD). Several mechanisms have been widely investigated in understanding the complex pathophysiology of SA-AKI, including hemodynamic alterations, inflammation, oxidative stress, and direct cellular injury driven by pathogens or cell-derived products (pathogen-associated molecular patterns and damage-associated molecular patterns). Despite advancements in the management of septic patients, the prognosis of SA-AKI patients remains significantly poor and is associated with high in-hospital mortality and adverse long-term outcomes. Therefore, recent research has focused on the early identification of specific SA-AKI endotypes and subphenotypes through epigenetic analysis and the use of potential biomarkers, either alone or in combination with clinical data, to improve prognosis. Epigenetic regulation, such as DNA methylation, histone modifications, and noncoding RNA modulation, is crucial in modulating gene expression in response to stress and renal injury in SA-AKI. At the same time, these modifications are dynamic and reversible processes that can alter gene expression in several pathways implicated in the context of SA-AKI, including inflammation, immune response, and tolerance status. In addition, specific epigenetic modifications may exacerbate renal damage by causing persistent inflammation or cellular metabolic reprogramming, leading to progression toward CKD. This review aims to provide a comprehensive understanding of the epigenetic characteristics that define SA-AKI, also exploring targeted therapies that can improve patient outcomes and limit the chronic progression of this syndrome.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111911","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}

引用次数: 0

Lung Transplant for Chronic Obstructive Pulmonary Disease. 肺移植治疗慢性阻塞性肺病。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-07-19 DOI: 10.1055/s-0044-1787560

Kyle Swartz, Ali Mansour, Sammar Alsunaid

引用次数: 0

Five Questions to Help Prompt End-of-Life Planning in Neuromuscular Disease. 帮助神经肌肉疾病患者制定生命终结计划的五个问题。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-07-19 DOI: 10.1055/s-0044-1787994

Benjamin J Lipanot, Gabriel Bosslet

引用次数: 0