A retrospective study utilized MIMIC-IV database to explore the potential association between triglyceride-glucose index and mortality in critically ill patients with sepsis

Scientific Reports, Год журнала: 2024, Номер 14(1)

Опубликована: Окт. 15, 2024

Triglyceride-glucose (TyG) index has emerged as a novel biomarker for detecting insulin resistance (IR) and been proven to be associated with various diseases. However, its correlation the prognosis of severe sepsis remains unraveled. This retrospective cohort study utilized patient records from Medical Information Mart Intensive Care (MIMIC-IV, version 2.2) examine outcomes patients sepsis. The primary were hospital mortality intensive care unit (ICU) mortality. between TyG was evaluated through Kaplan-Meier method, Log-rank test, univariate multivariate Cox regression analyses. Additionally, restricted cubic spline (RCS) analysis employed delve into nonlinear relationship baseline outcomes, trend significance assessed quartile levels. Subgroup analyses conducted evaluate consistency index's prognostic value across influencing factors. included 1,742 requiring care. in-hospital rate 19.75% (344/1,742), ICU 14.75% (257/1,742). revealed that, in comparison first (Q1), fourth (Q4) had 63% higher risk (HR 1.63 [95% CI 1.22 2.18], P < 0.01) 79% 1.79 1.28 2.51], 0.001). Model 3 showed that risks Q4, Q3, Q2 240%, 75%, 33% higher, respectively 3.40 2.24 5.16], 0.001; HR 1.75 1.16 2.63], = 0.007; 1.33 1.20 1.53], RCS identified association (overall nonlinearity 0.001, an inflection point at 8.9). effect size direction consistent different subgroups, suggesting stability results. demonstrates is significantly increased critically ill patients, evidence non-linear correlation. Therefore, helps identify ICU.

Язык: Английский

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Acute Kidney Injury During Sepsis and Prognostic Role of Coexistent Chronic Heart Failure

Journal of Clinical Medicine, Год журнала: 2025, Номер 14(3), С. 964 - 964

Опубликована: Фев. 3, 2025

Background: The recently updated definition of sepsis considers pathophysiologic mechanisms to guide initial therapy. Clearly, generalized recommendations for therapy may be limited by pre-existing multimorbidity in addition sepsis-related multi-organ failure. In particular, a recommendation regarding fluid rescue require adequate cardiac function and/or the absence sepsis-induced cardiomyopathy. all patients with compromised or cardiomyopathy, patient-specific regimen is required prevent pulmonary edema and early death. Similarly, sepsis, acute kidney injury without chronic disease requires attention paid excretory renal avoid hypervolemia-mediated heart addition, hyponatremia related intravascular hypovolemia explained vasopressin stimulation. However, hypothetically, hyporesponsiveness contribute injury. this review, relevant cardiorenal pathomechanisms will assessed context Conclusions: conclusion, has take comorbidity, if present, into account. extent which aggravates sepsis-mediated insufficiency should remain subject further study.

Язык: Английский

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Sepsis subphenotypes: bridging the gaps in sepsis treatment strategies

Frontiers in Immunology, Год журнала: 2025, Номер 16

Опубликована: Фев. 6, 2025

Sepsis, a heterogeneous illness produced by dysregulated host response to infection, remains severe mortality risk. Recent discoveries in sepsis research have stressed phenotyping as feasible strategy for tackling heterogeneity and enhancing therapy precision. Sepsis has moved from traditional stratifications based on severity prognosis dynamic, phenotype-driven therapeutic options. This review covers recent progress connecting subgroups personalized treatments, with focus phenotype-based predictions decision-support systems. Despite ongoing challenges, such standardizing frameworks incorporating findings into clinical practice, this topic enormous promise. By investigating phenotypic variation responses, we hope uncover new biomarkers solutions, laying the groundwork more effective therapies and, ultimately improving patient outcomes.

Язык: Английский

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S100A9 in Sepsis: A Biomarker for Inflammation and a Mediator of Organ Damage

Biochemical and Biophysical Research Communications, Год журнала: 2025, Номер unknown, С. 151484 - 151484

Опубликована: Фев. 1, 2025

Язык: Английский

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TREM2 improves coagulopathy and lung inflammation in sepsis through the AKT-mTOR pathway

International Immunopharmacology, Год журнала: 2025, Номер 150, С. 114330 - 114330

Опубликована: Фев. 18, 2025

Язык: Английский

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Assessing gastrointestinal system dysfunction in intensive care

Current Opinion in Critical Care, Год журнала: 2025, Номер unknown

Опубликована: Янв. 30, 2025

Purpose of review To summarize the current knowledge on assessment gastrointestinal dysfunction. Recent findings Clinical is becoming more structured but remains largely subjective. Some instrumental tools to assess motility have been developed not yet widely applied in clinical practice. Imaging techniques offer a good method for static (i.e. nonfunctional) diagnostics standardized dynamic at bedside currently unavailable. studies biomarkers provided convincing results accurate evaluation function. Summary main tool assessing A single sign or symptom does reflect dysfunction adequately, and set variables might be needed. Studies reflecting response enteral nutrients, including absorption, are warranted.

Язык: Английский

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Sepsis: the evolution of molecular pathogenesis concepts and clinical management

MedComm, Год журнала: 2025, Номер 6(3)

Опубликована: Фев. 23, 2025

Abstract The mortality rate of sepsis is approximately 22.5%, accounting for 19.7% the total global mortality. Since Lewis Thomas proposed in 1972 that “it our response makes disease (sepsis)” rather than invading microorganisms, numerous drugs have been developed to suppress “overwhelming” inflammatory response, but none them has achieved desired effect. Continued failure led investigators question whether deaths septic patients are indeed caused by uncontrolled inflammation. Here, we review history clinical trials based on evolving concepts pathogenesis over past half century, summarize factors these historical and prerequisites success future drugs, propose basic principles preclinical research ensure successful translation. strategy targeting like attempting eliminate invaders suppressing host's armed forces, which logically untenable. Sepsis may not be complex; rather, result a fight microbes when force an pathogen overwhelms defenses. Thus, strengthening body's defense forces instead correct overcome sepsis.

Язык: Английский

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Indirubin attenuates sepsis by targeting the EGFR/SRC/PI3K and NF-κB/MAPK signaling pathways in macrophages

Frontiers in Pharmacology, Год журнала: 2025, Номер 16

Опубликована: Март 12, 2025

Background Isatidis Folium , a botanical drug widely used in traditional medicine, is known for its anti-inflammatory properties, including heat-clearing, detoxifying, and blood-cooling effects. Although potential sepsis treatment has been suggested, the bioactive metabolites underlying mechanisms remain poorly understood. Methods Network pharmacology molecular docking were employed to identify therapeutic effects of Indirubin, major metabolite treatment. In vivo cecal ligation puncture (CLP)-induced mouse model was evaluate protective Indirubin through histopathological analysis, ELISA, biochemical assays. vitro RAW264.7 cells stimulated with LPS treated varying concentrations Indirubin. The assessed using apoptosis assays, Western blotting. Results analysis identified as EGFR SRC key targets. Experimental validation demonstrated that significantly improved survival rates, alleviated tissue injury, suppressed inflammatory responses models. Mechanistically, inhibited LPS-induced activation EGFR/SRC/PI3K NF-κB/MAPK pathways macrophages, reducing cell death inflammation cells. Conclusion primary exerts against by targeting signaling macrophages. These findings provide mechanistic basis development multi-target agent

Язык: Английский

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Liver injury in sepsis: manifestations, mechanisms and emerging therapeutic strategies

Frontiers in Immunology, Год журнала: 2025, Номер 16

Опубликована: Март 28, 2025

Sepsis is defined as a condition related to infection that manifests with multiorgan dysfunction, representing life-threatening state. Consequently, severe complications frequently occur, liver injury being one of the most prevalent serious sepsis. Liver dysfunction during sepsis serves an independent predictor mortality. This review provides comprehensive overview current research on sepsis-induced (SILI), encompassing clinical manifestations, diagnostic criteria, pathogenesis and therapeutic strategies associated this condition. SILI may manifest hypoxic hepatitis due ischemia shock, cholestasis resulting from abnormal bile metabolism, or duct sclerosis. The pathophysiology involves intricate interactions among inflammatory response, oxidative stress, cell death. All these factors complicate treatment represent potential targets for intervention. Furthermore, addresses limitations inherent in conventional therapies currently employed managing emphasizes novel targeted aimed at addressing fundamental mechanisms underlying

Язык: Английский

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Impact of enteral nutrition initiated within 24 h of ECMO on nutritional status and inflammatory response in children

Frontiers in Pediatrics, Год журнала: 2025, Номер 13

Опубликована: Март 31, 2025

Malnutrition remains a significant issue in children undergoing ECMO. This study aimed to investigate the effects of initiating enteral nutrition (EN) within 24 h on adequacy nutrient intake, nutritional status, anabolic metabolism, and inflammatory markers receiving was prospective observational cohort study, including ECMO therapy at Children's Hospital Chongqing Medical University China from April 2018 August 2024. Patients were divided into early EN (EEN) late (LEN) groups based whether effective initiated after start T-tests or Mann-Whitney U Chi-square tests used compare clinical characteristics, serum total protein (TP), cholinesterase (CHE), C-reactive (CRP) levels between two groups. Linear mixed-effects models (LME) applied assess effect EEN changes CRP CHE over time during A 47 included this with patients (51.1%) successfully EEN. The PRISM3 score higher LEN group (P = 0.016). majority had pneumonia ARDS < 0.001). average daily energy as well their adequacy, compared 0.001), although experienced more frequent interruptions 0.05). Serum TP than those first 3 days median higher, lower LME analysis showed interaction Successfully significantly improves status ECMO, promotes hepatic reduces responses. provided new insights data support for strategies

Язык: Английский

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