Endotoxins in chronic heart failure

Brunkhorst, Frank M.

doi:10.1016/s0140-6736(05)77954-x

Cited by 16 publications

(6 citation statements)

References 4 publications

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“…It is known that LBP levels may increase after extensive cardiothoracic surgical procedures and decrease after death due to the onset of postmortem phenomena [24,25]. Similarly, numerous non-septic situations can be characterized by increased PCT values [7,8,[10][11][12][13][14][15][16][17]. Our findings indicate that increases in both postmortem serum PCT and LBP levels may corroborate the existence of underlying septic states.…”

Section: Discussionsupporting

confidence: 59%

“…Plasma concentrations observed under these conditions are not as high, however, as in patients with severe sepsis or septic shock [5]. Increased PCT values have also been described, together with other signs of systemic inflammation, in prolonged cardiogenic shock, likely in relation to endotoxin translocation after gastrointestinal perfusion impairment [16,17].…”

Section: Introductionmentioning

confidence: 97%

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Diagnostic value of lipopolysaccharide-binding protein and procalcitonin for sepsis diagnosis in forensic pathology

et al. 2012

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The aims of this study were twofold. The first was to investigate the diagnostic performance of two biochemical markers, procalcitonin (PCT) and lipopolysaccharide-binding protein (LBP), considering each individually and then combined, for the postmortem diagnosis of sepsis. We also tested the usefulness of pericardial fluid for postmortem LBP determination. Two study groups were formed, a sepsis-related fatalities group of 12 cases and a control group of 30 cases. Postmortem native CT scans, autopsy, histology, neuropathology, and toxicology as well as other postmortem biochemical investigations were performed in all cases. Microbiological investigations were also carried out in the septic group. Postmortem serum PCT and LBP levels differed between the two groups. Both biomarkers, individually considered, allowed septic states to be diagnosed, whereas increases in both postmortem serum PCT and LBP levels were only observed in cases of sepsis. Similarly, normal PCT and LBP values in postmortem serum were identified only in non-septic cases. Pericardial fluid LBP levels do not correlate with the presence of underlying septic states. No relationship was observed between postmortem serum and pericardial fluid LBP levels in either septic or non-septic groups, or between pericardial fluid PCT and LBP levels.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 97%

Diagnostic value of lipopolysaccharide-binding protein and procalcitonin for sepsis diagnosis in forensic pathology

et al. 2012

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“…Moreover, patients with AHF with pulmonary hypertension (PH) tend to have a worse prognosis [3,4]. PH may have important consequences such as liver congestion [5], enteropathy [6], encephalopathy [7] and kidney failure [7,8].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort

et al. 2022

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Background and Objectives: Acute heart failure (AHF) is a common disease and a cause of high morbidity and mortality, constituting a major health problem. The main purpose of this study was to determine the impact of multiorgan ultrasound in identifying pulmonary hypertension (PH), a major prognostic factor in patients admitted due to AHF, and assess whether there are significant changes in the venous excess ultrasonography (VE × US) score or femoral vein Doppler at discharge. Materials and Methods: Patients were evaluated with a standard protocol of lung ultrasound, echocardiography, inferior vena cava (IVC) and hepatic, portal, intra-renal and femoral vein Doppler flow patterns at admission and on the day of discharge. Results: Thirty patients were enrolled during November 2021. The mean age was seventy-nine years (Standard Deviation–SD 13.4). Seven patients (23.3%) had a worsening renal function during hospitalization. Regarding ultrasound findings, VE × US score was calculated at admission and at discharge, unexpectedly remaining unchanged or even worsened (21 patients, 70.0%). The area under the curve for the lung score was 83.9% (p = 0.008), obtaining a cutoff value of 10 that showed a sensitivity of 82.6% and a specificity of 71.4% in the identification of intermediate and high PH. It was possible to monitor significant changes between both exams on the lung score (16.5 vs. 9.3; p < 0.001), improvement in the hepatic vein Doppler pattern (2.4 vs. 2.1; p = 0.002), improvement in portal vein Doppler pattern (1.7 vs. 1.4; p = 0.023), without significant changes in the intra-renal vein Doppler pattern (1.70 vs. 1.57; p = 0.293), VE × US score (1.3 vs. 1.1; p = 0.501), femoral vein Doppler pattern (2.4 vs. 2.1; p = 0.161) and IVC collapsibility (2.0 vs. 2.1; p = 0.420). Conclusions: Our study results suggest that performing serial multiorgan Point-of-Care ultrasound can help us to better identify high and intermediate probability of PH patients with AHF. Currently proposed multi-organ, venous Doppler scanning protocols, such as the VE × US score, should be further studied before expanding its use in AHF patients.

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“…Increased right atrial pressure (RAP) can be transmitted backwards across the venous tree and lead to congestive organ dysfunction[ 9 ]. This can manifest as elevated bilirubin from congestive hepatopathy[ 10 ], delirium from congestive encephalopathy[ 11 ], acute oliguric kidney injury from ‘intra-capsular tamponade’[ 7 ], and gut edema resulting in increased endotoxemia[ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Point of care venous Doppler ultrasound: Exploring the missing piece of bedside hemodynamic assessment

Galindo¹,

Gasca²,

Argaiz³

et al. 2021

WJCCM

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Accurate assessment of the hemodynamic status is vital for appropriate management of patients with critical illness. As such, there has been a constant quest for reliable and non-invasive bedside tools to assess and monitor circulatory status in order to ensure end-organ perfusion. In the recent past, point of care ultrasonography (POCUS) has emerged as a valuable adjunct to physical examination in various specialties, which basically is a clinician-performed bedside ultrasound to answer focused questions. POCUS allows visualization of the internal anatomy and flow dynamics in real time, guiding apt interventions. While both arterial (forward flow) and venous (organ outflow or afterload) limbs of hemodynamic circuit are important for tissue perfusion, the venous side remains relatively under-explored. With recent data underscoring the deleterious consequences of iatrogenic volume overload, objective evaluation of venous congestion is gaining attention. Bedside Doppler ultrasound serves this purpose and aids in diagnosing and monitoring the congestion/venous blood flow pattern. In this article, we summarize the rationale for integrating this technology into routine care of patients with volume-related disorders, discuss the normal and abnormal waveforms, limitations, and future directions.

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Endotoxins in chronic heart failure

Cited by 16 publications

References 4 publications

Diagnostic value of lipopolysaccharide-binding protein and procalcitonin for sepsis diagnosis in forensic pathology

Diagnostic value of lipopolysaccharide-binding protein and procalcitonin for sepsis diagnosis in forensic pathology

Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort

Point of care venous Doppler ultrasound: Exploring the missing piece of bedside hemodynamic assessment

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