Alterations in Regional Brain Microcirculation in Patients with Sepsis: A Prospective Study Using Contrast-Enhanced Brain Ultrasound.

Background: Alterations in regional brain microcirculation have not been well studied in patients with sepsis. Regional brain microcirculation can be studied using contrast-enhanced brain ultrasound (CEUS) with microbubble administration.

Methods: CEUS was used to assess alterations in regional brain microcirculation on 3 consecutive days in 58 patients with sepsis and within 24 h of intensive care unit admission in 10 aged-matched nonseptic postoperative patients.

Research on Abrasive Water Jet Polishing of Silicon Carbide Based on Fluid Self-Excited Oscillation Pulse Characteristics.

A self-excited oscillating pulsed abrasive water jet polishing method is proposed to solve the problems of low removal efficiency in traditional abrasive water jet polishing and the influence of an external flow field on the material surface removal rate. The self-excited oscillating chamber of the nozzle was used to generate pulsed water jets to reduce the impact of the jet stagnation zone on material surface removal and increase the jet speed to improve processing efficiency. ANSYS Fluent was employed to simulate the processing flow field characteristics for different lengths of oscillation cavities.

Significant Electromechanical Characteristic Enhancement of Coaxial Electrospinning Core-Shell Fibers.

Electrospinning is a low-cost and straightforward method for producing various types of polymers in micro/nanofiber form. Among the various types of polymers, electrospun piezoelectric polymers have many potential applications. In this study, a new type of functional microfiber composed of poly(γ-benzyl-α,L-glutamate) (PBLG) and poly(vinylidene fluoride) (PVDF) with significantly enhanced electromechanical properties has been reported.

Impact of maintenance, resuscitation and unintended fluid therapy on global fluid load after elective coronary artery bypass surgery.

Introduction: Standardized protocols are provided for maintenance and replacement fluid therapy in critically ill patients. However, unintended fluid sources (analgesics, antibiotics and other drugs) are not always taken into account when prescribing intravenous fluid therapy. We evaluated the extent to which maintenance, resuscitation and unintended fluids contributed to total fluid load in elective coronary artery bypass graft patients during their ICU stay.

Hypotension and a positive fluid balance are associated with delirium in patients with shock.

The pathogenesis of delirium in critically ill patients is multifactorial. How hypotension and hypoxemia affect brain function and whether they can promote delirium remains unclear. A high cumulative positive fluid balance may also have a negative effect on brain function and promote delirium.

High prolactin levels are associated with more delirium in septic patients.

Purposes: We investigated whether high prolactin levels were associated with delirium in septic patients because neuropsychiatric disorders are frequently associated with hyperprolactinemia.

Materials And Methods: Prolactin levels were measured daily for 4 days in 101 patients with sepsis. Delirium was assessed using the Richmond Agitation Sedation Scale and the Confusion Assessment Method in the ICU.

Cortisol is an associated-risk factor of brain dysfunction in patients with severe sepsis and septic shock.

Objectives: To investigate cortisol levels in brain dysfunction in patients with severe sepsis and septic shock.

Methods: In 128 septic and sedated patients, we studied brain dysfunction including delirium and coma by the evaluation of Richmond Agitation Sedation Scale (RASS), the Confusion Method Assessment in the ICU (CAM-ICU) after sedation withdrawal and the measurement of serum S100B biomarker of brain injury. Serum cortisol and S100B were measured within 12 hours after ICU admission and daily over the next four days.

High-frequency percussive ventilation in severe acute respiratory distress syndrome: A single center experience.

Background: Few studies have investigated high-frequency percussive ventilation (HFPV) in adult patients with acute respiratory distress syndrome (ARDS).

Materials And Methods: We retrospectively analyzed data from critically ill-patients with moderate and severe ARDS who received HFPV. Ventilation and oxygenation were governed according to a predefined protocol.

Serum S100B protein could help to detect cerebral complications associated with extracorporeal membrane oxygenation (ECMO).

Background: To investigate if serum S100B protein levels could early detect cerebral complications under treatment extracorporeal membrane oxygenation (ECMO).

Methods: Serum S100B levels were measured over 5 days in 32 patients with cardiogenic and septic shock, including 15 patients who treated by ECMO and 17 who did not. Cerebral complications included hemorrhage, stroke, encephalopathy with myoclonus, and brain death.

Drotrecogin alfa (activated) may attenuate severe sepsis-associated encephalopathy in clinical septic shock.

Introduction: Sepsis-associated encephalopathy (SAE) is a diffuse cerebral dysfunction induced by the immuno-inflammatory response to infection. Elevated levels of the brain-specific S100B protein are present in many septic patients and reflect the severity of SAE. Adjunctive treatment with drotrecogin alfa (activated) (DrotAA), the human recombinant form of activated protein C, has been shown to improve mortality in patients with severe sepsis-induced organ failure.

Elevated serum levels of S-100beta protein and neuron-specific enolase are associated with brain injury in patients with severe sepsis and septic shock.

Objective: We investigated whether serum levels of neuron-specific enolase (NSE) and S-100beta protein could be used to evaluate cerebral injury and to predict outcome in severe sepsis and severe septic shock.

Design: Prospective study.

Setting: University hospital.

Combination of therapeutic mild hypothermia and delayed fluid resuscitation improved survival after uncontrolled haemorrhagic shock in mechanically ventilated rats.

We challenged the current management of uncontrolled haemorrhagic shock (UHS) and put forward a hypothesis that therapeutic mild hypothermia combined with delayed fluid resuscitation will improve the survival rate. After an initial blood withdrawal of 3 ml/100g for 15 min, the rat's tail was amputated up to 75% to induce UHS phase I. The mean arterial blood pressure (MAP) was maintained at 40 mmHg or 80 mmHg, according to the assigned study group.

Effect of resuscitative mild hypothermia and oxygen concentration on the survival time during lethal uncontrolled haemorrhagic shock in mechanically ventilated rats.

Objective: To test the hypothesis that resuscitative mild hypothermia (MH) (34 degrees C) or breathing fractional inspired oxygen (FIo2) of 1.0 would prolong survival time during lethal uncontrolled haemorrhagic shock (UHS) in mechanically ventilated rats.

Methods: Forty Wistar rats were anaesthetized with halothane, nitrous oxide and oxygen (70/30%), intubated and mechanically ventilated.

Low-dose vasopressin in the treatment of septic shock in sheep.

After induction of cecal perforation, 20 anesthetized sheep were randomized to be treated, when arterial blood pressure fell below 75 mm Hg, with vasopressin (fixed dose of 0.02 U/minute), norepinephrine (0.5-5 microg/kg/minute titrated to maintain mean arterial pressure between 75 and 85 mm Hg), vasopressin + norepinephrine (vasopressin at fixed dose 0.