Challenges to Reporting the Global Trends in the Epidemiology of ICU-Treated Sepsis and Septic Shock

Raman, Vignesh; Laupland, Kevin B.

doi:10.1007/s11908-021-00749-y

Cited by 2 publications

(3 citation statements)

References 34 publications

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“… 3 Globally, sepsis leading to shock and/or end-organ failure has been identified as the most common indication for ICU admission and the leading cause of ICU death. 39 A pilot study in the ICU 40 showed that MDW levels at admission were significantly higher in patients with sepsis than in those without sepsis and those with sepsis during hospitalization. Interestingly, the MDW values were significantly higher at the time of clinical sepsis diagnosis than at admission.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and Prognostic Value of Monocyte Distribution Width in Sepsis

Wu¹,

Li²,

Luo³

2022

JIR

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Monocyte distribution width (MDW) is a blood monocyte morphological parameter that can be easily detected by an automated hemocyte analyzer and can provide clinicians with important information about cell volume variability in peripheral blood monocyte populations. The United States’ Food and Drug Administration and Conformite Europeenne have both been cleared for their clinical application in the detection of sepsis and developing sepsis in adult patients in the emergency department (ED). Recently, MDW has been found to have an early diagnosis and predictive value for sepsis in neonates and COVID-19 patients. Here, we summarize the findings of the studies investigating the clinical application of MDW in sepsis. Under different stimuli, especially in infectious diseases, the activation of innate immunity is the host’s first defense mechanism, and the change in monocyte volume is considered an early indicator reflecting the state of activation of innate immunity. Pivotal study data from a large multicenter patient cohort showed that abnormal MDW at presentation increases the odds of sepsis, considering the combination of MDW and White Blood Cell Count (WBC) as part of a standard sepsis assessment protocol for ED, which may increase the sensitivity and specificity of sepsis diagnosis. Meanwhile, MDW shares a diagnostic performance comparable to that of conventional biomarkers (C-reactive protein and procalcitonin) in sepsis. In addition, some evidence suggests that increased MDW, both in adults and neonates, may be associated with unfavorable short- and long-term outcomes, which indicates its prognostic value in sepsis. Taken together, MDW is a parameter of increased morphological variability of monocytes in response to infection, and numerous studies have shown that MDW could be used as a valuable diagnostic and prognostic index in patients with sepsis or suspected sepsis.

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Section: Introductionmentioning

confidence: 99%

Diagnostic and Prognostic Value of Monocyte Distribution Width in Sepsis

Wu¹,

Li²,

Luo³

2022

JIR

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“…Sepsis is a deadly systemic disease. Sepsis and its complications often cause uncontrolled inflammation, tissue damage, and multiple organ failure, resulting in the death of patients in the ICU (Raman and Laupland, 2021 ). Similarly, in this study, sepsis also led to death of the mice, although LcS + geniposide increased sepsis survival rates, and LcS + geniposide enhanced dexamethasone efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…Sepsis can affect all main organs of the body, and its pathogenesis and developmental mechanism are complex (Rudiger and Singer, 2007 ). Currently, 30–70% of intensive care unit (ICU) deaths are caused by sepsis and its complications (Zhang et al, 2021 ), although from 2015 to 2020, the death rate dropped to 30–40% (Raman and Laupland, 2021 ). Research shows that long-term cognitive impairment remains 1 year after discharge in ~45% of patients with sepsis who were treated and survived, and long-term cognitive impairment continues to affect 10% of patients 3 years after discharge, with inattention and memory loss continuing for up to 6 years after discharge (Wang et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Lactobacillus casei Strain Shirota Enhances the Ability of Geniposide to Activate SIRT1 and Decrease Inflammation and Oxidative Stress in Septic Mice

et al. 2021

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Gardenia jasminoides Ellis is rich in geniposide, which can be transformed into the anti-oxidant and anti-inflammatory agent genipin. Genipin exhibits greater efficacy than geniposide, but it is unstable and difficult to preserve. In this study, a mouse model for sepsis was established by cecal ligation and puncture, and then we explored the effects and mechanism of Lactobacillus casei strain Shirota (LcS) on the enhancement of the ability of geniposide to reduce sepsis and decrease inflammatory and oxidative levels in mice by the regulation of sirtuin type 1 (SIRT1). The mice were evaluated and analyzed by the open field test, Morris water maze test, flow cytometry, kit assay, qPCR, and western blot. The LcS + geniposide increased the survival rate in mice with sepsis, and increased the total travel distance, number of times the mice stood up, amount of time the mice spent grooming their fur, duration in the target quadrant, and crossing area number. The testing of mouse nerve cells showed that LcS + geniposide reduced the rate of nerve cell apoptosis caused by sepsis. LcS + geniposide also decreased the amount of inflammatory-related indicators of TNF-α, IL-6, and IL-1β, and the oxidation-related levels of malondialdehyde (MDA) in the hippocampi of septic mice, and it increased the oxidase activities of superoxide dismutase (SOD) and catalase (CAT). Additionally, LcS + geniposide increased the SOD1, SOD2, and CAT mRNA expression in the hippocampi of mice with sepsis and decreased the expression of TNF-α, IL-1β, NF-κB, and p53 mRNA. LcS+geniposide also increased the SIRT1 protein expression and decreased the Ac-FOXO1, Ac-NF-κB, and Ac-p53 protein expression in the hippocampi of mice with sepsis. We also observed that LcS + geniposide decreased the inflammatory and oxidative damage in the mice with sepsis. The effect of LcS + geniposide was similar to that of the drug dexamethasone and stronger than the effect of geniposide utilized alone. LcS also enhanced the ability of geniposide to activate SIRT1 and decrease the inflammation and oxidative stress in the septic mice, and it achieved an effect same with that obtained by the use of the drug dexamethasone.

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Challenges to Reporting the Global Trends in the Epidemiology of ICU-Treated Sepsis and Septic Shock

Cited by 2 publications

References 34 publications

Diagnostic and Prognostic Value of Monocyte Distribution Width in Sepsis

Diagnostic and Prognostic Value of Monocyte Distribution Width in Sepsis

Lactobacillus casei Strain Shirota Enhances the Ability of Geniposide to Activate SIRT1 and Decrease Inflammation and Oxidative Stress in Septic Mice

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