Year in review in Intensive Care Medicine 2012. II: Pneumonia and infection, sepsis, coagulation, hemodynamics, cardiovascular and microcirculation, critical care organization, imaging, ethics and legal issues

Antonelli, Massimo; Bonten, Marc J. M.; Cecconi, Maurizio; Chastre, Jean; Citerio, Giuseppe; Conti, Giorgio; Curtis, J. Randall; Hedenstierna, Göran; Joannidis, Michael; MacRae, Duncan; Maggiore, Salvatore Maurizio; Mancebo, Jordi; Mebazaa, Alexandre; Preiser, Jean‐Charles; Rocco, Patricia R. M.; Timsit, Jean‐François; Wernerman, Jan; Zhang, Haibo

doi:10.1007/s00134-012-2804-9

Cited by 12 publications

(8 citation statements)

References 93 publications

(93 reference statements)

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“…Milestones have included the incorporation of the World Society of the Abdominal Compartment Syndrome (WSACS; www.WSACS.org), and the Society’s publication of IAH and ACS expert consensus definitions in 2006 [3, 4], clinical practice guidelines in 2007 [5], and recommendations for research in 2009 [6]. Changes in the management of critically ill surgical and/or medical patients have included increased use of damage control surgery and resuscitation [7–11], percutaneous catheter-based and other minimally invasive therapies, early goal-directed therapy for severe sepsis [12, 13], and a heightened appreciation of the risks of over-resuscitation [14, 15]. In light of such developments, the WSACS reviewed the literature and updated their proposed 2006 consensus definitions and 2007 management statements.…”

Section: Introductionmentioning

confidence: 99%

Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome

et al. 2013

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PurposeTo update the World Society of the Abdominal Compartment Syndrome (WSACS) consensus definitions and management statements relating to intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS).MethodsWe conducted systematic or structured reviews to identify relevant studies relating to IAH or ACS. Updated consensus definitions and management statements were then derived using a modified Delphi method and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines, respectively. Quality of evidence was graded from high (A) to very low (D) and management statements from strong RECOMMENDATIONS (desirable effects clearly outweigh potential undesirable ones) to weaker SUGGESTIONS (potential risks and benefits of the intervention are less clear).ResultsIn addition to reviewing the consensus definitions proposed in 2006, the WSACS defined the open abdomen, lateralization of the abdominal musculature, polycompartment syndrome, and abdominal compliance, and proposed an open abdomen classification system. RECOMMENDATIONS included intra-abdominal pressure (IAP) measurement, avoidance of sustained IAH, protocolized IAP monitoring and management, decompressive laparotomy for overt ACS, and negative pressure wound therapy and efforts to achieve same-hospital-stay fascial closure among patients with an open abdomen. SUGGESTIONS included use of medical therapies and percutaneous catheter drainage for treatment of IAH/ACS, considering the association between body position and IAP, attempts to avoid a positive fluid balance after initial patient resuscitation, use of enhanced ratios of plasma to red blood cells and prophylactic open abdominal strategies, and avoidance of routine early biologic mesh use among patients with open abdominal wounds. NO RECOMMENDATIONS were possible regarding monitoring of abdominal perfusion pressure or the use of diuretics, renal replacement therapies, albumin, or acute component-parts separation.ConclusionAlthough IAH and ACS are common and frequently associated with poor outcomes, the overall quality of evidence available to guide development of RECOMMENDATIONS was generally low. Appropriately designed intervention trials are urgently needed for patients with IAH and ACS.Electronic supplementary materialThe online version of this article (doi:10.1007/s00134-013-2906-z) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome

et al. 2013

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“…On an annual basis, sepsis is diagnosed in ~600,000 patients in North America, with a mortality rate ranging between 30 and 50% (1), thereby resulting in an expensive medical problem. Moreover, sepsis is a leading cause of mortality among patients in intensive care units (2). Although sepsis can be brought under control with the use of comprehensive treatment (3), specific therapeutic interventions for this disease have not been identified, posing a serious threat to human health.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of microRNA-155 relieves sepsis-induced liver injury through inactivating the JAK/STAT pathway

Zhang

Cui

et al. 2015

Molecular Medicine Reports

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The present study aimed to investigate whether the microRNA (miR)‑155 inhibitor has an anti‑inflammatory effect on sepsis‑associated liver injury and whether this effect is associated with the activity of the janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway. BALB/c mice were randomly divided into three groups (n=40 per group): Control, lipopolysaccharide (LPS) and miR‑155 inhibitor plus LPS groups. Liver injury was induced by injection of LPS (20 mg kg‑1). In the inhibitor plus LPS group, LPS was administered after injecting the miR‑155 inhibitor (80 mg kg‑1) for 3 days. Liver tissues were collected at 6, 12, 24 and 48 h after LPS exposure. Hematoxylin and eosin was used to identify the histological changes in the liver. The expression levels of miR‑155, suppressor of cytokine signaling 1 (SOCS1) and STAT1 were determined by reverse transcription‑quantitative polymerase chain reaction. The protein expression of tumor necrosis factor (TNF)‑α and interleukin (IL)‑10 were detected by ELISA. miR‑155 inhibitor pretreatment alleviated the symptoms of LPS‑exposed mice, and reduced LPS‑induced mortality and liver injury. Compared with the LPS group, expression of miR‑155 was significantly reduced in the miR‑155 inhibitor plus LPS group at 6 h (P<0.05). SOCS1 expression was significantly increased in miR‑155 inhibitor plus LPS group compared with the control and the LPS group at 12 h (P<0.05). There was a lower level of STAT1 in the miR‑155 inhibitor plus LPS group compared with the LPS group (P<0.05). In addition, TNF‑α and IL‑10 were significantly decreased in the miR‑155 inhibitor plus LPS group compared with the LPS group (P<0.05). In conclusion, the miR‑155 inhibitor relieves liver injury by enhancing the expression of SOCS1 and inactivating JAK/STAT signaling.

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“…Essa forma não é associada a nenhum processo de entubação orotraqueal ou à técnica de ventilação mecânica (VM). Se por acaso a enfermidade evoluir, o indivíduo pode ser encaminhado para a UTI (ANTONELLI et al, 2013).…”

Section: Classificação Da Pneumoniaunclassified

A Importância do Tratamento Odontológico em pacientes em UTI na diminuição de problemas relacionados à Pneumonia Associada à Ventilação Mecânica (PAVM) : uma Revisão de Literatura/ The Importance of Dentistry Treatment in UTI patients in Reducing problems related to Mechanical ventilation associated pneumonia: a literature review

Marinho¹,

Francelino²,

Canuto³

2021

Braz. Ap. Sci. Rev.

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Objetivo: Demonstrar a relevância do papel do Cirurgião Dentista (CD) como profissional efetivo nas Unidades de Terapia Intensiva (UTI), dispondo como desígnio à prevenção de possível ocorrência de Pneumonia Associada à Ventilação Mecânica (PAVM). Revisão bibliográfica: Nas últimas décadas o CD vêm ganhando bastante importância e espaço no ambiente hospitalar, principalmente quando refere-se a indivíduos internados em UTI’s. Esses profissionais possuem conhecimentos técnicos e científicos dos quais podem diminuir possíveis agravos com relação a infecções em pacientes que encontram-se entubados. Os CD’s assumem um papel de ser um membro na equipe multiprofissional existente nos hospitais, tendo como propósito assegurar a assistência de maneira integral aos indivíduos que necessitam, e encontram-se nas UTI’s ou até mesmo nos ambulatórios. Tais condutas nos processos terapêuticos asseguram na maioria das vezes a redução da propagação de microrganismos responsáveis pelo surgimento de biofilmes com agentes patogênicos responsáveis pelo surgimento da PAVM. Considerações Finais: A presença do CD nas UTI’s é indispensável no que se refere a infecções da cavidade bucal e trato respiratório, principalmente quando se fala sobre a PAVM, tendo em vista através de artigos científicos que a presença desses profissionais reduzem o tempo do paciente, diminuindo assim as despesas hospitalares.

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Year in review in Intensive Care Medicine 2012. II: Pneumonia and infection, sepsis, coagulation, hemodynamics, cardiovascular and microcirculation, critical care organization, imaging, ethics and legal issues

Cited by 12 publications

References 93 publications

Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome

Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome

Inhibition of microRNA-155 relieves sepsis-induced liver injury through inactivating the JAK/STAT pathway

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