Prevalence and Outcome of Diastolic Dysfunction in Children With Fluid Refractory Septic Shock—A Prospective Observational Study*

Sankar, Jhuma; Das, Rashmi Ranjan; Jain, Anjali; Dewangan, Shashikant; Khilnani, Praveen; Yadav, Dinesh Kumar; Dubey, Nand Kishore

doi:10.1097/pcc.0000000000000249

Cited by 38 publications

(36 citation statements)

References 38 publications

(74 reference statements)

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“…Sankar et al pointed out that the prevalence of left ventricular diastolic dysfunction among 56 children with fluid-refractory septic shock (3 months to 17 years of age) was as much as 41% with their mortality rate of 43% [41]. Raj et al also investigated 30 septic shock children and adolescents (1 month to 21 years of age) and showed that the prevalence of left ventricular systolic, diastolic, and both dysfunction was 37%, 33%, and 17%, respectively, [42].…”

Section: Hemodynamic Managementmentioning

confidence: 99%

Update on pediatric sepsis: a review

Kawasaki

2017

j intensive care

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BackgroundSepsis is one of the leading causes of mortality among children worldwide. Unfortunately, however, reliable evidence was insufficient in pediatric sepsis and many aspects in clinical practice actually depend on expert consensus and some evidence in adult sepsis. More recent findings have given us deep insights into pediatric sepsis since the publication of the Surviving Sepsis Campaign guidelines 2012.Main textNew knowledge was added regarding the hemodynamic management and the timely use of antimicrobials. Quality improvement initiatives of pediatric “sepsis bundles” were reported to be successful in clinical outcomes by several centers. Moreover, a recently published global epidemiologic study (the SPROUT study) did not only reveal the demographics, therapeutic interventions, and prognostic outcomes but also elucidated the inappropriateness of the current definition of pediatric sepsis.ConclusionsWith these updated knowledge, the management of pediatric sepsis would be expected to make further progress. In addition, it is meaningful that the fundamental data on which future research should be based were established through the SPROUT study.

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Section: Hemodynamic Managementmentioning

confidence: 99%

Update on pediatric sepsis: a review

Kawasaki

2017

j intensive care

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“…DBS is known to have an excitatory or inhibitory effect depending on stimulation frequency stimulation, although results tend to vary as a function of stimulation parameters and brain region under study (67-69), and biphasic cathode-first stimulation tends to be more effective in eliciting functional responses (70-72). In the present study, we tested different stimulation parameter combinations and selected biphasic pulse trains with 20 Hz frequency, ±8 V amplitude, 100μs pulse duration, 500 ms pulse train duration and 10s pulse trains intervals.…”

Section: Methodsmentioning

confidence: 99%

Basal Forebrain Deep Brain Stimulation Impacts the Regulation of Extracellular Vesicle Related Proteins in the Rat Brain

Nair

et al. 2018

Preprint

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Extracellular vesicle (EV) signaling has attracted considerable attention in recent years because EVs play a key role in long distance cellular communication functions. EV studies have begun to reveal aspects of physiological and physiopathological regulation in numerous applications, although many areas remain to date largely unexplored. Deep brain stimulation (DBS) has shown remarkable therapeutic benefits of patients with neuropsychiatric disorders, but despite of the long and successful history of use, the mechanisms of action on neural ensemble activity are not yet fully understood. Here we explore how DBS of the basal forebrain impacts EV signaling in the rat brain. We employed differential centrifugations to isolate the EVs prefrontal cortex (PFC), hippocampus and striatum. We then performed quantitative analysis of EV-associated proteins using an MS-based proteomics method. We identified a considerable number of EV-associated proteins are modulated by DBS in three brain regions, some of which have been previously linked with central nervous system disorders. Particularly, neurofilament proteins NFL and NFM were both significantly changed in EVs of PFC, hippocampus and striatum after DBS stimulation compared with controls. The SOD1 protein, associated previously with neurodegenerative diseases, was significantly increased only in PFC. Our study is the first, to our knowledge, to use EV protein analysis to examine DBS effects on brain physiological regulation. Our findings open an entirely new perspective on brain area specific DBS effects.

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“…Although many studies have commented on the left ventricular (LV) systolic function in patients with septic shock, diastolic function is often overlooked despite being a very important part of echocardiographic assessment in such patients, [14][15][16][17] The systolic function parameters were below the accepted normal cutoffs in 25%, 45%, and 15%, respectively, while diastolic dysfunction was seen in 12.5%. Overall, more than half (55%) had at least one echocardiographic parameter of myocardial dysfunction.…”

mentioning

confidence: 99%

“…Second, one needs to define which particular cardiac biomarker to study in patients with septic shock, viz., only CK-MB (as done in the current study) or troponins (as described in most of the previous reports), with the introduction of hs-cTn further enhancing diagnostic sensitivity. 7,10,17,18 An advantage of using multiple biomarkers is to be able to document if diverse markers (CK-MB, troponins, C-reactive protein, etc.) have differential release kinetics and develop cutoffs for them to predict outcomes.…”

mentioning

confidence: 99%

Is Sepsis a Cardiac Nemesis? Exploring New Vistas

Kapoor

2020

Indian Journal of Critical Care Medicine

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Prevalence and Outcome of Diastolic Dysfunction in Children With Fluid Refractory Septic Shock—A Prospective Observational Study*

Cited by 38 publications

References 38 publications

Update on pediatric sepsis: a review

Update on pediatric sepsis: a review

Basal Forebrain Deep Brain Stimulation Impacts the Regulation of Extracellular Vesicle Related Proteins in the Rat Brain

Is Sepsis a Cardiac Nemesis? Exploring New Vistas

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