Sepsis Retreat

ByJim

9:10 – 9:55am       Tony Pietropaoli

  • Must drink liters of water but not urinating. Retaining. Massive edema. Cases that recover must absorb
  • 1/3 to 1/2 of all patient deaths in hospital are related to sepsis. May be an underlying cause but sepsis triggers the hospitalization and causes the death. –  Liu JAMA 2014
  • Bone Chest 1992 – Sepsis definitions – SIRS criteria
  • Criticism of definitions Alberti Am J. Respir Crit Care Med 2003. Not predictive of mortality.
  • Having 4 SIRS criteria is actually protective. So need to mount a SIRS response.
  • Also Kaurkonen N Eng J Med 2015 – 12% of ICU patients are missed because they do not present >= 2 SIRS criteria
  • Golden Hour of Sepsis – Kumar Critical Care Medicine 34: 1589 2006. Survival is strongly dependent on when antibiotic treatment is given after hypotension onset. Need to administer before . Need broad spectrum antibiotics because need to administer before
  • Microcirculation is the motor of sepsis – Can Ince Ciritical Care 2005 9:S13. See other papers by Ince.

10:00 – 10:45am   Jonathan Reichner

  • Works on mac-1 (also known as CR3)
  • I-domain to bind ECM and lectin binding site that binds carbohydrates
  • Uses glucan to probe the lectin site of CR3
  • VLA-3 not VLA-5 regulates neutrophil migration on Fn when supplemented by B-Glucan
  • Yeast are too large to phagocytose. Neutrophils attach and spread along these tubular structures. Need to kill from plasma membrane.
  • B-glucan is the middle of a yeast cell wall.
  • Fungal infection happen in tissues not blood

 

Similar Posts