Risposta infiammatoria - Dove siamo? -

Slides:

Advertisements

Similar presentations

Potential Use of Plasma Exchange in Septic Shock

Advertisements

Management of Hyperglycemia in the Critical Care Setting

Maxvold Nutrition in PCRRT Norma J Maxvold Pediatric Critical Care.

Norma J Maxvold Pediatric Critical Care

Fill in missing numbers or operations

Name: Date: Read temperatures on a thermometer Independent / Some adult support / A lot of adult support

Giancarlo Agnelli Università di Perugia Anticoagulant treatment for PE: optimal duration.

Workshop 4: Il late-presenter Moderatori: G. Ippolito, M. Moroni Discussant: R. Iardino Limportanza della risposta immunologica S. Rusconi.

Workshop 4: Il late-presenter Moderatori: G. Ippolito, M. Moroni Discussant: R. Iardino Risposta virologico-clinica e scelta della terapia C. Mussini.

1 Copyright © 2013 Elsevier Inc. All rights reserved. Appendix 01.

SAT-10 Practice Mark your answers correctly on the SAT-10 Practice paper.

2 pt 3 pt 4 pt 5 pt 1 pt 2 pt 3 pt 4 pt 5 pt 1 pt 2 pt 3 pt 4 pt 5 pt 1 pt 2 pt 3 pt 4 pt 5 pt 1 pt 2 pt 3 pt 4 pt 5 pt 1 pt ShapesPatterns Counting Number.

Year 6 mental test 10 second questions

WHEN TO CONSIDER RRT Timothy E Bunchman Founder PCRRT

SUN−336 HIGH PREVALENCE OF VITAMIN D DEFFICIENCY AND ITS ASSOCIATION WITH METABOLIC SYNDROME IN ELDERLY MEN LIVING IN THE TROPICS INTRODUCTION An inverse.

Asymptomatic Left Ventricular Dysfunction After Myocardial Infarction

Pericarp of Mangosteen Inhibits Nuclear Factor κ B (NF- κ B) Activation and Reduces ICAM-1 and IL-6 in Atherosclerosis Department of Cardiology, Brawijaya.

EU Market Situation for Eggs and Poultry Management Committee 21 June 2012.

Renal Replacement Therapies in Critical Care

Renal Replacement Therapy Options for Children

Continuous Renal Replacement Therapy

Haemofiltration In Sepsis

Continuous Renal-Replacement Therapy CRRT

Pediatric CRRT: Terminology and Physiology

Definition Continuous Renal Replacement Therapy (CRRT)

CRRT in SEPSIS Benan Bayrakci, 2014

Pediatric Septic Shock

Nurse Led Clinics Opportunity for nurses to make a difference Wilma Scholte op Reimer, RN, PhD Amsterdam School of Health Professions Academic Medical.

D. P. Laporta MD presented to McGill Residents D. P. Laporta MD Departments of Adult Critical Care and Medicine, Sir MB Davis Jewish General Hospital McGill.

September 29,2010 Karen Harkness RN CCNC PhD. Definition Not a clinical diagnosis Heart failure is a complex syndrome in which abnormal heart function.

TREATMENT Coagulopathy of Liver Failure. Fresh Frozen Plasma – Most effective way to correct hemostasis in patients with liver failure – Infusion (5-10mL/kg)

CVVH vs CVVHD Does it Matter?

William J. Gradishar MD, FACP Betsy Bramsen Professor of Breast Oncology Director, Maggie Daley Center For Women's Cancer Care Robert H. Lurie Comprehensive.

Renal Intensive Care. Rivers, E. P. et al. CMAJ 2005;173: Sepsis – The “ real milieu ” Sepsis.

ABYLCAP CARBON DIOXIDE REMOVAL ECCO2R

PSSA Preparation.

Number Factors and Multiples Saturday, 09 September 2006 ©RSH.

The Duration of Hypotension Prior to Initiation of Effective Antimicrobial Therapy is the Critical Determinant of Survival in Human Septic Shock Anand.

Continuous Renal Replacement Therapy for Sepsis Treatment

Serum Lactate Post-Antibiotic antibiotic † † ＊＊ Kumar et al. J Infect Dis 2006; 193:

Early Goal Therapy in Severe Sepsis & Septic Shock

 Exemplary Care  Cutting-edge Research  World-class Education  Raghavan Murugan MD, MS, FRCP Associate Professor Dept. of Critical Care Medicine Clinical.

C-Reactive Protein: a Prognosis Factor for Septic Patients Systematic Review and Meta-analysis Introduction to Medicine – 1 st Semester Class 4, First.

Hemodynamic changes during hemofiltration in meningococcal septicemia Dr Rajiv Chhabra Dr Prabhat Maheshwari Dr Claudine De Munter.

Pediatric Septic Shock

Estimates of the Impact of Sepsis Syndromes Annually in U.S. Sepsis 200,000 Severe sepsis 200,000 Septic shock 200,000 Mortality Deaths -46%92, %40,000.

Acute Kidney Injury & Sepsis Patrick D Brophy, MD, MHCDS Director Pediatric Nephrology Professor The University of Iowa London 2015.

Is There a Rationale To Use CRRT For Treating Sepsis? James D. Fortenberry MD, FCCM, FAAP Pediatrician in Chief Children’s Healthcare of Atlanta Professor.

Haemofiltration for sepsis: burial or resurrection?

Brophy University of Iowa RST for pediatric AKI in the setting of MODS/sepsis Patrick Brophy MD Director Pediatric Nephrology University of Iowa- Children’s.

Cytokine and Soluble Fas Ligand Response in Children with Septic Acute Renal Failure (ARF) on CVVH Paden ML, Fortenberry JD, Rigby MR, Trexler AM, Heard.

Prise en charge de l'IRA au cours du sepsis " Quelle place pour l’hémofiltration continue ? " Bertrand Souweine Clermont-Ferrand.

Procalcitonin 정량검사의 평가

Brophy University of Iowa Acute Kidney Injury & Sepsis Patrick Brophy MD Director Pediatric Nephrology University of Iowa- Children’s Hospital PCRRT Orlando.

Role of CRRT in Sepsis Dr Apoorva Jain Agra.

Regional Citrate Anticoagulation Limits Sepsis-Associated Tissue Injury Through The Decreased Release Of Microvesicles From Activated Leukocytes And Platelets.

Date of download: 9/17/2016 From: Plasma Cytokine and Endotoxin Levels Correlate with Survival in Patients with the Sepsis Syndrome Ann Intern Med. 1993;119(8):

University of Alabama at Birmingham

Vasopressin and noradrenaline reduce LPS-induced monocyte TNF release

CITRATE ANTICOAGULATION IMPROVES BLOOD COMPATIBILITY IN DIALYSIS AND APERESIS – DATA FROM IN VITRO EXPERIMENTS S. Harm, J. Hartmann Center for Biomedical.

The significantly different metabolites between the systemic inflammatory response syndrome SIRS (n=15) and sepsis (n=35) groups (A); the sepsis (n=10)

Identifying and treating the stages of sepsis

Andrew Durward St Thomas NHS Foundation Trust Orlando 2017 CRRT IN AKI.

Activated endothelial cells

Volume 56, Pages S15-S19 (November 1999)

Typical liquid chromatography–mass spectrometry spectra of sera from patients with sepsis (A) or systemic inflammatory response syndrome (SIRS) (B) and.

Volume 58, Pages S148-S155 (August 2000)

Various possible courses of the immune response to severe sepsis and septic shock over 28 days. Various possible courses of the immune response to severe.

Presentation transcript:

Risposta infiammatoria - Dove siamo? - Infection Sepsis Severe Sepsis MODS Death “mixed” “pro” SIRS = Systemic inflammatory response syndrome CARS = Compensatory anti-inflammatory response syndrome Hyper-inflammation Normal Immunoparalysis “anti”

high-molecular-weight kininogen Immunosuppression is a primary rather than a compensatory response to sepsis Pathogens promote the early activation of the contact system factor XII prekallicrein high-molecular-weight kininogen and the complement cascade, and induce the rapid release of inflammatory mediators from monocytes and endothelial cells, which correspond to the clinical designation of SIRS. Simultaneously, endogenous antinflammatory pathways are activated, which dampen the inflammatory response: the compensatory anti-inflammatory response syndrome (CARS). Int J Artif Organ 2002; 25: 733-47

Volume 355:1018-1028 September 7, 2006 Number 10

Volume 355:1018-1028 September 7, 2006 Number 10

Volume 355:1018-1028 September 7, 2006 Number 10

Peak concentration hypotesis RONCO et all RISPOSTA PRO E ANTI-INFIAMMATORIA Peak concentration hypotesis RONCO et all Concentrazione plasmatica LPS TNF IL-1 IL-6 IL-8 IL-10 C.P.F.A. Stimolo endotossinico tempo

Coupled Plasma Filtration Adsorption Modello dello shock settico 1.0 R+ 16/20 (80%) PF R 0.8 LPS 0.05 mg/kg no. 20 0.6 Sopravvivenza Cumulativa 0.4 PF L+ 5/19 (25%) 0.2 LPS 0.05 mg/kg no. 19 2 4 6 8 giorni Miglioramento della sopravvivenza senza correlazione con i livelli plasmatici di TNF e PAF Tetta C et al. Crit Care Med 2000; 28: 1526-33

Hemodynamic response to coupled plasmafiltration-adsorption in human septic shock Marco Formica, Carlo Olivieri, Sergio Livigni, Giulio Cesano, Antonella Vallero, Mariella Maio and Ciro Tetta Intensive Care Med (2003) 29: 703-708 Objective: The objective was to examine the effect of repeated applications of coupled plasmafiltration-adsorption on the hemodynamic response in septic shock patients hospitalized in intensive care units (ICUs). Conclusion: Coupled plasmafiltration-adsorption was a feasible and safe extracorporeal treatment and exerted a remarkable improvement in the hemodynamic, the pulmonary function, and the outcome in septic shock patients with or without concomitant ARF.

PLASMAFILTRAZIONE E ADSORBIMENTO ASSOCIATE (CPFA) LYNDA (Bellco, Mirandola, Italia) Plasmafiltro (Polieteresulfone MICROPES® 0.45 m2 cut-off di circa 800 kDa) Cartuccia di resine idrofobiche (140 ml per 70 gr, con superficie adsorbente di circa 700 m2/gr) Emofiltro (Polieteresulfone DIAPES®-HF 1.2 m2, CVVH, CVVHD)