Prophylactic antibiotic treatment for preventing nosocomial infection in extracorporeal membrane oxygenation–resuscitated circulatory arrest patients

JTCVS Open, Journal Year: 2023, Volume and Issue: 16, P. 582 - 601

Published: Aug. 23, 2023

Objective: We aimed to investigate the characteristics of nosocomial infections (NIs) and impact prophylactic antibiotic administration on NI outcomes in patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR).Methods: This retrospective study analyzed rate, type, pathogens, outcomes, risk factors NIs that developed adult ECPR at our institution between January 2002 2022.Results: Among 105 (median age, 58.59 [interquartile range, 46.53-67.32]years), 57 (54.29%) during their membrane oxygenation (ECMO) courses.The incidence rates per 1,000 ECMO days were 135.91 for overall 40.06 multidrug-resistant (MDR) infections.Ventilator-associated pneumonia was most common type (73.68%), followed by bloodstream (17.89%).Prophylactic antibiotics with Pseudomonas aeruginosa coverage protective against infection (hazard ratio [HR], 0.518; 95% confidence interval [CI], 0.281-0.953;P = .034).High dynamic driving pressure ventilator (cmH2O) a prognostic factor hospital mortality (HR, 1.096; CI, 1.008-1.192;P .032).An Acute Physiology Chronic Health Evaluation (APACHE) II score ≥24 6.443; 1.380-30.088;P .018)was developing MDR infections.Conclusions: In patients, treatment P. J o u r n l P e -p f 7 is associated lower NIs, while an APACHE infections.In modern era therapy, development does not increase among undergoing ECPR.

Language: Английский

---

Early restricted oxygen therapy after resuscitation from cardiac arrest (ER-OXYTRAC): protocol for a stepped-wedge cluster randomised controlled trial

BMJ Open, Journal Year: 2023, Volume and Issue: 13(9), P. e074475 - e074475

Published: Sept. 1, 2023

Cardiac arrest is a critical condition, and patients often experience postcardiac syndrome (PCAS) even after the return of spontaneous circulation (ROSC). Administering restricted amount oxygen in early phase ROSC has been suggested as potential therapy for PCAS; however, optimal target arterial partial pressure or peripheral saturation (SpO

Language: Английский

---

Early predictive value of lipocalin-type prostaglandin D synthase for 28-day mortality in cardiac arrest patients: study protocol for a prospective study

BMJ Open, Journal Year: 2024, Volume and Issue: 14(6), P. e083136 - e083136

Published: June 1, 2024

Public training in cardiopulmonary resuscitation and treatment emergency intensive care unit have made tremendous progress. However, cardiac arrest remains a major health burden worldwide, with brain damage being significant contributor to disability mortality. Lipocalin-type prostaglandin D synthase (L-PGDS), which is mainly localised the central nervous system, has been previously shown inhibit postischemia neuronal apoptosis. Therefore, we aim observe whether serum L-PGDS can serve as potential biomarker explore its role determining severity prognosis of patients who achieved restoration spontaneous circulation (ROSC). This prospective observational study. The participants (n = 60) achieve ROSC will be distributed into two groups (non-survivor survivor) based on 28-day survival. Healthy volunteers 30) enrolled controls. Each individual's relevant information extracted from Electronic Medical Record System Xinhua Hospital, including demographic characteristics, clinical data, laboratory findings so on. On days 1, 3 7 after ROSC, blood samples drawn batch tested level neuron-specific enolase, soluble protein 100β, L-PGDS, procalcitonin, tumour necrosis factor-alpha interleukin-6. cerebral performance category score was assessed 28th day ROSC. study performed approval Clinical Ethical Committee Hospital Affiliated Shanghai Jiao Tong University School Medicine (Approval No. XHEC-C-2023-130-1). results published peer-reviewed journal. Chinese Trial Registry (ChiCTR2300078564).

Language: Английский

---

Administration of Delphinidin to Improve Survival and Neurological Outcome in Mice After Cardiac Arrest and Resuscitation

Antioxidants, Journal Year: 2024, Volume and Issue: 13(12), P. 1469 - 1469

Published: Nov. 29, 2024

Reactive oxygen species (ROS) play an important role in ischemia–reperfusion (I/R) after cardiac arrest and cardiopulmonary resuscitation (CA-CPR). Early administration of vitamin C at a high dose experimental models resulted less myocardial damage had positive effect on survival resuscitation. Here, we postulated that the ROS scavenging activity anthocyanin (i.e., delphinidin) would positively influence outcomes. We hypothesized delphinidin immediately CA-CPR could attenuate systemic inflammation standardized mouse model thereby improve long-term Outcomes up to 28 days were evaluated control group (saline-treated) delphinidin-treated cohort. Survival, neurological cognitive parameters assessed. Post-CPR infusion deteriorated time 10 min CA. Survivors amongst controls showed significantly more anxious behavior than pre-CPR phases. This tendency was also observed animals treated with delphinidin. In our study, did not find improvement no learning behavior. Our behavioral tests clearly show is associated development post-interventional anxiety-like symptoms. findings open scopes investigate intrinsic factors (e.g., oxidative stress, inflammatory systemic-microbial response, etc.) influencing therapeutic efficacy anthocyanins vivo.

Language: Английский

---

METTL3, m6A modification, and EGR1: interplay affecting myocardial I/R injury outcomes

Cell Biology and Toxicology, Journal Year: 2024, Volume and Issue: 41(1)

Published: Dec. 20, 2024

The occurrence of severe myocardial ischemia/reperfusion (I/R) injury is associated with the clinical application reestablishment technique for heart disease, and understanding its underlying mechanisms currently an urgent issue. Prior investigations have demonstrated potential enhancement MIRI through EGR1 suppression, although precise regulatory pathways require further elucidation. core focus this investigation to examine molecular regulates mitophagy-mediated cell pyroptosis impact on MIRI. Cardiomyocyte hypoxia/reoxygenation (H/R) models mouse I/R were used investigate involvement in regulating injury. research outcomes that under H/R conditions, expression was upregulated inhibited JAK2/STAT3 pathway, leading enhanced mitophagy disrupted mitochondrial fusion/fission dynamics, ultimately resulting pyroptosis. Further revealed upregulation mediated by methyltransferase like 3 (METTL3)-mediated m6A modification mRNA depended binding insulin growth factor 2 mrna protein (IGF2BP2) N6-methyladenosine (m6A) site enhance stability. In vivo animal experiments confirmed METTL3 IGF2BP2 suppressed activation janus kinase (JAK2) /signal transducer activator transcription (STAT3) thereby inhibiting mitophagy, disrupting promoting pyroptosis, exacerbating

Language: Английский

---