Sepsis, venous return, and teleology

McNeilly, Richard

doi:10.1016/j.mehy.2014.09.001

Cited by 3 publications

(3 citation statements)

References 31 publications

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“…The combination of β-blockade with PDE III inhibition is counterintuitive; they have opposing effects on intracellular cAMP concentrations. A pharmacological clamp is effectively applied to the heart, holding it at a given contractility and rate, opposing fluctuations in endogenous catecholamines ( McNeilly, 2014 ). Acute β-blockade in the presence of a PDE III inhibitor has been shown to be feasible and suggested as cardioprotective in sepsis ( Schmittinger et al, 2008 ; Morelli et al, 2013 ).…”

Section: Managementmentioning

confidence: 99%

Milrinone in Enterovirus 71 Brain Stem Encephalitis

Wang

2016

Front. Pharmacol.

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Enterovirus 71 (EV71) was implicated in a widespread outbreak of hand-foot-and-mouth disease (HFMD) across the Asia Pacific area since 1997 and has also been reported sporadically in patients with brain stem encephalitis. Neurogenic shock with pulmonary edema (PE) is a fatal complication of EV71 infection. Among inotropic agents, milrinone is selected as a therapeutic agent for EV71- induced PE due to its immunopathogenesis. Milrinone is a type III phosphodiesterase inhibitor that has both inotropic and vasodilator effects. Its clinical efficacy has been shown by modulating inflammation, reducing sympathetic over-activity, and improving survival in patients with EV71-associated PE. Milrinone exhibits immunoregulatory and anti-inflammatory effects in the management of systemic inflammatory responses in severe EV71 infection.

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Section: Managementmentioning

confidence: 99%

Milrinone in Enterovirus 71 Brain Stem Encephalitis

Wang

2016

Front. Pharmacol.

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“…[23] Vasoactive drugs such as nitrates and dihydroergotamine can modulate vascular tone, improve circulation and tissue perfusion, and attenuate organ dysfunction and tissue damage. [24] β-Antimicrobials such as lactams and macrolides can directly kill bacteria, prevent further spread and exacerbation of infection, and protect the organism from damage due to infection. [25] The main results of this study were that cd3d, CD247 were abnormally expressed in sepsis shock, which may affect the development and progression of sepsis shock.…”

Section: Discussionmentioning

confidence: 99%

CD3D and CD247 are the molecular targets of septic shock

et al. 2023

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Septic shock is a serious systemic disease with circulatory failure and abnormal cell metabolism caused by sepsis. However, the relationship between CD3D and CD247 and septic shock remains unclear. The septic shock datasets GSE33118 and GSE142255 profiles were generated from the gene expression omnibus databases GPl570, GPl17586. Differentially expressed genes (DEGs) were screened and weighted gene co-expression network analysis was performed. The construction and analysis of protein–protein interaction (PPI) network, functional enrichment analysis, gene set enrichment analysis (GSEA) were performed. Gene expression heat map was drawn. Immune infiltration analysis was performed. Comparative toxicogenomics database (CTD) analysis were performed to find the disease most related to the core gene. Targets can was used to screen miRNAs regulating the hub DEGs. 467 DEGs were identified. According to the gene ontology analysis, they were mainly enriched in the regulation of immune response, cell activation, signaling receptor activity, enzyme binding. Kyoto encyclopedia of genes and genomes analysis showed that they were mainly enriched in the TCR signaling pathway, Fc epsilon RI signaling pathway. GSEA showed that the DEGs were mainly enriched in immune response regulation, cell activation, TCR signaling pathway, Fc epsilon RI signaling pathway. Positive regulation of Fc receptor signaling pathway, PID IL12 2 pathway, immune response was observed in go enrichment items in the enrichment items of metascape. PPI networks got 5 core genes. Gene expression heat map showed that 5 core genes (CD247, Lck, cd3e, cd3d, ITK) were lowly expressed in the sepsis shock samples and highly expressed in the normal samples. CTD analysis showed that 5 core genes (CD247, Lck, cd3e, cd3d, ITK) were found to be associated with hemorrhage and necrosis. Low expression of cd3d, CD247 was observed in septic shock, and the lower the level of cd3d, CD247, the worse the prognosis.

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“…Loss of vascular tone, both arterial and venous, is a quintessential component of sepsis-related circulatory dysfunction. Therefore, early initiation of vasopressors to set the venous tone and reinstate adequate venous return was deemed teleologically reasonable [ 26 ]. Indeed, experimental sepsis and clinical data have indicated that, compared to fluid resuscitation alone or late start of vasopressors, an early start of norepinephrine (NE) combined with fluid resuscitation could help limit volume requirements and time until shock control, and be associated with improved tissue oxygenation, superior splanchnic blood flow redistribution, and better clinical outcomes [ 27 , 28 , 29 ].…”

Section: Macrocirculationmentioning

confidence: 99%

Hemodynamic Monitoring in Sepsis—A Conceptual Framework of Macro- and Microcirculatory Alterations

et al. 2021

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Circulatory failure in sepsis is common and places a considerable burden on healthcare systems. It is associated with an increased likelihood of mortality, and timely recognition is a prerequisite to ensure optimum results. While there is consensus that aggressive source control, adequate antimicrobial therapy and hemodynamic management constitute crucial determinants of outcome, discussion remains about the best way to achieve each of these core principles. Sound cardiovascular support rests on tailored fluid resuscitation and vasopressor therapy. To this end, an overarching framework to improve cardiovascular dynamics has been a recurring theme in modern critical care. The object of this review is to examine the nature of one such framework that acknowledges the growing importance of adaptive hemodynamic support combining macro- and microhemodynamic variables to produce adequate tissue perfusion.

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Sepsis, venous return, and teleology

Cited by 3 publications

References 31 publications

Milrinone in Enterovirus 71 Brain Stem Encephalitis

Milrinone in Enterovirus 71 Brain Stem Encephalitis

CD3D and CD247 are the molecular targets of septic shock

Hemodynamic Monitoring in Sepsis—A Conceptual Framework of Macro- and Microcirculatory Alterations

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