Maintenance of gut integrity has long been recognized as crucial for survival in sepsis, but alterations in protein metabolism have not previously been documented. Therefore, in the present study, we measured in a -induced porcine sepsis model fractional protein synthesis (FSR) and breakdown rates (FBR) in jejunal mucosa in a fasted, conscious state. FSR was measured by the incorporation rate of stable tracer amino acid (l-[-C]phenylalanine) into tissue protein. FBR was determined using the relation between blood arterial enrichment and intracellular enrichment of phenylalanine in consecutive mucosal biopsies after a pulse of l-[N]phenylalanine. Additionally, we determined the FSR in jejunum, ileum, liver, muscle, and lung tissue. We found in this sham-controlled acute sepsis pig model (control: = 9; sepsis: = 13) that jejunal mucosal protein turnover is reduced with both decreased FSR (control: 3.29 ± 0.22; sepsis: 2.32 ± 0.12%/h, = 0.0008) and FBR (control: 0.72 ± 0.12; sepsis: 0.34 ± 0.04%/h, = 0.006). We also found that FSR was unchanged in ileum and muscle, whereas it was higher in the liver (control: 0.87 ± 0.05; sepsis: 1.05 ± 0.06%/h, = 0.041). Our data, obtained with a translational acute sepsis model, suggest that jejunal mucosal protein metabolism is diminished in acute sepsis. Comparison with other tissues indicates that the most serious acute metabolic changes in sepsis occur in the jejunum rather than the muscle. In a highly translational acute sepsis model, presented data suggest that jejunal mucosal protein metabolism is diminished in acute sepsis, even if the origin of the sepsis is not located in the gut. Comparison with other tissues indicates that the most serious acute changes in the protein synthesis rates in sepsis occur in the gut rather than the muscle. Therefore, we hypothesize that preventing a compromised gut is critical to maintain gut function during sepsis.
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http://dx.doi.org/10.1152/ajpgi.00407.2018 | DOI Listing |
Intern Emerg Med
January 2025
Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
Identifying frequent users of Emergency Medical Services (EMS) in the post-discharge period can potentially direct interventions to prevent deterioration at home. This study aimed to describe the frequency of post-discharge emergency phone calls within 30 days after common medical and surgical categories of hospital admission. A retrospective cohort study retrieved data from the electronic medical record and the EMS Capital Region Denmark database after approval by the Danish Health Data Authority.
View Article and Find Full Text PDFJ Trauma Acute Care Surg
January 2025
From the Division of Trauma and Critical Care, Department of Surgery (K.S.A.), Feinberg School of Medicine, Northwestern University, Illinois; Department of Surgery (K.S.A.), School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; Department of Organ Surgery and Transplantation (M.A.C.) and Department of Organ Surgery and Transplantation (A.B.), University of Copenhagen, Copenhagen, Denmark; Department of Surgery (W.-Q.W.), Vanderbilt University Medical Center, Tennessee, Nashville; Department of Surgery (A.K.), Columbia University Medical Center, New York; Center for Genetic Medicine (J.P., M.R.-P.), Feinberg School of Medicine, Northwestern University; Department of Anesthesiology (R.J.M.), Rush University Medical Center; Division of Trauma and Critical Care, Department of Surgery (H.B.A.), Feinberg School of Medicine, Northwestern University, Chicago, IL; and Department of Organ Surgery and Transplantation (M.H.S.), University of Copenhagen, Copenhagen, Denmark.
Background: Early and accurate diagnosis of sepsis and the ensuing organ dysfunction remain a challenge in the postoperative setting. Susceptibility to infections, as well as the subsequent immunological response, are driven to some extent by the genetic predisposition of the patient. The purpose of this study was to identify novel genetic variants associated with postoperative sepsis (POS) and surgical site infections (SSIs).
View Article and Find Full Text PDFIndian J Crit Care Med
December 2024
Department of Critical Care Medicine, Alexandria University, Faculty of Medicine, Alexandria, Egypt.
Background: Prediction of prognosis in sepsis is an essential research area aiming to improve disease outcomes. In this study, we investigated the role of the C-reactive protein (CRP)/procalcitonin (PCT) ratio as a prognostic tool in sepsis patients.
Materials And Methods: This prospective observational study was conducted at the intensive care unit (ICU) of Alexandria Main University Hospital in the period from January to June 2024.
Cureus
December 2024
Internal Medicine, One Brooklyn Health, New York, USA.
We present a case report of a 72-year-old female with a history of stage III rectal adenocarcinoma undergoing chemotherapy who developed neutropenic sepsis and acute respiratory failure. The patient was admitted to the intensive care unit (ICU) due to worsening respiratory status and was subsequently diagnosed with disseminated herpes simplex virus (HSV) infection including acute respiratory distress syndrome (ARDS). This case highlights the challenges in diagnosing and managing HSV infection in critically ill patients and emphasizes the importance of early recognition and appropriate treatment in improving patient outcomes.
View Article and Find Full Text PDFJ Obstet Gynaecol India
December 2024
Department of Nephrology, SMS Medical College and Hospital, Jaipur, Rajasthan India.
Background: Development of PRAKI due to various gestation-related complication leads to poor maternal and foetal outcome. The aim of this study was to estimate the prevalence of PRAKI resulting in CKD, associated factors and feto-maternal outcome.
Methods: In this prospective observational study patients with PRAKI requiring ≥ 1 session of haemodialysis were included and followed up for 6 months to assess renal outcomes.
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