Article
Gastroenterology & Hepatology
Francois Durand, John A. Kellum, Mitra K. Nadim
Summary: Fluid resuscitation is complicated in patients with cirrhosis and hypotension due to circulatory changes and hyperdynamic state. Echocardiography shows promise for assessing fluid status. Large volumes of saline should be avoided in cirrhosis patients, and albumin may be superior for controlling inflammation. Vasopressors should be initiated early in cirrhosis patients with sepsis and hypotension, with norepinephrine as the first-line option.
JOURNAL OF HEPATOLOGY
(2023)
Review
Medicine, General & Internal
Rachael Cusack, Susan O'Neill, Ignacio Martin-Loeches
Summary: Sepsis is a common and deadly syndrome in intensive care settings, and fluid therapy is often used as an intervention. However, the effects of fluid bolus on microcirculation in sepsis have not been fully addressed. This systematic review aims to analyze studies examining the microcirculatory outcomes after a fluid bolus in sepsis patients. The review found no clear effects of fluid bolus on microcirculation parameters, but the heterogeneity between studies and methodologies prevented meta-analysis. Further research is needed to understand the effects of different resuscitation fluids on microcirculation.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, Research & Experimental
Yu-Ming Wang, Ying Chen, Yan-Jun Zheng, Yun-Chuan Huang, Wei-Wei Chen, Ran Ji, Li-Li Xu, Zhi-Tao Yang, Hui-Qiu Sheng, Hong-Ping Qu, En-Qiang Mao, Er-Zhen Chen
Summary: For patients with sepsis and septic shock, a low fluid intake volume during the first 24 h and a persistent negative fluid balance from the second day were found to be associated with favorable outcomes. The mean daily fluid balance was also identified as an independent prognostic factor for these patients.
EXPERIMENTAL AND THERAPEUTIC MEDICINE
(2021)
Article
Critical Care Medicine
Ishaq Lat, Craig M. Coopersmith, Daniel De Backer
Summary: This study builds upon the research priorities related to fluid resuscitation and vasopressor therapy identified by a group of experts, providing important insights and directions for future studies.
CRITICAL CARE MEDICINE
(2021)
Article
Critical Care Medicine
Dong-gon Hyun, Jee Hwan Ahn, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Haein Lee, Chae-Man Lim
Summary: This study investigated the impact of cumulative fluid balance during the first three days of ICU on the mortality of patients with sepsis. The results showed that a positive fluid balance on the second and third ICU days was associated with higher mortality at day 28 in sepsis patients.
ANNALS OF INTENSIVE CARE
(2023)
Article
Emergency Medicine
Gun Tak Lee, Sung Yeon Hwang, Jong Eun Park, Ik Joon Jo, Won Young Kim, Sung Phil Chung, You Hwan Jo, Gil Joon Suh, Sung-Hyuk Choi, Tae Gun Shin
Summary: The study aimed to investigate the diagnostic accuracy of post-fluid resuscitation lactate levels in predicting 28-day mortality in suspected septic shock patients. The results showed that post-fluid resuscitation lactate levels were more accurate than initial lactate levels in predicting mortality.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Multidisciplinary Sciences
Tongtian Ni, Yi Wen, Yihui Wang, Weisong Jiang, Huiqiu Sheng, Erzhen Chen, Enqiang Mao, Zhixin Lan, Yaguo Huang, Yuhua Zhou
Summary: This study aimed to investigate the association between albumin/prealbumin levels and prognosis in severe acute pancreatitis (SAP) and establish a new goal-directed therapy involving these proteins. The results showed that serum albumin and prealbumin levels in the early stage of SAP are significantly relevant to prognosis, and raising these levels can improve the prognosis.
SCIENTIFIC REPORTS
(2022)
Article
Emergency Medicine
Haya S. Kaseer, Rusha Patel, Calvin Tucker, Marie-Carmelle Elie, Benjamin J. Staley, Nicolas Tran, Steve Lemon
Summary: This study compared the outcomes of using different fluid resuscitation dosing strategies in obese patients with severe sepsis, showing that there were similar rates of progression to septic shock between the IBW and non-IBW groups. Additionally, the length of hospital stay and mortality rates were not significantly different between the two groups.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Review
Medicine, General & Internal
Gianluca Tullo, Marcello Candelli, Irene Gasparrini, Sara Micci, Francesco Franceschi
Summary: Sepsis and septic shock are leading causes of in-hospital mortality worldwide, with significant burden on healthcare systems. Ultrasound has been used as an adjunctive tool for the diagnosis and treatment of these conditions, providing valuable information for clinicians. Further research is needed to determine the impact of ultrasound on patient survival.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Critical Care Medicine
Chang Liu, Heyi Li, Zhiyong Peng, Bo Hu, Yue Dong, Xiaolan Gao, Ryan D. Frank, Rahul Kashyap, Ognjen Gajic, Kianoush B. Kashani
Summary: The study demonstrates that the use of albumin during the initial 6 hours of resuscitation in septic patients does not provide benefits in clinical outcomes.
Article
Pediatrics
Amanda Harley, Shane George, Megan King, Natalie Phillips, Gerben Keijzers, Debbie Long, Kristen Gibbons, Rinaldo Bellomo, Luregn J. Schlapbach
Summary: This study aims to investigate the feasibility of early use of inotropes in children with septic shock compared to standard fluid resuscitation. The study is an open label randomized controlled pilot study conducted at four specialized pediatric Emergency Departments. The main clinical outcome assessed will be survival free of organ dysfunction censored at 28 days.
FRONTIERS IN PEDIATRICS
(2021)
Review
Critical Care Medicine
Jing Yue, Ronghao Zheng, Huiping Wei, Jie Li, Jiannan Wu, Ping Wang, Hui Zhao
Summary: The study found that in pediatric patients with septic or severe infection shock, the no bolus group showed significantly lower mortality rates at 48 hours, especially in cases of malaria. Similar results were observed with colloids and crystalloids solution treatment in malaria shock patients.
Article
Multidisciplinary Sciences
Timothy Coyle, Samuel M. John
Summary: The study evaluated the use of albumin in a community hospital setting over a 6-month period, finding that the most common indications for albumin administration were sepsis or septic shock, hypotension or hypovolemia, and intradialytic hypotension. Critical care, nephrology, and surgery were the departments most frequently ordering albumin.
Article
Emergency Medicine
Jutamas Saoraya, Lipda Wongsamita, Nattachai Srisawat, Khrongwong Musikatavorn
Summary: This study investigated the association between plasma syndecan-1 levels and clinical outcomes in emergency department patients with sepsis. The results showed that syndecan-1 levels were correlated with fluid requirements, sepsis severity, organ dysfunction, and mortality, highlighting its potential as a marker for predicting outcomes in this patient population.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Multidisciplinary Sciences
Hiroki Ishibashi, Kohsuke Hagisawa, Manabu Kinoshita, Yukako Yuki, Morikazu Miyamoto, Tomoko Kure, Hiromi Sakai, Daizoh Saitoh, Katsuo Terui, Masashi Takano
Summary: In a pregnant rabbit model, HbV infusion effectively prevents lethal hemorrhagic shock in severe PPH, with 8 out of 10 rabbits surviving for 6 hours. While no rabbits survived beyond 6 hours with HES infusion alone, all rabbits receiving RBC/PPP transfusion survived.
SCIENTIFIC REPORTS
(2021)
Article
Immunology
Sophie Uyoga, Perpetual Wanjiku, Jesse C. Rop, Johnstone Makale, Alexander W. Macharia, Gideon M. Nyutu, Mohammed Shebe, Kennedy A. Awuondo, Neema Mturi, Charles J. Woodrow, Arjen M. Dondorp, Kathryn Maitland, Thomas N. Williams
Summary: The clinical severity of Plasmodium falciparum malaria infections is directly related to the total parasite load, with higher parasite counts found in uncomplicated cases. The concentration of PfHRP2 also increases with severity, except in cases of severe malaria with concomitant bacterial infections where it is significantly lower. A quantitative test for plasma concentrations of PfHRP2 may aid in identifying children at the greatest clinical risk and differentiating critically ill children with malaria as a secondary cause.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Hematology
Sophie Uyoga, Elizabeth C. George, Imelda Bates, Peter Olupot-Olupot, Yami Chimalizeni, Elizabeth M. Molyneux, Kathryn Maitland
Summary: Point-of-care haemoglobin testing is increasingly popular globally, but remains neglected in African health services. Prioritizing the use of POC Hb can lead to more rapid and accurate diagnosis of anemia, saving lives and reducing unnecessary transfusions in Africa.
BRITISH JOURNAL OF HAEMATOLOGY
(2021)
Article
Hematology
Kathryn Maitland, Sarah Kiguli, Peter Olupot-Olupot, Robert O. Opoka, Yami Chimalizeni, Florence Alaroker, Sophie Uyoga, Dorothy Kyeyune-Byabazaire, Bridon M'baya, Imelda Bates, Thomas N. Williams, Deogratias Munube, Dora Mbanya, Elizabeth M. Molyneux, Annabelle South, A. Sarah Walker, Diana M. Gibb, Elizabeth C. George
Summary: The TRACT trial found that conservative management of uncomplicated severe anaemia was safe, and that transfusion volume had opposing effects on mortality depending on fever status. A stakeholder meeting in 2020 reviewed the results and additional analyses, leading to the development of a transfusion management algorithm for safe implementation.
BRITISH JOURNAL OF HAEMATOLOGY
(2021)
Article
Critical Care Medicine
K. Maitland, S. Kiguli, P. Olupot-Olupot, M. Hamaluba, K. Thomas, F. Alaroker, R. O. Opoka, A. Tagoola, V. Bandika, A. Mpoya, H. Mnjella, E. Nabawanuka, W. Okiror, M. Nakuya, D. Aromut, C. Engoru, E. Oguda, T. N. Williams, J. F. Fraser, D. A. Harrison, K. Rowan
Summary: The study conducted a trial on the role of oxygen therapy in severe pneumonia in African children, finding that the use of high-flow nasal therapy may be beneficial, prompting further research to confirm.
INTENSIVE CARE MEDICINE
(2021)
Article
Pharmacology & Pharmacy
Matthew A. Wells, Louise E. See Hoe, Peter Molenaar, Sanne Pedersen, Nchafatso G. Obonyo, Charles McDonald, Weilan Mo, Mahe Bouquet, Kieran Hyslop, Margaret R. Passmore, Nicole Bartnikowski, Jacky Y. Suen, Jason N. Peart, David C. McGiffin, John F. Fraser
Summary: The study found that brain stem death and transplantation may impair the contractility of the donor heart, especially the right ventricle. For the donor heart, this contractile dysfunction appears to be independent of changes to beta(1)-adrenoceptor sensitivity.
PHARMACOLOGICAL RESEARCH
(2021)
Article
Public, Environmental & Occupational Health
Jonathon P. Fanning, Srinivas Murthy, Nchafatso G. Obonyo, J. Kenneth Baillie, Steve Webb, Heidi J. Dalton, John F. Fraser
Summary: International research collaboration is essential for addressing rapidly spreading diseases, but barriers exist, especially in low- and middle-income countries. Building capacity and collaborative platforms in these countries is crucial for efficiently answering clinical research questions and changing the trajectory of a pandemic.
GLOBALIZATION AND HEALTH
(2021)
Article
Biochemistry & Molecular Biology
K. Walweel, A. C. Boon, L. E. See Hoe, N. G. Obonyo, S. E. Pedersen, S. D. Diab, M. R. Passmore, K. Hyslop, S. M. Colombo, N. J. Bartnikowski, M. Bouquet, M. A. Wells, D. M. Black, L. P. Pimenta, A. K. Stevenson, K. Bisht, K. Skeggs, L. Marshall, A. Prabhu, L. N. James, D. G. Platts, P. S. Macdonald, D. C. McGiffin, J. Y. Suen, J. F. Fraser
Summary: Inflammatory responses following brain stem death can affect the availability and quality of organs for transplantation, as well as cardiovascular physiology.
BIOMEDICAL JOURNAL
(2022)
Article
Cardiac & Cardiovascular Systems
Kei Sato, Nicole White, Jonathon P. Fanning, Nchafatso Obonyo, Michael H. Yamashita, Vinesh Appadurai, Anna Ciullo, Meryta May, Elliott T. Worku, Leticia Helms, Shinichiro Ohshimo, Dafsah A. Juzar, Jacky Y. Suen, Gianluigi Li Bassi, John F. Fraser, Rakesh C. Arora
Summary: This study found that previous use of ACEi/ARBs was associated with a reduced risk of in-hospital mortality in critically ill COVID-19 patients. However, patients in the ACEi/ARB group had longer hospital stay.
BMC CARDIOVASCULAR DISORDERS
(2022)
Article
Critical Care Medicine
Nchafatso G. Obonyo, Peter Olupot-Olupot, Ayub Mpoya, Julius Nteziyaremye, Martin Chebet, Sophie Uyoga, Rita Muhindo, Jonathon P. Fanning, Kenji Shiino, Jonathan Chan, John F. Fraser, Kathryn Maitland
Summary: This study investigates the efficacy of fluid-conservative resuscitation in African children with septic shock. The results demonstrate that maintenance-only fluid therapy improves clinical and myocardial disturbances without compromising cardiac function, while fluid-bolus management leads to a higher fatality rate.
PEDIATRIC CRITICAL CARE MEDICINE
(2022)
Article
Medicine, General & Internal
Martin Urner, Adrian G. Barnett, Gianluigi Li Bassi, Daniel Brodie, Heidi J. Dalton, Niall Ferguson, Silver Heinsar, Carol L. Hodgson, Giles Peek, Kiran Shekar, Jacky Y. Suen, John F. Fraser, Eddy Fan
Summary: An observational study found that extracorporeal membrane oxygenation (ECMO) is associated with a reduced risk of mortality in adults with COVID-19 associated respiratory failure. Age, severity of hypoxaemia, and duration and intensity of mechanical ventilation were identified as modifiers of treatment effectiveness, and should be taken into consideration when deciding to initiate ECMO in patients with COVID-19.
BMJ-BRITISH MEDICAL JOURNAL
(2022)
Article
Hematology
Olivia Lucey, Susan Acana, Peter Olupot-Olupot, Rita Muhindo, Ronald Ayikobua, Sophie Uyoga, Dorothy Kyeyune-Byabazaire, Graham Cooke, Kathryn Maitland
Summary: Adequate supplies of donor blood is a major challenge in sub-Saharan Africa, particularly in Uganda where confirmatory testing for transfusion-transmitted infections is lacking. This study aims to determine the false discovery rate of the Architect anti-HCV screening assay and develop an algorithm for confirmatory testing, in order to reduce unnecessary blood wastage and donor deferral.
Article
Medicine, General & Internal
Kei Sato, Karin Wildi, Jonathan Chan, Chiara Palmieri, Nchafatso G. Obonyo, Silver Heinsar, Keibun Liu, Samantha Livingstone, Noriko Sato, Carmen Ainola, Gabriella Abbate, Mahe Bouquet, Emily Wilson, Margaret Passmore, Kieran Hyslop, David G. Platts, Jacky Suen, Gianluigi Li Bassi, John F. Fraser
Summary: This study found that the proposed speckle-tracking echocardiography parameter, Pressure-Strain Product (PSP), can be used to predict catheter-based left ventricular stroke work index (LVSWI) and afterload-related cardiac performance (ACP) in septic cardiomyopathy. PSP also has the potential to distinguish sub-phenotypes of acute respiratory distress syndrome (ARDS).
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
(2023)
Article
Critical Care Medicine
Gianluigi Li Bassi, Kristen Gibbons, Jacky Y. Suen, Heidi J. Dalton, Nicole White, Amanda Corley, Sally Shrapnel, Samuel Hinton, Simon Forsyth, John G. Laffey, Eddy Fan, Jonathon P. Fanning, Mauro Panigada, Robert Bartlett, Daniel Brodie, Aidan Burrell, Davide Chiumello, Alyaa Elhazmi, Mariano Esperatti, Giacomo Grasselli, Carol Hodgson, Shingo Ichiba, Carlos Luna, Eva Marwali, Laura Merson, Srinivas Murthy, Alistair Nichol, Mark Ogino, Paolo Pelosi, Antoni Torres, Pauline Yeung Ng, John F. Fraser
Article
Critical Care Medicine
Gianluigi Li Bassi, Jacky Y. Suen, Heidi J. Dalton, Nicole White, Sally Shrapnel, Jonathon P. Fanning, Benoit Liquet, Samuel Hinton, Aapeli Vuorinen, Gareth Booth, Jonathan E. Millar, Simon Forsyth, Mauro Panigada, John Laffey, Daniel Brodie, Eddy Fan, Antoni Torres, Davide Chiumello, Amanda Corley, Alyaa Elhazmi, Carol Hodgson, Shingo Ichiba, Carlos Luna, Srinivas Murthy, Alistair Nichol, Pauline Yeung Ng, Mark Ogino, Antonio Pesenti, Huynh Trung Trieu, John F. Fraser
Summary: This study provides a comprehensive account of C-RS in COVID-19 patients on mechanical ventilation, showing its association with ventilatory management and outcomes. The C-RS measured within 48 hours from commencement of mechanical ventilation has marginal predictive value for 28-day mortality.
Article
Cell Biology
Nuala Calder, Kevin Walsh, Peter Olupot-Olupot, Tonny Ssenyondo, Rita Muhindo, Ayub Mpoya, Jerusa Brignardello, Xuedan Wang, Eleanor McKay, Douglas Morrison, Elaine Holmes, Gary Frost, Kathryn Maitland
Summary: A pilot trial in Uganda compared feeds targeting disordered gastrointestinal function in African children with severe acute malnutrition. There were no significant differences in weight gain, mortality, or edema resolution among different feed groups. Legume-enriched feeds supported aspects of gut function and the microbiome.
CELL REPORTS MEDICINE
(2021)