Summary of your 'study carrel' ============================== This is a summary of your Distant Reader 'study carrel'. The Distant Reader harvested & cached your content into a collection/corpus. It then applied sets of natural language processing and text mining against the collection. The results of this process was reduced to a database file -- a 'study carrel'. The study carrel can then be queried, thus bringing light specific characteristics for your collection. These characteristics can help you summarize the collection as well as enumerate things you might want to investigate more closely. This report is a terse narrative report, and when processing is complete you will be linked to a more complete narrative report. Eric Lease Morgan Number of items in the collection; 'How big is my corpus?' ---------------------------------------------------------- 45 Average length of all items measured in words; "More or less, how big is each item?" ------------------------------------------------------------------------------------ 16098 Average readability score of all items (0 = difficult; 100 = easy) ------------------------------------------------------------------ 45 Top 50 statistically significant keywords; "What is my collection about?" ------------------------------------------------------------------------- 42 sepsis 19 patient 10 LPS 10 ICU 7 cell 6 study 6 TNF 5 septic 5 result 5 infection 5 increase 5 group 4 mortality 4 method 4 SIRS 3 sofa 3 response 3 level 3 introduction 3 high 3 figure 3 day 3 conclusion 3 VAP 3 PCT 3 IL-10 3 Hospital 3 Care 3 APACHE 2 shock 2 severe 2 objectives 2 neonatal 2 inflammatory 2 immunoglobulin 2 expression 2 cytokine 2 blood 2 University 2 TBI 2 Sepsis 2 PMN 2 MOF 2 Intensive 2 IL-8 2 IL-6 2 IL-1 2 Fig 2 ECMO 2 CRP Top 50 lemmatized nouns; "What is discussed?" --------------------------------------------- 8009 patient 4890 % 4522 sepsis 2678 study 2612 cell 2232 group 1848 level 1604 mortality 1593 blood 1589 infection 1576 shock 1512 day 1490 response 1270 p 1250 result 1236 effect 1111 care 1098 factor 1059 injury 1025 treatment 1018 time 996 datum 991 outcome 960 organ 950 risk 891 therapy 876 cytokine 855 failure 854 hospital 852 score 852 analysis 837 protein 829 rate 776 expression 749 model 732 admission 730 system 726 ml 726 disease 713 control 702 production 702 h 679 function 675 receptor 659 hour 647 role 632 mouse 630 lung 624 value 621 tissue Top 50 proper nouns; "What are the names of persons or places?" -------------------------------------------------------------- 1877 ICU 793 der 777 LPS 726 TNF 498 al 470 II 447 IL-6 435 et 352 bei 351 von 347 ± 338 C 337 . 327 mg 316 Care 308 mit 298 T 285 und 284 APACHE 276 ARDS 262 AKI 248 kg 248 SIRS 247 OBJECTIVES 235 METHODS 230 eine 216 Sepsis 216 IL-10 206 einer 201 Fig 199 IL 194 Patienten 191 CI 188 Hospital 186 werden 185 Schock 183 B 177 zu 177 IL-1 171 INTRODUCTION 168 PCT 165 L 164 CRP 159 des 158 Intensive 153 RNA 151 den 150 durch 150 IL-8 150 Group Top 50 personal pronouns nouns; "To whom are things referred?" ------------------------------------------------------------- 2051 we 1148 it 500 i 375 they 146 them 44 us 39 he 25 you 24 itself 17 themselves 13 one 7 she 5 me 4 interleukin-10 3 him 2 s 2 il1-α 1 ≥110 1 wi~ 1 tnf~ 1 ta 1 sglt2-inhibitors 1 oct 1 myself 1 mine 1 interferon-7 1 il-1β 1 ifitem 1 icd-10 1 himself 1 her 1 gluts.mine 1 gas6 1 f6r 1 em 1 circ_0005075 1 aptt 1 alpha=0.05 Top 50 lemmatized verbs; "What do things do?" --------------------------------------------- 24052 be 3629 have 1852 use 1594 increase 1118 associate 1081 show 1076 include 974 compare 958 induce 947 die 815 follow 799 do 704 reduce 626 find 601 decrease 588 perform 584 measure 519 receive 510 evaluate 508 treat 484 develop 482 assess 470 improve 465 identify 465 determine 465 activate 459 suggest 443 lead 441 observe 433 relate 431 admit 424 base 417 study 407 require 401 demonstrate 385 occur 378 cause 373 report 371 provide 359 produce 358 investigate 355 indicate 339 define 330 remain 325 predict 310 give 308 result 305 involve 303 consider 296 obtain Top 50 lemmatized adjectives and adverbs; "How are things described?" --------------------------------------------------------------------- 1873 not 1751 - 1663 septic 1616 high 1218 severe 1165 clinical 1007 also 964 low 951 inflammatory 947 acute 937 more 843 immune 832 early 811 significantly 797 significant 714 well 703 other 695 however 621 human 588 only 584 first 575 endothelial 570 respiratory 552 such 537 intensive 519 non 519 cardiac 513 most 510 different 484 bacterial 462 systemic 453 ill 445 critically 433 specific 432 anti 429 mean 427 as 406 multiple 389 pulmonary 385 renal 385 major 385 arterial 379 new 377 important 376 respectively 372 surgical 371 normal 368 mechanical 365 critical 358 negative Top 50 lemmatized superlative adjectives; "How are things described to the extreme?" ------------------------------------------------------------------------- 114 most 100 least 64 high 59 good 56 Most 30 low 15 late 15 common 13 bad 10 strong 10 large 9 great 8 early 4 old 4 near 2 long 2 close 2 big 2 -defensin-2 1 ~trointesfimd 1 young 1 wide 1 small 1 simple 1 sick 1 severe 1 p=0.016 1 nfthe 1 new 1 lfigh 1 intensive 1 fair 1 cfDNA 1 cert,+r 1 \10 1 LPS2= 1 IFN)-alpha 1 -to 1 -rollen Top 50 lemmatized superlative adverbs; "How do things do to the extreme?" ------------------------------------------------------------------------ 399 most 86 least 16 well 1 worst 1 long 1 highest Top 50 Internet domains; "What Webbed places are alluded to in this corpus?" ---------------------------------------------------------------------------- 4 ccforum.com 2 doi.org 1 www.r-project.org 1 www.ncbi.nlm.nih.gov 1 www.ihi.org 1 www.enago.jp 1 www.brainit.org 1 creativecommons.org Top 50 URLs; "What is hyperlinked from this corpus?" ---------------------------------------------------- 3 http://ccforum.com/content/6/S3/S1 2 http://doi.org/10 1 http://www.r-project.org 1 http://www.ncbi.nlm.nih.gov/ 1 http://www.ihi.org 1 http://www.enago.jp 1 http://www.brainit.org 1 http://creativecommons.org/licenses/by/4.0/ 1 http://ccforum.com/content/6/S3/S1Appendix Top 50 email addresses; "Who are you gonna call?" ------------------------------------------------- 1 thato@iu.edu 1 shalini.prasad@utdallas.edu Top 50 positive assertions; "What sentences are in the shape of noun-verb-noun?" ------------------------------------------------------------------------------- 18 levels were significantly 17 patients did not 8 data are available 8 levels were lower 8 sepsis is still 7 group was significantly 7 sepsis was not 6 % were male 6 cells are also 6 mortality did not 5 % had septic 5 groups were not 5 levels were higher 5 levels were not 5 patients had more 5 patients were consecutively 5 patients were prospectively 5 patients were randomly 5 sepsis is not 4 % had at 4 group did not 4 groups did not 4 infections were more 4 levels were also 4 mortality was significantly 4 patients do not 4 patients had at 4 patients has not 4 patients is unknown 4 patients received mechanical 4 patients were male 4 patients were not 4 sepsis did not 4 sepsis has not 4 sepsis induced aki 4 sepsis is also 4 sepsis is more 4 studies have not 4 study are available 4 study does not 3 % had severe 3 % were female 3 cells do not 3 data was retrospectively 3 effect was not 3 group was not 3 group were more 3 groups were similar 3 level is not 3 level was significantly Top 50 negative assertions; "What sentences are in the shape of noun-verb-no|not-noun?" --------------------------------------------------------------------------------------- 3 levels were not significantly 2 groups were not significantly 2 infection do not substantially 2 sepsis is not well 2 sepsis was no longer 2 therapies are not mutually 1 % had no risk 1 blood are not interchangeable 1 care has not previously 1 care is not always 1 cells are not significantly 1 cells do not phagocytose 1 cells had no effect 1 cells showed no immuno 1 cytokines is not yet 1 data are not publicly 1 data are not yet 1 data showed no differences 1 data was not statistically 1 effects was not different 1 group had no further 1 group showed no significant 1 group was not completely 1 group was not significant 1 group was not significantly 1 group were not significantly 1 groups was not clinical 1 groups was not significantly 1 groups were not significant 1 groups were not statistically 1 groups were not uniform 1 icu is not superior 1 icu showed no statistically 1 icu were not so 1 infection does not adversly 1 infections did not spontaneously 1 injury is not directly 1 injury is not fully 1 level is not necessary 1 levels are not sensitive 1 levels showed no differences 1 mortality is not free 1 outcomes are not yet 1 outcomes were not formally 1 patient has not completely 1 patients are not only 1 patients do not yet 1 patients had no sedation 1 patients had no such 1 patients is not invariably A rudimentary bibliography -------------------------- id = cord-028164-yn53209z author = Abe, Toshikazu title = Epidemiology of sepsis and septic shock in intensive care units between sepsis-2 and sepsis-3 populations: sepsis prognostication in intensive care unit and emergency room (SPICE-ICU) date = 2020-06-30 keywords = ICU; definition; sepsis-3 summary = Sepsis-3 was established to improve risk stratification among patients with infection based on organ failures, but it has been still controversial compared with previous definitions. RESULTS: In total, 618 patients with suspected infection were admitted to 22 ICUs during the study, of whom 530 (85.8%) met the sepsis-2 definition and 569 (92.1%) met the sepsis-3 definition. Patients with infection in ICUs were compared according to whether they met sepsis-2 or sepsis-3 definition. Characteristics and in-hospital mortality were compared according to sepsis-2 and sepsis-3 definitions in this prospective observational cohort of ICU patients. In our cohort, 96 (16%) patients had "not available" (NA) sepsis-3 baseline SOFA, which was indicated as zero according to the sepsis-3 definition, although all data of chronic organ failures were tried to obtain. A majority of the patients who were admitted to the ICU with suspected infection met sepsis-2 and sepsis-3 definitions. doi = 10.1186/s40560-020-00465-0 id = cord-347833-b3yrxkt0 author = Ahlström, Björn title = A nationwide study of the long-term prevalence of dementia and its risk factors in the Swedish intensive care cohort date = 2020-09-04 keywords = ICU; dementia; sepsis summary = We aimed to investigate whether intensive care-treated sepsis is an independent risk factor for a later diagnosis of dementia in a large cohort of intensive care unit (ICU) patients. CONCLUSION: Although dementia is more common among patients treated with sepsis in the ICU, sepsis was not an independent risk factor for later dementia in the Swedish national critical care cohort. The following covariates were chosen from available variables through directed acyclic graph analysis and a literature review: sepsis; age [1] and sex, all of which have been previously described as independent risk factors for dementia [33] ; CCI; SAPS3 box 2+3; hospital length of stay (H-LoS); ICU-LoS; invasive ventilator therapy; and RRT. However, after adjusting for age, sex, CCI score, SAPS3 box 2+3, H-LoS, ICU-LoS, invasive ventilator therapy, and RRT, sepsis was no longer an independent risk factor for dementia (HR 1.01, 95% CI 0.91-1.11) (Fig. 4) doi = 10.1186/s13054-020-03203-y id = cord-005569-9d51l6bn author = Antonelli, Massimo title = Year in review in Intensive Care Medicine, 2008: I. Brain injury and neurology, renal failure and endocrinology, metabolism and nutrition, sepsis, infections and pneumonia date = 2008-12-09 keywords = ICP; ICU; NTM; TBI; VAP; patient; sepsis; study summary = Key recommendations, listed by category, include: early goal-directed resuscitation of the septic patient during the first 6 h after recognition (1C); blood cultures prior to antibiotic therapy (1C); imaging studies performed promptly to confirm potential source of infection (1C); administration of broad-spectrum antibiotic therapy within 1 h of diagnosis of septic shock (1B) and severe sepsis without septic shock (1D); reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate (1C); a usual 7-10 days of antibiotic therapy guided by clinical response (1D); source control with attention to the balance of risks and benefits of the chosen method (1C); administration of either crystalloid or colloid fluid resuscitation (1B); fluid challenge to restore mean circulating filling pressure (1C); reduction in rate of fluid administration with rising filling pressures and no improvement in tissue perfusion (1D); vasopressor preference for norepinephrine or dopamine to maintain an initial target of mean arterial pressure [ or =65 mm Hg (1C); dobutamine inotropic therapy when cardiac output remains low despite fluid resuscitation and combined inotropic/vasopressor therapy (1C); stress-dose steroid therapy given only in septic shock after blood pressure is identified to be poorly responsive to fluid and vasopressor therapy (2C); recombinant activated protein C in patients with severe sepsis and clinical assessment of high risk for death (2B except 2C for post-operative patients). doi = 10.1007/s00134-008-1371-6 id = cord-017470-sjk7a34u author = Arlati, Sergio title = Pathophysiology of Acute Illness and Injury date = 2018-06-14 keywords = SIRS; TNF; car; cell; cytokine; increase; inflammatory; sepsis; tissue summary = The endothelium is a key factor for production of remote organ damage as it exerts potent chemo-attracting effects on inflammatory cells, allows for leukocyte trafficking into tissues and organs, and promotes further inflammation by cytokines release. Thus, pneumococcal pneumonia can transform into severe sepsis or septic shock if a generalized inflammatory reaction develops by either cellular (neutrophils, monocytes, macrophages, endothelium) or humoral effectors (complement, contact phase proteins, leukotrienes, cytokines, chemokines) resulting into increased capillary permeability (tissue edema), vasodilation (hypotension), and coagulation activation (ischemic organ damage). However, the severe decrease of innate immune function and the widespread hibernation of nonimmune cell type (cellular hibernation response) [137, 138] make apoptosis a primary mechanism for multiple organ dysfunction and ultimately death. The loss of physiologic anticoagulation in sepsis results from the action of several humoral (IL1-β, TNF-α, and IL6, C-reactive protein) and cellular (vascular endothelial cells, monocytes, macrophages, and platelet) pro-inflammatory mediators. doi = 10.1007/978-3-319-95114-0_2 id = cord-006460-3ayc0hne author = Baue, Arthur E. title = Multiple organ failure – the discrepancy between our scientific knowledge and understanding and the management of our patients date = 2000-10-19 keywords = MOF; SIRS; failure; multiple; organ; patient; sepsis summary = Here, then, is an example of a Nobel Prize being awarded for the study of endothelial A.E. Baue ( ✉ ) cell-produced NO on the one hand, and the concept of excess vasodilatation in septic shock, the hypothesis that this was due to NO and a clinical trial blocking NO that increased mortality on the other. 3. We have tried to lump together and treat human abnormalities according to symptoms and signs rather than to the basic causes of their diseases -we have tried to treat inflammation, sepsis, systemic inflammatory response syndrome (SIRS), and multiple organ dysfunction syndrome (MODS) rather than what caused them; perforated diverticulitis is not acute pancreatitis and neither are ventilator-associated pneumonia and appendicitis. There has been significant improvement in survival of patients with persistent severe organ system failure." Thus, this report confirms again (1) that better intensive care is helping, and (2) my insistence that the secret to MOF is prevention. doi = 10.1007/s004230000162 id = cord-297039-vfuem6bk author = Beltrán-García, Jesús title = Circular RNAs in Sepsis: Biogenesis, Function, and Clinical Significance date = 2020-06-25 keywords = RNA; circrna; circular; expression; figure; sepsis summary = Recent findings propose that circular RNAs (circRNAs) may play a prominent role in regulating the patients'' immune system against different pathogens, including bacteria and viruses. Due to the role that circRNAs play in the modulation of different cytokines and immune proteins [62, 63] , altered states of alternative splicing in sepsis may alter the expression of circRNAs, which could partially explain the changes in the immune response of septic patients. However, circRNAs may play a key role in sepsis because of their ability to modulate different molecular mechanisms [10] , including inflammation [83] and immune response [62] , and to control multiple biological processes in metabolic organs (i.e., liver, pancreas [84] ) ( Figure 3 and Table 1 ). Interestingly, circRNAs may function as "molecular sponges", by controlling the expression of different types of non-coding RNAs, such as miRNAS, involved in regulating different processes in sepsis [105] [106] [107] [108] . doi = 10.3390/cells9061544 id = cord-005603-kjcbbgse author = Brun-Buisson, C. title = The epidemiology of the systemic inflammatory response date = 2000 keywords = ICU; SIRS; sepsis summary = Objective: To examine the incidence, risk factors, aetiologies and outcome of the various forms of the septic syndromes (the systemic inflammatory response syndrome [SIRS] sepsis, severe sepsis, and septic shock) and their relationships with infection.¶Design: Review of published cohort studies examining the epidemiology of the septic syndromes, with emphasis on intensive care unit (ICU) patients.¶Results: The prevalence of SIRS is very high, affecting one-third of all in-hospital patients, and > 50 % of all ICU patients; in surgical ICU patients, SIRS occurs in > 80 % patients. In the French Bacteraemia/Sepsis study, including 24 hospitals on the one hand [5] and 170 ICUs on the other [13] both surveyed during a 2-month period, the overall incidence of severe sepsis and shock (including clinically and microbiologically documented infection) was of 6/1000 of all hospital admissions, but only of 2.9/ 1000 in medical/surgical wards and 119/1000 in ICUs ( Table 2 ). doi = 10.1007/s001340051121 id = cord-001293-dfaxj3bv author = Cavaillon, Jean-Marc title = Is boosting the immune system in sepsis appropriate? date = 2014-03-24 keywords = TNF; patient; sepsis summary = In response to the failure of therapies aiming to target either the up-stream microbial activators or the effector molecules of the inflammatory cascade, a new concept has emerged of boosting the immune system to counter immunosuppression that develops in patients who survive the initial, hyperinflammatory period of sepsis [1] . One can conjecture that systemic treatment with IL-7 may act in undesired places, as illustrated by the following: IL-7 worsens graft-versus-host-induced tissue inflammation [81] ; favors inflammation in colitis [82] , contributes to arthritis severity [83] ; upregulates chemokines, IFNγ, macrophage recruitment, and lung inflammation [84] ; and, finally, increases production of inflammatory cytokines by monocytes and T cells [85] . Not only are PD-1-deficient mice markedly protected from the lethality of sepsis, accompanied by a decreased bacterial burden and suppressed inflammatory cytokine response [98] , but also blockade of PD-1 or PD-L1 improves survival in a murine model of sepsis, reverses immune dysfunction, inhibits lymphocyte apoptosis, and attenuates organ dysfunction [99] [100] [101] . doi = 10.1186/cc13787 id = cord-002956-e5ihpe4i author = Chang, Ya-Chun title = Ventilator Dependence Risk Score for the Prediction of Prolonged Mechanical Ventilation in Patients Who Survive Sepsis/Septic Shock with Respiratory Failure date = 2018-04-04 keywords = dependence; patient; sepsis; ventilator summary = title: Ventilator Dependence Risk Score for the Prediction of Prolonged Mechanical Ventilation in Patients Who Survive Sepsis/Septic Shock with Respiratory Failure A total of 379 patients with sepsis or septic shock and acute respiratory failure requiring mechanical ventilation were admitted to the medical intensive care unit in the Kaohsiung Chang Gung Memorial Hospital from August 2013 to October 2015. We also tested and found that SOFA PaO 2 /FiO 2 subscore and GCS subscore on admission day 7 could help predict ventilator dependence on sepsis and septic shock patients with significant difference in univariate analysis ( Table 5 ). Ventilator dependence risk score, including a history of stroke and data from day 7 (thrombocytopenia, acidosis, and the higher fraction of inspired oxygen), can be applied to predict prolonged mechanical ventilation in patients who survive sepsis and septic shock. doi = 10.1038/s41598-018-24028-4 id = cord-252859-zir02q69 author = Chung, T. Philip title = Molecular Diagnostics in Sepsis: From Bedside to Bench date = 2006-09-11 keywords = CLP; LPS; gene; sepsis summary = BACKGROUND: Based on recent in vitro data, we tested the hypothesis that microarray expression profiles can be used to diagnose sepsis, distinguishing in vivo between sterile and infectious causes of systemic inflammation. Lists of genes with substantial changes in expression between study and control groups were used to identify nine mouse common inflammatory response genes, six of which were mapped into a single pathway using contemporary pathway analysis tools. 17, 18 We hypothesized that leukocyte gene expression profiles obtained using DNA microarrays could be used to predict septic states; in particular, distinguishing between sterile and infectious sources of systemic inflammation, a common conundrum in caring for the critically ill or injured. 30 PCA analysis of these 25 probe sets revealed that the seven experimental groups were clustered into three apparent phenotypes (Fig. 4) : control animals, LPS-treated animals (sterile source of systemic inflammation), and those that had any CLP treatment (Sepsis). doi = 10.1016/j.jamcollsurg.2006.06.028 id = cord-312197-d5d8amk7 author = Edmond, Karen title = New Approaches to Preventing, Diagnosing, and Treating Neonatal Sepsis date = 2010-03-09 keywords = PCR; country; infection; neonatal; sepsis summary = Health facility infections are also a major problem in lowincome countries, but the more pressing issues are the high proportion of home deliveries in unclean environments predisposing to sepsis and ensuring that all neonates have access to effective interventions from health care providers in the first days of life 2 . Randomised controlled trials (RCTs) of maternal protein-calorie and multiple micronutrient and supplementation have demonstrated significant improvements in rates of prematurity and birth weight and variable impact on mortality; but no studies have examined their impact on rates of neonatal sepsis [20, 21] . New studies from Malawi and Nepal indicate that maternal antisepsis interventions such as vaginal chlorhexidine during labour may have a significant impact on rates of neonatal mortality and sepsis in developing countries [33] . Intrapartum antibiotic prophylaxis has been highly effective in reducing both early-onset neonatal bacterial and maternal sepsis in developed countries [35] . doi = 10.1371/journal.pmed.1000213 id = cord-006414-60lpjg09 author = Engelmann, L. title = Die Diagnose der Sepsis date = 2006 keywords = PCT; sepsis summary = Patients have to be considered as septic with a serum PCT level higher than 1 ng/ml particularly when clinical signs do not exclude sepsis and in cases of positive blood cultures. Ärzten von Notaufnahmen und klinisch tätigen Ärzten steht neben dem Wissen um die variable Klinik des septischen Patienten vor allem der Laborparameter Procalcitonin zur Verfügung. CRP ist das Produkt der durch Zytokine stimulierten Hepatozyten und somit das Endergebnis der Inflammationsreaktion, damit ein Akut-Phase-Protein [48] . Patienten mit Inflammationreaktion septischer und nicht-septischer Genese unterscheiden sich nicht im CRP-Verlauf (Abb. 4), während bei gesicherter Sepsis dem CRP-Verhalten eine prognostische Bedeutung zukommt (Abb. 5; [41, 50] ) Die Inflammationsreaktion ist eine weitestgehend uniforme Reaktion des Organismus auf Schädigung. High circulating levels of interleukin-6 in patients with septic shock: evolution during sepsis, prognostic value, and interplay with other cytikines doi = 10.1007/s00390-006-0741-y id = cord-018284-grvj99eh author = Fresenius, Michael title = SIRS, Sepsis und Multiorganversagen date = 2014-10-04 keywords = sepsis; septic summary = Selenium in Intensive Care: results of a prospective randomized, placebo-controlled, multicenter study in patients with severe systemic inflammatory response syndrome, sepsis and septic shock Effect of treatment with low doses of hydrocortisone and fludrocortisones on mortality in patients with septic shock Effect of treatment with low doses of hydrocortisone and fludrocortisones on mortality in patients with septic shock A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock Effects of high dosis of selenium, as sodium selenit, in septic shock: a placebo-controlled, randomized, double-blind, phase II study Early antimicrobial therapy in severe sepsis and septic shock Early goal-directed therapy in the treatment of severe sepsis and septic shock Hydrocortisone therapy for patients with septic shock Guidelines for the management of severe sepsis and septic shock doi = 10.1007/978-3-642-44933-8_24 id = cord-001319-mlkaowqr author = Giamarellos-Bourboulis, Evangelos J title = Kinetics of circulating immunoglobulin M in sepsis: relationship with final outcome date = 2013-10-21 keywords = IgM; sepsis; septic summary = RESULTS: Serum IgM was decreased in septic shock compared to patients with systemic inflammatory response syndrome (SIRS) and patients with severe sepsis. The current study was designed in order to embed into the changes of circulating IgM levels of patients upon progression to the more severe stages of sepsis in relation with the production of IgM from circulating lymphocytes and with the final outcome. The primary endpoint was the over-time changes of IgM serum levels of patients upon progression to septic shock in relation with the final outcome that is survival or 28-day mortality. The study end point was the kinetics of serum IgM upon progression from severe sepsis to septic shock in relation with final outcome. The time curves of IgM were designed for 30 patients with severe sepsis who progressed into septic shock. doi = 10.1186/cc13073 id = cord-298505-r7ihqb96 author = Górski, Andrzej title = Sepsis, Phages, and COVID-19 date = 2020-10-15 keywords = COVID-19; SARS; phage; sepsis summary = In fact, in addition to data obtained in experimental animals, there are already reports of successful phage therapy in patients with sepsis [2] . Phage therapy efficacy has also been studied in a mouse model of neonatal sepsis caused by Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, Citrobacter freundii and Moraxella catarrhalis. High effectiveness of phage therapy in the treatment of experimental sepsis induced by multidrug resistant P. Further progress in phage therapy of sepsis has recently been achieved by introducing engineered phages used to treat a patient with a disseminated drug resistant mycobacterial infection. In recent years, a number of reports derived from experimental studies in animals and human clinics have suggested the potential value of phage therapy in the treatment of sepsis. The anti-inflammatory and the immunomodulating properties of phages could also be useful in the treatment of severe COVID-19 syndrome including viral sepsis (Table 2) . doi = 10.3390/pathogens9100844 id = cord-016127-tbot0fc9 author = Hurtado, F. J. title = Sepsis: Clinical Approach, Evidence-Based at the Bedside date = 2009-11-19 keywords = infection; patient; sepsis; septic summary = Since 2002 the Surviving Sepsis Campaign was introduced with the initial goal of increasing clinicians'' awareness about severe sepsis mortality and to improve outcome in this patient population. Despite the fact that most of these recommendations were not supported by high levels of evidence, they represented the international consensus on the best available standards of care for the management of sepsis. Mortality increases according to the presence of shock, and metabolic markers like arterial lactate are useful to characterize disease severity and the response to treatment [8] . The current management of severe sepsis and septic shock aims to control infection, achieve hemodynamic stabilization, modulate the immune response, and provide metabolic and organ support. The SSC is a global initiative that involves several international organizations with the common objective of elaborating evidence-based guidelines and recommendations for the management of severe sepsis and septic shock. Early goal-directed therapy in the treatment of severe sepsis and septic shock doi = 10.1007/978-88-470-1436-7_25 id = cord-103081-k7ev5qkn author = Janosevic, Danielle title = The orchestrated cellular and molecular responses of the kidney to endotoxin define the sepsis timeline date = 2020-05-30 keywords = Fig; Supplementary; cell; sepsis summary = Note that the expression of cluster-defining markers varied significantly during the injury and 63 recovery phases of sepsis ( Fig. S1b; Supplementary Table 1 ). One of the subclusters showed 112 increased expression of alternatively activated macrophages (M2) markers such as Arg1 113 (Arginase 1) and Mrc1 (Cd206) 27 at later time points (36 hours, Supplementary Fig. 4b) . Such 181 communication patterns among these four cell types may also explain macrophage clustering 182 around S1 tubules at later time points in sepsis as we previously reported 13 . To this end, we selected the differentially expressed genes from all cells combined (pseudo 203 bulk) for each time point across the mouse sepsis timeline (Supplementary Table 4) . Our data 215 cover nearly all renal cell types and are time-anchored, thus providing a detailed and precise 216 view of the evolution of sepsis in the kidney at the cellular and molecular level. doi = 10.1101/2020.05.27.118620 id = cord-349076-x3rjasg0 author = Jarczak, Dominik title = Use of Intravenous Immunoglobulins in Sepsis Therapy—A Clinical View date = 2020-08-03 keywords = cell; immunoglobulin; patient; sepsis summary = With this review, we aim to provide an overview of the role of immunoglobulins, with emphasis on IgM-enriched formulations, in the therapy of adult patients with sepsis and septic shock. The clinical rationale for IVIg therapy in sepsis can be categorized as follows: the role of immunoglobulins in (i) recognition and clearance of pathogens and toxins, (ii) scavenging and inhibition of up-and downstream mediator gene transcription, and (iii) anti-apoptotic effects on immune cells. The clinical rationale for IVIg therapy in sepsis can be categorized as follows: the role of immunoglobulins in (i) recognition and clearance of pathogens and toxins, (ii) scavenging and inhibition of up-and downstream mediator gene transcription, and (iii) anti-apoptotic effects on immune cells. Relationship between the timing of administration of IgM and IgA enriched immunoglobulins in patients with severe sepsis and septic shock and the outcome: A retrospective analysis Effects of the timing of administration of IgM-and IgA-enriched intravenous polyclonal immunoglobulins on the outcome of septic shock patients doi = 10.3390/ijms21155543 id = cord-302379-jh6jxwyn author = Jevon, Phil title = Management of odontogenic infections and sepsis: an update date = 2020-09-25 keywords = dental; infection; sepsis summary = A patient with non-odontogenic-related infection could also present with sepsis at a dental practice. Age-specific sepsis decision support tools have been developed by the UK Sepsis Trust to help dental staff recognise and manage patients with suspected sepsis. The aim of this article is to provide an update on the management of odontogenic infections and sepsis in the dental practice. A careful history, thorough clinical examinations and a high index of suspicion will enable the GDP to diagnose and appropriately manage patients presenting with odontogenic sepsis. The ''GDP sepsis decision support tool for primary dental care'' (Fig. 3) should be applied to all adults and young people aged 12 years and over with fever (or recent fever), symptoms presenting with a source of orofacial/dental infection (including post-operative infection) or have clinical observations outside normal limits. This stresses the importance for dental teams to be familiar with sepsis and the decision tools described here for safe management of such patients. doi = 10.1038/s41415-020-2114-5 id = cord-348785-f67amppy author = Kapicibaşi, Hasan Oğuz title = Pulmonary effects of ozone therapy at different doses combined with antibioticotherapy in experimental sepsis model date = 2020-07-13 keywords = Group; ozone; sepsis summary = PURPOSE: This experimental sepsis model created with Escherichia coli aimed to investigate the histopathological effects of two different doses of ozone combined with antibiotherapy on lung tissue. Based on the known positive and negative effects of ozone, in our study we aimed to assess the effect of two different doses of ozone therapy added to antibiotic treatment in an experimental sepsis model induced with Escherichia coli on the histopathologic findings observed in the inflammatory process in the lungs. In an experimental necrotizing pancreatitis model, ozone therapy was seen to be more effective to reduce oxidative stress levels, tissue injury and bacterial translocation rates compared to hyperbaric oxygen treatment 30 . Data obtained as a result of our study lead to the consideration that ozone therapy administered in addition to antibiotherapy may cause negative effects on lung tissue damaged due to sepsis. doi = 10.1590/s0102-865020200060000004 id = cord-018840-ts2g1ux7 author = Katragkou, Aspasia title = Role of Immunoglobulin Therapy to Prevent and Treat Infections date = 2018-06-19 keywords = IVIG; antibody; immunoglobulin; patient; sepsis summary = While the main clinical applications of immunoglobulin therapy concern their use as replacement for patients with primary immunodeficiencies, or as treatment for autoimmune and inflammatory disorders, their role in infectious disease is limited largely to viral and toxin neutralization and replacement therapy in patients with immunoglobulin deficiencies. The first clinical trial, which evaluated the effect of IgMA-enriched immunoglobulin preparation (7.8 g IgM, 7.8 g IgA, and 49.4 g IgG), which have shown to contain superior antibody content against bacterial lipopolysaccharides, in an appreciable number of neutropenic patients with hematologic malignancies and sepsis or septic shock, showed that immunoglobulins had no beneficial effects [51] . A controlled trial of long-term administration of intravenous immunoglobulin to prevent late infection and chronic graft-vs.-host disease after marrow transplantation: clinical outcome and effect on subsequent immune recovery doi = 10.1007/978-3-319-77674-3_17 id = cord-006426-baf2d47y author = Kimura, Fumio title = Immunosuppression following surgical and traumatic injury date = 2010-08-26 keywords = IL-10; cell; patient; sepsis; th1 summary = Suppression of cell-mediated immunity may be caused by multifaceted cytokine/inhibitor profiles in the circulation and other compartments of the host, excessive activation and dysregulated recruitment of polymorphonuclear neutrophils, induction of alternatively activated or regulatory macrophages that have anti-inflammatory properties, a shift in the T-helper (Th)1/Th2 balance toward Th2, appearance of regulatory T cells, which are potent suppressors of the innate and adaptive immune system, and lymphocyte apoptosis in patients with sepsis. 13, 14 In response to major tissue injury and/or bacterial infection, endothelial and epithelial cells, as well as neutrophils, macrophages, and lymphocytes, produce powerful proinfl ammatory cytokines, especially tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6. doi = 10.1007/s00595-010-4323-z id = cord-104180-f3hoz9bu author = Kirk-Bayley, Justin title = Recently published papers: inflammation, elucidation, manipulation? date = 2003-07-03 keywords = patient; sepsis summary = They looked at end-organ epithelial cell apoptosis in a rabbit model of ARDS and at the effects of plasma on epithelial cells from recipients of the injurious ventilatory strategy, and analyzed samples from a previous trial into lung protective ventilation [8] . Choosing the right ventilation strategy for ARDS patients has more benefits than just lung protection, and therapeutic targeting of these factors that induce end organ apoptosis may be the next step. Stress doses of hydrocortisone reduce severe systemic inflammatory response syndrome and improve early outcome in a risk group of patients after cardiac surgery Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial Dose-response characteristics during long-term inhalation of nitric oxide in patients with severe acute respiratory distress syndrome: a prospective, randomized, controlled study doi = nan id = cord-033064-3b4jv1zb author = Larsen, Reinhard title = Sepsis und septischer Schock date = 2016-06-14 keywords = Sepsis summary = Die Sepsis ist eine lebensbedrohliche Organfunktionsstörung aufgrund einer fehlregulierten Reaktion des Körpers auf eine Infektion. Hinweise sind ein Abfall des systolischen Blutdrucks auf unter 100 mm Hg, Bewusstseinsatörungen und ein Anstieg der Atemfrequenz auf über 22/min (qSOFA-Score) Beim septischen Schock, einer Unterform der Sepsis, muss die Herz-Kreislauf-Funktion mit kardiovaskulären Medikamenten und Volumenersatz gestützt werden. Trotz intensiver Bemühungen ist die Letalität der Sepsis unverändert hoch. DIe Sepsis-Konsensuskonferenz von 2016 bewertet die SIRS-Kriterien als zu ungenau für die Diagnose einer Sepsis und empfiehlt daher, den Begriff nicht mehr zu verwenden. Sepsis ist eine systemische Entzündungsreaktion des Organismus auf eine Infektion durch Mikroorganismen (Bakterien, Viren, Pilze, Rickettsien, Protozoen). Die Sepsis ist Folge einer komplexen generalisierten Entzündungsreaktion durch eine Infektion. Trotz intensiver Bemühungen ist die Letalität der Sepsis weiterhin unverändert hoch. Eine frühzeitige Diagnosestellung und Therapie ist für das Überleben der Patienten von entscheidender Bedeutung. Eine frühzeitige Diagnosestellung und Therapie ist für das Überleben der Patienten von entscheidender Bedeutung. doi = 10.1007/978-3-662-50444-4_66 id = cord-017376-wrhkfcff author = Liu, Yongjian title = Pro-resolution of Inflammation: New Hints to Manage Sepsis? date = 2019-05-28 keywords = Annexin; LXA4; sepsis summary = Carbon monoxide, synthesized by HO-1, performs multiple stances of anti-inflammation and pro-resolution along with the SPMs. If the potentially beneficial effects of these mediators would be well evaluated in clinical trials, they present encouraging new hints in managing infectious maladies especially sepsis. Previous studies have shown that IV administration of RvD2 on a CLP sepsis model exhibits the following protective pro-resolution effects and increases survival rate: (1) reduce viable aerobic bacterial load in peritoneal exudates and blood; (2) reduce PMN migration into the peritoneum; (3) reduce plasma levels of IL-10 and IL-17; (4) reduce pro-inflammatory cytokine (IL-6, IL-1β, IL-23 and TNF-α) levels in plasma and peritoneum; (5) reduce concentrations of the pro-inflammatory lipids PGE2 and LTB4; while (6) increase clearance of bacteria by phagocytes in inguinal lymph nodes and in vitro; (7) enhance phagocytosis of E. doi = 10.1007/978-981-13-3353-8_8 id = cord-023935-o2ffxgnn author = Lorts, Angela title = Sepsis date = 2011-12-16 keywords = IL-1; LPS; TNF; response; sepsis; septic; shock summary = SIRS i s a state of infl ammatory/ immune activation and is based on the presence of at least two of the four following clinical criteria: Temperature >38°C or <36°C, heart rate >90th percentile for age, respiratory rate >90th percentile for age, or hyperventilation to PaCO 2 < 32 mm Hg. The defi nition attempts to "capture" all patients at risk for the subsequent development of severe sepsis or septic shock. Among these, the nuclear factor-k B (NF-k b ) and the mitogen activated protein kinase (MAPK) pathways play a prominent role in regulating the expression of a number of infl ammatory gene products key to propagating the sepsis response. Nuclear factork B (NFk b ) and the mitogen activated protein kinase (MAPK) pathways play a prominent role in regulating the expression of a number of infl ammatory gene products key to propagating the sepsis response. doi = 10.1007/978-0-85729-923-9_27 id = cord-014658-oeuvelb1 author = Martin, Greg S. title = Optimal fluid management in sepsis date = 2019-11-07 keywords = sepsis summary = Fluid administration should be targeted to achieve a MAP of at least 65 mm Hg, and to normalize lactate in patients with elevated lactate due to hypoperfusion.(3) Balanced crystalloids are the fluid of first choice for sepsis resuscitation based on ready availability and taking medication costs into account. Use of 0.9% saline compared to a balanced crystalloid, such as lactated Ringer''s or PlasmaLyte, produces more kidney dysfunction and with a greater risk of dying.(4) The individual side effect profiles may best differentiate the natural and synthetic colloids. Albumin may be considered for administration to sepsis patients with refractory shock or who have received substantial amounts of crystalloid fluids, but should not be administered to patients with severe traumatic brain injury.(5) Hydroxyethyl starch (HES) products should not be administered to patients with sepsis because of increased risk of acute kidney injury and death. doi = 10.5339/qmj.2019.qccc.40 id = cord-020643-0yzkqykg author = Müller-Werdan, U. title = Schock date = 2006 keywords = Abschn; Einsatz; Gabe; Herz; Letalität; Lösungen; MODS; PCI; Patienten; Schock; Score; TNF; Therapie; Werdan; als; auf; bei; den; der; des; die; durch; eine; ist; kann; mit; nicht; sepsis; und; von; zur summary = Auch dass nichtinfektiöse Noxen (Trauma, Pankreatitis, herzchirurgische Operationen mit der Herz-Lungen-Maschine) zu einem ganz ähnlichen klinischen Bild wie bei bakteri-ell ausgelöster Sepsis und septischem Schock führen können, spricht für eine mehr oder weniger gemeinsame Zytokin-/Mediatorendstrecke als verantwortliche Schädigungskaskade sowohl bei infektiösen als auch bei nichtinfektiösen (SIRS, . Eine Ausnahme von dieser Regel stellt die Hirndurchblutung dar, die in der Sepsis weiterhin die Fähigkeit zur Autoregulation beibehält: Bei Patienten mit Sepsis ist die Hirndurchblutung bereits vor der Ausbildung des Schockzustandes um ein Drittel reduziert, wobei diese Durchblutungseinschränkung jedoch nicht als Ursache der septischen Enzephalopathie angesehen wird. Im Koronargefäßsystem fällt dagegen der Widerstand noch stärker ab als in den anderen Organen und demzufolge ist die Koronarperfusion bei Patienten mit septischem Schock sogar häufi g erhöht (Dhainaut et al. Die Messung des zentralen Venendrucks ist bei kritisch Kranken, insbesondere Schockpatienten, für das hämodynamische Monitoring normalerweise nicht genügend, eine Abschätzung der linksventrikulären Vorlast kann damit nicht ausreichend sicher durchgeführt werden, ebenso wenig wie mit der klinischen Einschätzung allein. doi = 10.1007/3-540-29425-2_6 id = cord-015946-biu5zxd1 author = Peng, Daizhi title = Research Advances in Biomarker for Sepsis date = 2016-11-16 keywords = biomarker; dna; expression; patient; sepsis summary = Most commonly proposed sepsis and infection biomarkers including C-reactive protein (CRP), procalcitonin (PCT) [5, 6] , cytokines (TNF-α, IL-1, IL-6, IL-10, osteopontin) [7, 8] , chemokines [macrophage migration inhibitory factor (MIF), high-mobility-group box 1 (HMGB1)] [9, 10] , soluble receptor [soluble triggering receptor expressed on myeloid cells 1 (sTREM-1), soluble urokinase-type plasminogen activator receptor (suPAR)] [11, 12] etc. When it comes to sepsis, by using genome-wide miRNA profiling with microarray in peripheral blood leukocytes and quantitative RT-PCR, Vasilescu [71] found that miR-150 levels were significantly reduced in both leukocytes and plasma of sepsis patients and had a negative correlation with the level of disease severity measured by the Sequential Organ Failure Assessment (SOFA) score, which made it a biomarker of early sepsis. As they were significantly correlated with disease severity, classical markers of inflammation and bacterial infection, as well as organ failure, high miR-133a levels were considered as independent biomarkers for unfavorable prognosis of critically ill patients. doi = 10.1007/978-981-10-2425-2_15 id = cord-005697-l1zmrq4p author = Pène, Frédéric title = Is this critically ill patient immunocompromised? date = 2015-12-02 keywords = patient; sepsis summary = A subset of septic patients infected with highly virulent pathogens may die rapidly from refractory shock, disseminated intravascular coagulation, and intractable multiple organ failure as a result of hyper-cytokinemia and uncontrolled inflammatory response. However, with improvements in acute care and resuscitation therapies, this classical exuberant presentation is relatively rare nowadays, and the physician is more often challenged by a blunted clinical response to infection, with subtle findings including lethargy or depressed mental status, glucose intolerance and hyperglycemia, hypothermia, and/or a change in the white blood cell count or cell differential. In addition to overt immunosuppressive conditions (e.g., cancer and hematological malignancies, solid organ transplant, autoimmune and systemic diseases, HIV, use of immunosuppressive drugs), many septic patients commonly exhibit additional risk factors affecting immune status [3] . Regardless of underlying comorbidities and primary injuries responsible for ICU admission, a significant proportion of critically ill patients can reasonably be considered to be immunocompromised and at risk for ICU-acquired infections, especially if they develop overt signs of immunosuppression. doi = 10.1007/s00134-015-4161-y id = cord-302295-nblmshni author = Savva, Athina title = Targeting Toll-Like Receptors: Promising Therapeutic Strategies for the Management of Sepsis-Associated Pathology and Infectious Diseases date = 2013-11-18 keywords = HCV; LPS; TLR2; TLR3; TLR4; TLR7; Toll; sepsis summary = TLR4 and TLR2 are favorite targets for developing anti-sepsis drugs, and antagonistic compounds have shown efficient protection from septic shock in pre-clinical models. Recombinant human activated protein C (rhAPC, Xigris®, Eli Lilly), the only drug specifically registered for sepsis, has recently been withdrawn from the market following the negative results from the PROWESS-SHOCK study that did not show reduction in mortality at 28 or 90 days in patients with septic shock (4) . The discovery of TLRs and their involvement in innate immune responses has attracted much interest into the development of drugs for controlling infections and improving sepsis management. Moreover, upon infection, innate immune cells will likely sense several MAMPs via several TLRs and non-TLR PRRs. For example, Gram-negative bacteria express MAMPs that may trigger redundant inflammatory pathways through TLR2 (lipopeptides), TLR4 (LPS), TLR5 (flagellin), TLR7 (ssRNA), and TLR9 (bacterial DNA). doi = 10.3389/fimmu.2013.00387 id = cord-017420-tjwxec77 author = Stephens, R. Scott title = Neutropenic Fever in the Intensive Care Unit date = 2019-07-09 keywords = fever; infection; neutropenic; patient; sepsis summary = Neutropenic patients with septic shock tend to have more frequently positive blood cultures, more fungal infections, more multidrug-resistant bacterial infections, and higher mortality rates than immunocompetent patients. Accordingly, current guidelines for the management of neutropenic fever and sepsis recommend monotherapy with an antipseudomonal beta-lactam unless otherwise dictated by circumstances such as patient allergies, the presence of resistant organisms, or refractory hemodynamic instability [28, 57, 61] . The use of surveillance rectal cultures, performed pre-transplant and then weekly after HSCT, to identify patients with MDR infections and allow immediate initiation of antibiotic therapy targeted against MDR organisms may result in better outcomes [26] . Patients with neutropenia and sepsis are at high risk of developing multi-organ failure, particularly the acute respiratory distress syndrome (ARDS) [4, 5] . Neutropenic sepsis continues to confer a poor prognosis, with recent data suggesting an approximate 46% mortality rate in patients with hematologic malignancies who develop septic shock [7, 39, 47] . doi = 10.1007/978-3-319-74588-6_118 id = cord-030385-btf502ju author = Sun, Zhiheng title = 17β-Estradiol Promotes Trained Immunity in Females Against Sepsis via Regulating Nucleus Translocation of RelB date = 2020-07-22 keywords = LPS; figure; immunity; sepsis summary = However, it has not been clarified whether β-glucan-induced trained immunity causes different responses to early sepsis between male and female mice. The changes of inflammatory cytokines expression, and macrophage polarization in male, female, and ovariectomized C57BL/6 mice in sepsis model were investigated. Macrophage polarization toward the M1 phenotype, which exhibited enhanced trained immunity, was related to the difference in sepsis resistance between female and male mice. Mechanistically, we found that E2 inhibited the nuclear translocation of RelB, which is a member of non-canonical pathway of NFκB and contributes to macrophage polarization to change the intensity of trained immunity. Our results showed that females expressed higher IL-6 and TNFα than males in sepsis, and trained immunity exacerbated this trend (Figures 1I,J) . The in vitro trained immunity model was established with RAW264.7 and J774 ( Figure 5C ) cell lines derived from male and female mice, respectively. doi = 10.3389/fimmu.2020.01591 id = cord-354384-bshj0w3o author = Tanak, Ambalika S. title = Multiplexed cytokine detection using electrochemical point-of-care sensing device towards rapid sepsis endotyping date = 2020-10-19 keywords = IL-10; IL-6; IL-8; Sepsis; TRAIL summary = As a point-of-care treatment option, to date, no molecular host biomarker panel is available which makes an informed decision on the specific intervention based on the diagnosis of the immune response or the ability to detect improvements in the status of patients with sepsis (Albert-Vega et al., 2018; Gunsolus et al., 2019) . To address this technological gap this work demonstrates first-of-a-kind near-patient testing ''DETecT Sepsis'' (Direct Electrochemical Technique Targeting Sepsis) sensor, which directly measures a panel of five host immune biomarkers in <5 minutes to guide the physician with active feedback on patient immune status for better therapeutic administration. The advantages of the DETecT Sepsis sensor over existing point-of-care tests are: (i) direct hassle-free measurement from a single drop of undiluted blood plasma; (ii) allows sepsis stratification based on the body''s hyper and hypo immune response; (iii) specifically surface engineered sensor design facilitates high sensitivity and specificity; (iv) portable handheld format enables multi-measure capabilities at near-patient testing. doi = 10.1016/j.bios.2020.112726 id = cord-000522-d498qj2b author = Vincent, Jean-Louis title = Reducing mortality in sepsis: new directions date = 2002-12-05 keywords = EGDT; ICU; mortality; patient; sepsis; severe summary = Five topics were selected that have been shown in randomized, controlled trials to reduce mortality: limiting the tidal volume in acute lung injury or acute respiratory distress syndrome, early goal-directed therapy, use of drotrecogin alfa (activated), use of moderate doses of steroids, and tight control of blood sugar. The present article provides guidelines from experts in the field on optimal patient selection and timing for each intervention, and provides advice on how to integrate new therapies into ICU practice, including protocol development, so that mortality rates from this disease process can be reduced. The interventions discussed encompassed low tidal volume in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) (Edward Abraham), early goal-directed therapy (EGDT) (Emanuel Rivers), drotrecogin alfa (activated) (Gordon Bernard), moderate-dose corticosteroids (Djillali Annane), and tight control of blood sugar (Greet Van den Berghe). doi = 10.1186/cc1860 id = cord-017337-vq3edhxn author = Vincent, Jean-Louis title = PIRO: The Key to Success? date = 2009 keywords = PIRO; patient; sepsis summary = Building on a system that had emerged at the Fifth Toronto Sepsis Roundtable held in Toronto, Canada, in 2000 [6] , the sepsis defi nitions conference participants, therefore, proposed the PIRO system [5] , which can classify patients on the basis of their predisposing conditions, the nature and extent of the infection, the nature and magnitude of the host response, and the degree of concomitant organ dysfunction. The PIRO system for the grading of sepsis uses clinical and laboratory parameters to aid diagnosis and patient classifi cation, with each element being divided according to the degree of involvement (e.g., infection can be classifi ed as localized, extended, or generalized; immune response can be classifi ed as limited, extensive, or excessive; organ dysfunction can be classifi ed as mild, moderate, severe). Improved classifi cation of septic patients using the PIRO system may, thus, facilitate the development and evaluation of clinical trials of sepsis therapies and will also encourage further study into the pathophysiology and epidemiology of sepsis. doi = 10.1007/978-3-642-00479-7_1 id = cord-005872-w1x1i0im author = Volk, T. title = Endothelium function in sepsis date = 2000 keywords = HUVEC; LPS; TNF; cell; endothelial; human; sepsis summary = Defects in endothelium dependent vasoregulation in animal models are well known and again human studies are largely missing.¶An imbalanced production of reactive oxygen species including nitric oxide has been found to be involved in all endothelial functions and may provide a common link which at present can be supported only in animal studies. S. aureus has been reported to directly infect human umbilical vein endothelial cells (HUVEC) thereby inducing secretion of cytokines and functional upregulation of adhesion molecules [2] . Infection and activation of endothelial cells by Listeria monocytogenes is believed to be a critical component of the pathogenesis of this disease and includes ceramide generation, transcription factor activation and increases in adhesion molecule expression on HUVEC [11] . E-selectin expression in human endothelial cells by TNF-alpha-induced oxidant generation and NF-kappaB activation doi = 10.1007/s000110050579 id = cord-270213-ygb64yxc author = Williams, Alexander T. title = Control of systemic inflammation throughearly nitric oxide supplementation with nitric oxide releasing nanoparticles date = 2020-10-02 keywords = LPS; inflammatory; sepsis summary = Given that endothelial dysfunction is a common denominator in many acute inflammatory conditions, it is likely that NO enhancement strategies may be useful for the treatment of sepsis and other acute inflammatory insults that trigger severe systemic pro-inflammatory responses and often result in a cytokine storm, as seen in COVID-19. A well-described hallmark of sepsis is endothelial dysfunction in response to a cytokine 81 ''storm'', which is associated with an increase in a series of negative consequences arising from 82 overproduction of reactive oxygen species (ROS), disruption of the glycocalyx, and endothelial 83 nitric oxide synthase (eNOS) uncoupling, all contributing to increased adhesion of red blood 84 cells (RBCs), white blood cells (WBCs), and platelets to the endothelium lining, enhanced 85 platelet activation, blood stagnation, decreased tissue perfusion and increased vascular 86 permeability. Mice treated with Control-np in our study 382 experienced significantly increased vascular permeability, as shown in Figure 4 , suggesting 383 endothelial cell and glycocalyx disruption in these animals. doi = 10.1016/j.freeradbiomed.2020.09.025 id = cord-022592-g7rmzsv5 author = Wynn, James L. title = Pathophysiology of Neonatal Sepsis date = 2016-07-06 keywords = PMN; cell; increase; infant; infection; neonatal; neonate; response; sepsis summary = 14, 15, [27] [28] [29] [30] [31] [32] [33] Prematurity, low birth weight (especially infants weighing less than 1,000 g), male sex, a maternal vaginal culture positive for group B streptococcus (GBS), prolonged rupture of membranes, maternal intrapartum fever, and chorioamnionitis are strongly associated with an increased risk for early-onset sepsis. In addition to the initial inflammatory response including complement activation, molecular detection of PAMPs promotes IL-1β and IL-6 production, which in turn increases the production of multiple other innate proteins that possess valuable immune function and serve to reduce pathogen load. Very low birth weight preterm infants with early onset neonatal sepsis: the predominance of gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network Very low birth weight preterm infants with early onset neonatal sepsis: the predominance of gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network doi = 10.1016/b978-0-323-35214-7.00152-9 id = cord-261633-r4qlbnc5 author = Xie, Guo-Hao title = Defensins and Sepsis date = 2014-08-19 keywords = defensin; sepsis; severe summary = The impact of -defensin-2 on the inflammatory response (e.g., the level of ICAM-1 expression), the severity of lung injury, and the sepsis outcome (7-day survival rate) were observed and evaluated. Previous studies showed that single nucleotide polymorphism (SNP) of -defensin-1 gene (DEFB1) correlates with chronic obstructive pulmonary disease, asthma, genetic allergy, HIV infection, and pseudomonas species infection in oral mucosa [38] [39] [40] [41] [42] . Distribution of alleles, gene types, and haplotypes associating with these loci were studied and compared between septic patients and controls, as well as between survivals and victims of severe sepsis. The authors found that patients with high copy number of DEFA1/DEFA3 were predisposed to severe sepsis and tended to have lower level of plasma HNP1-3 as well as cytokines such as TNF-, IL-6, and IL-10. doi = 10.1155/2014/180109 id = cord-005497-w81ysjf9 author = nan title = 40th International Symposium on Intensive Care & Emergency Medicine: Brussels, Belgium. 24-27 March 2020 date = 2020-03-24 keywords = AKI; AUC; CRP; CRRT; Care; Critical; ECMO; Fig; Hospital; ICU; IQR; Intensive; LOS; LPS; OHCA; PCT; ROC; TBI; Unit; University; VAP; blood; day; figure; group; high; introduction; mortality; patient; result; sepsis; sofa; study; table summary = The positive NC group had more plasma transfusion (p-value 0.03) and a lower median hematocrit at 24 hrs (p-value 0.013), but similar hospital length of stay (p=0.17) and mortality rate (p=0.80) Conclusions: NC at ICU admission identifies subclinical AKI in TBI patients and it maight be used to predictclinical AKI. In patients with pneumonia requiring intensive care (ICU) admission, we hypothesise that abnormal right ventricular (RV) function is associated with an increased 90-day mortality. The objective of this study was to describe the incidence of each AKI stages as defined by KDIGO definition (with evaluation of urine output, serum creatinine and initiation of renal replacement therapy (RRT)), in a mixed medical and surgical population of patients hospitalized in ICU and PCU over a 10-year period (2008-2018). This study aimed at investigating the relationship of goal-directed energy and protein adequacy on clinical outcomes which includes mortality, intensive care unit(ICU) and hospital length of stay (LOS), and length of mechanical ventilation (LOMV). doi = 10.1186/s13054-020-2772-3 id = cord-014996-p6q0f37c author = nan title = Posters_Monday_12 October 2009 date = 2009-08-06 keywords = AKI; ALI; APACHE; Care; Hospital; ICU; LPS; PCT; SAPS; VAP; conclusion; group; introduction; method; mortality; objectives; patient; result; sepsis; sofa; study summary = Data recorded on admission were the patient demographics with, acute physiology and chronic health evaluation II score (APACHE II), and type of admission; during intensive care stay, sepsis-related organ failure assessment score (SOFA) and clinical concomitant factors and conditions. For each severe septic patient the following data was registered: time delay, APACHE II and SOFA scores at ICU admission, diagnosis, the rate of compliance with the resucitation and management bundles, microbiological data, evolution of levels of serum lactate, empiric antibiotic therapy, length of stay and mortality in ICU. Sepsis and septic shock remain the most important causes of acute kidney injury (AKI) in critically ill patients and account for more than 50% of cases of acute renal failure (ARF) in intensive care units (ICU). There were no significant differences between the demographic data (sex, age) or the data on admission to intensive care (APACHE II score, ratio of medical to surgical patients) and duration of mechanical ventilation between the two groups. doi = 10.1007/s00134-009-1593-2 id = cord-015021-pol2qm74 author = nan title = Third International Congress on the Immune Consequences of Trauma, Shock and Sepsis —Mechanisms and Therapeutic Approaches date = 1994 keywords = APACHE; ARDS; CD14; CD4; CLP; CRP; CSF; ELISA; ICU; IFN; III; IL-1; IL-2; IL-4; IL-6; IL-8; LEH; LPS; MOF; PAF; PMN; SIRS; TNF; University; animal; blood; cell; control; cytokine; day; effect; endotoxin; factor; follow; group; high; increase; injury; level; method; mouse; patient; production; rat; release; response; result; sepsis; septic; shock; study; trauma summary = It is our current understanding that LPS is responsible for many of the pathophysiological events observed during gramnegative infections and that one of the major mechanisms leading to shock and death is the LPS-induced activation of macrophages resulting in the production and release of lipid and peptide mediators, among which tumor necrosis factor seems to be the most important. However plasma IL-6 estimation revealed a statistically significant reduction at 6 hours in tanrine-treated animals compared to glycino and TW controls ( Objective: To evaluate the effects of allogeneic blood transfusion, thermal injury and bacterial garage on interteukin 4 (IL-4), tumor necrosis factor alpha (TNF) production and host mortality and to study if the administration of thymopentth (THY) could affect these events. doi = 10.1007/bf02258437 id = cord-015024-2xzc0uc5 author = nan title = ESICM 2010 WEDNESDAY SESSIONS 13 October 2010 date = 2010-08-31 keywords = APACHE; ARDS; CVP; Care; ECMO; Hospital; ICU; Intensive; conclusion; day; group; high; increase; introduction; level; method; objectives; patient; result; sepsis; sofa; study summary = We performed a prospective clinical study in a 17-bed multidisciplinary intensive care unit, including 21 patients with controlled mechanical ventilation and monitored with the Vigileo Ò monitor, for whom the decision to give fluids was taken due to the presence of circulatory, including arterial hypotension (MAP B 65 mmHg or systolic arterial pressure \90 mmHg), and preserved preload-responsiveness condition, defined as SVV C10%. The aim of this study was to compare and evaluate four severity scoring systems in intensive care unit (ICU), including APACHE II, APACHE III, SASP II and MODS in severe septic patient. A prospective observational study was performed in 16 mechanically ventilated critically ill patients (12 M, age 49 ± 17 yr, BMI 25 ± 5 kg/m 2 , ICU admission day 5 ± 3, APACHE II on study 20 ± 7; mean ± SD) and 6 healthy subjects (3 M, age 24 ± 9 year, BMI 24 ± 45 kg/m 2 ). doi = 10.1007/s00134-010-2001-7 id = cord-015082-l629n8is author = nan title = Poster Sessions 323-461 date = 2002-08-29 keywords = ICU; IL-10; LPS; conclusion; group; increase; level; method; mortality; patient; result; sepsis; study summary = 14 patients awaiting urgent cardiac surgical re-vascularisation were studied with measurement of: spirometry; percentage increase in transfer factor from sitting to lying position (TF) as an indicator of micro-vascular lung disease; overnight oximetry on air; and 24hour holter monitoring Patients, who were reintubated on decreased indices of arterial oxygenation under MOSF progressing died in 100% cases ( NIMV is effective method in complex therapy of ARF, developing in postoperative period after cardiac surgery, that leads to significant improvement of lungs biomechanics and gases change function. In a prospective observational study we performed bedside ptO2 measurements in 8 patients with sepsis/septic shock to gain insight in ptO2 values and their dynamic changes related to the course of the illness, as well as investigating the practical applicability of tissue oxygen measurement in the ICU setting. doi = 10.1007/s00134-002-1455-7