13-7-2012: Sepsis: If you have any family member who is seriously ill in the hospital then you better print out these articles incase you may want to use them.
Reported July 13, 2012
New Sepsis Treatment Could Save Lives
(Ivanhoe Newswire) -- Every year 750,000 people are struck with severe sepsis. Researchers are looking into new treatments for this life threatening condition.
Sepsis is a serious medical condition caused by an overwhelming immune response to infection. Immune chemicals released into the blood to combat the infection trigger widespread inflammation, which leads to blood clots and leaky vessels. This results in impaired blood flow, which damages the body’s organs by depriving them of nutrients and oxygen. In severe cases, one or more organs fail. In the worst cases, blood pressure drops, the heart weakens and the patient spirals toward septic shock. Once this happens, multiple organs (lungs, kidneys, liver) may quickly fail and the patient can die.
In this study, researchers randomly assigned patients with severe sepsis to fluid resuscitation in the ICU with either 6% HES 130/0.4 or Ringer's acetate at a dose of up to 33 ml per kilogram of ideal body weight per day.
Of the 804 patients who underwent randomization, 798 were included in the modified intention-to-treat population. The two intervention groups had similar baseline characteristics. At 90 days after randomization, 201 of 398 patients assigned to HES 130/0.4 had died, as compared with 172 of 400 patients assigned to Ringer's acetate. 1 patient in each group had end-stage kidney failure.
In the 90-day period, 87 patients assigned to HES 130/0.4 were treated with renal-replacement therapy versus 65 patients assigned to Ringer's acetate. The results were supported by multivariate analyses, with adjustment for known risk factors for death or acute kidney injury at baseline.
Patients with severe sepsis assigned to fluid resuscitation with HES 130/0.4 had an increased risk of death at day 90 and were more likely to require renal-replacement therapy, as compared with those receiving Ringer's acetate.
Source: New England Journal of Medicine, July 2012
Vitamin B12: the forgotten micronutrient for critical care..................those with severe sepsis/septic shock.
..............Current evidence suggests that high-dose parenteral vitamin B12 [= injections] may prove an innovative approach to treatcritically ill systemic inflammatory response syndrome patients, especially those with severe sepsis/septic shock.
Current Opinion in Clinical Nutrition & Metabolic Care:
November 2010 - Volume 13 - Issue 6 - p 662–668
doi: 10.1097/MCO.0b013e32833dfaec
Micronutrients: Edited by Henry C. Lukaski and Gil Hardy
Vitamin B12: the forgotten micronutrient for critical care
Manzanares, Williama; Hardy, Gilb
Abstract
Purpose of review: To analyse the anti-inflammatory and antioxidant properties of vitamin B12 and evaluate current evidence on vitamin B12 status in the critically ill with systemic inflammation.
Recent findings: Data on vitamin B12 status of intensive care unit patients are scarce. Cobalamins could potentially be useful agents for inhibiting nitric oxide synthase and nitric oxide production, controlling nuclear factor-kappa B activation, and restoring optimal bacteriostasis and phagocytosis in which transcobalamins play a proven role. The antioxidant properties of vitamin B12, with a glutathione-sparing effect, are secondary to stimulation of methionine synthase activity and reaction with free oxygen or nitrogen radicals. Large parenteral doses are routinely administered for cyanide poisoning, with only mild, reversible side-effects. Current evidence suggests that high-dose parenteral vitamin B12 may prove an innovative approach to treat critically ill systemic inflammatory response syndrome patients, especially those with severe sepsis/septic shock. In this setting, vitamin B12 and transcobalamins could modulate systemic inflammation contributing to the anti-inflammatory cascade and potentially improve outcome.
Summary: Despite evidence from animal studies, so far there are no clinical intervention trials that have studied vitamin B12 as a pharmaconutrient strategy for critical care. Well designed animal and clinical studies are required to clarify several outstanding questions on the optimal posology, safety, and efficacy of high-dose vitamin B12 in the critically ill.
Vitamin C may prevent and help sepsis
18-Nov-2010
A single injected dose of vitamin C may not only prevent the onset of sepsis, but also reverse the disease, according to data from a mouse study from The University of Western Ontario and Lawson Health Research Institute.
Sepsis is caused by a bacterial infection that can begin anywhere in your body. Your immune system goes into overdrive, overwhelming normal processes in your blood. The result is that small blood clots form, blocking blood flow to vital organs. This can lead to organ failure. Babies, the elderly and those with weakened immune systems are most likely to get sepsis. But even healthy people can become deathly ill from the disease. Severe sepsis has a mortality of 40 percent.
According to data from a mouse study, Dr Karel Tyml and his co-workers report that a single bolus of vitamin C injected early at the time of induction of sepsis, prevents capillary plugging.
"Our research in mice with sepsis has found that early as well as delayed injections of vitamin C improves chance of survival significantly," explains Dr. Tyml. "Furthermore, the beneficial effect of a single bolus injection of vitamin C is long lasting and prevents capillary plugging for up to 24 hours post-injection."
"Vitamin C is cheap and safe. Previous studies have shown that it can be injected intravenously into patients with no side effects," he added. "It has the potential to significantly improve the outcome of sepsis patients world-wide. This could be especially beneficially in developing countries where sepsis is more common and expensive treatments are not affordable."
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Effects of Melatonin Treatment in Septic Newborns
I am sending you a link for an-in my opinion extremely- life saving treeatment in newborns
and who knows , also in older people]
one seldom sees such dramatic results in medicine.
this article should never be “needed”-B”H- for any one’s child ,but it is good to print it out and keep it at hand ,in case you know any child in such a condition.
Effects of Melatonin Treatment in Septic Newborns
http://www.pedresearch.org/cgi/content/full/50/6/756
At 72 h after the diagnosis of sepsis, 3 of 10 non-melatonin treated
children had died, while all the melatonin-treated newborns survived,
and continue to do so. [quoted from the article]
Nicotine
| ................But immunologistLuis Ulloa has found that it can also reverse the condition called sepsis, which killssome 250,000 Americans a year. | |||||||||||
We all know nicotine as the addictive substance that gets people hooked on cigarettes, which can kill you. But as this ScienCentral News video explains, now nicotine could also be a tool in defeating one of the leading causes of death in the developed world.
Putting Out the Fire
The nicotine that gets people hooked on cigarettes can be implicated in hundreds of thousands of deaths in the U.S. each year. But immunologist Luis Ulloa has found that it can also reverse the condition called sepsis, which kills some 250,000 Americans a year.
Typically, when your body responds to an infection, immune cellssend out chemical messengers called cytokines. Some of these cytokines force your blood to clot, which ensures that the threatening material doesn't spread throughout the body.
Usually sparked by trauma or a bacterial infection, sepsis is when this immune response goes into overdrive. Ulloa explains, "Your immune system becomes very strong, [and it] wants to protect your body at any cost."
Previous studies showed that smokers are less prone to another disease of the immune system, ulcerative colitis. This inflammatory disease attacks the digestive system, but was found to affect a disproportionate number of non-smokers.
This led Ulloa and his team at The Feinstein Institute for Medical Research to study nicotine as an anti-inflammatory for sepsis. He discovered that nicotine grabs immune cells and prevents them from spewing inflammatory cytokines throughout the body.
In laboratory tests it was able to reverse sepsis in mice. After inducing sepsis, researchers waited until the mice became sick to inject the nicotine. It worked: many of the mice, Ulloa says, got better within 24 hours. He says that this experiment closely replicates how sepsis could be treated in the real world, "because for patients, you can't predict when someone will go into sepsis. So you have to develop different experimental strategies to be able to rescue the patient."
"When you're smoking, you may have some small beneficial effect from nicotine, but you still have another thousand chemical products that is killing your body," says Ulloa.
But since his team also found the specific receptor on immune cells that nicotine latches onto, researchers can now see if drugs that work like nicotine can help battle the fires within.
Other researchers are currently working with one nicotine-like drug, originally developed to fight Alzheimer's, to treat inflammation. This drug, namedGTS-21, was found to be ineffective in the treatment of Alzheimer's because it wasn't able to penetrate the brain. But Ulloa says that it has great potential as an anti-inflammatory, since it can avoid the brain and target other parts of the body.
Ulloa's research was featured in the June 2006 Scientific American magazine, August 2005Nature, and November 2004 Nature Medicine. His research is funded by the Faculty Awards Program of the North Shore Health System, the North Shore-Long Island Jewish General Clinical Research Center, National Institute of General Medical Sciences, and the Defense Advanced Research Projects Agency.
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Selenium intravenous
COPYRIGHT 2008 The Townsend Letter Group
Two-hundred and thirty-eight patients with systemic inflammatory response syndrome (SIRS) due to severe sepsis or septic shock were randomly assigned to receive, in double-blind fashion, intravenous selenium (as sodium selenite) or placebo for 14 days. The dose of selenium was 1,000 mcg given over 30 minutes, followed by 1,000 mcg per 24 hours as a continuous infusion.Each group was allowed up to 100 mcg per day of additional selenium as a component of parenteral nutrition. After exclusion of 49 patients because of severe protocol violations, the 28-day mortality rate was 42.4% in the selenium group and 56.7% in the placebo group (25% reduction; p < 0.05). In predefined subgroup analyses, the mortality rate was significantly reduced in patients with septic shock with disseminated intravascular coagulation (p < 0.02) as well as in the most critically ill patients (p = 0.04) and in patients with more than three organ dysfunctions (p < 0.04). Whole blood selenium concentrations and glutathione peroxidase-3 activity were within the upper normal range during selenium treatment, whereas they remained significantly low in the placebo group. No side effects were observed.
Comment: SIRS is a significant cause of morbidity and mortality in critically ill patients. In SIRS, inflammatory pathways are activated, leading to the release of free radicals, which can damage cell membranes and other cell components. Selenium has antioxidant, anti-inflammatory, and immune-enhancing effects, each of which may be beneficial for patients with sepsis and SIRS. The results of this study indicate that intravenous administration of high-dose selenium reduced the mortality rate in this group of critically ill patients. Based on the observed 14.3% absolute risk reduction, one life would be saved for every seven patients treated with selenium.
Angstwurm MWA, et al. Selenium in Intensive Care (SIC): results of a prospective randomized, placebo-controlled, multiple-center study in patients with severe systemic inflammatory response syndrome, sepsis, and septic shock. Crit Care Med.2007;35:118-126.