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The Complexities of Sepsis-Induced Cardiomyopathy: A Clinical Case and Review of Inflammatory Pathways and Potential Therapeutic Targets.
Cureus
December 2024
Internal Medicine, Kempegowda Institute of Medical Sciences, Bangalore, IND.
Sepsis-induced cardiomyopathy (SICM) is a life-threatening complication of sepsis characterized by myocardial dysfunction. SICM significantly increases mortality rates in sepsis. Despite its clinical relevance, SICM lacks a unified definition and standardized diagnostic criteria, complicating early identification and treatment.
View Article and Find Full Text PDFSeptic cardiomyopathy (SCM) is a reversible cardiac dysfunction occurring in patients with sepsis or septic shock, characterized by transient impaired myocardial contractility. Despite its prevalence in severe sepsis and significant impact on patient outcomes, SCM remains underdiagnosed and is one of the least studied forms of cardiomyopathy. Its recognition and management are further complicated by the absence of a universally accepted consensus on its diagnostic criteria and definition.
View Article and Find Full Text PDFAnatomic and non-anatomic substrates in infants with two ventricles undergoing aortic arch repair.
Cardiol Young
November 2024
Department of Pediatric & Congenital Cardiovascular Surgery, St Joseph's Children's Hospital, Tampa, FL, USA.
Objectives: We sought to examine the relative importance of surgical lesion complexity versus the presence of genetic/syndromic/extracardiac anomalies (GSAs) in determining survival, morbidity or need for reinterventions following repair for aortic arch hypoplasia.
Methods: A single-centre, retrospective cohort study of infants undergoing biventricular aortic arch repair sternotomy from 2010 to 2021 was conducted. Survival analysis was performed using Kaplan-Meier methods, with additional Bayesian survival modelling for subgroups.
High VExUS grades are linked to cardiac function in general ICU patients.
Eur Heart J Acute Cardiovasc Care
November 2024
University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France.
Background: Even though initially considered as a new standard in systemic venous congestion assessment, the semi-quantitative Doppler ultrasound-based Venous Excess Ultrasound Grading System (VExUS) showed inconsistent associations with outcomes in general intensive care unit (ICU) patients. It is unclear why VExUS is so effective in predicting outcomes in some cohorts and not in others. The determinants of higher VExUS have not been studied in a general ICU cohort.
View Article and Find Full Text PDFActive CNS delivery of oxycodone in healthy and endotoxemic pigs.
Fluids Barriers CNS
October 2024
Translational Pharmacokinetics/Pharmacodynamics Group (tPKPD), Department of Pharmacy, Uppsala University, Husargatan 3, 752 37, Uppsala, Sweden.
Background: The primary objective of this study was to advance our understanding of active drug uptake at brain barriers in higher species than rodents, by examining oxycodone brain concentrations in pigs.
Methods: This was investigated by a microdialysis study in healthy and endotoxemic conditions to increase the understanding of inter-species translation of putative proton-coupled organic cation (H/OC) antiporter-mediated central nervous system (CNS) drug delivery in health and pathology, and facilitate the extrapolation to humans for improved CNS drug treatment in patients. Additionally, we sought to evaluate the efficacy of lumbar cerebrospinal fluid (CSF) exposure readout as a proxy for brain unbound interstitial fluid (ISF) concentrations.
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