Impact of the early goal-directed therapy of severe sepsis and septic shock in the endoplasmic reticulum stress, myocardial function and mortality in patients treated at an emergency unit

• Grant number: 11/13785-0
• Support Opportunities: Regular Research Grants
• Start date: December 01, 2011
• End date: May 31, 2014
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Marco Antonio de Carvalho Filho
• Grantee: Marco Antonio de Carvalho Filho
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Sepsis is defined by the combination of proven or suspected infection accompanied by the systemic inflammatory response syndrome. It has high morbidity and mortality and is associated with activation of the innate immune response triggered by specific cell surface receptors, including TLR4 and TLR2, which can be found on antigen-presenting cells. Recently it was reported that this innate immune response can activate the intracellular pathways related to the endoplasmic reticulum stress, and that these activated pathways can lead to organ dysfunction. The hemodynamic and cardiac failures in sepsis are among the organic dysfunctions with the greatest impact on mortality, since the circulatory collapse eventually culminate in multiple organ failure and death. Understanding the molecular mechanisms of these changes will guide the development of future therapies. This study aims to standardize the initial treatment of sepsis in the emergency department of an university hospital, based on initial treatment protocol guided by targets associated with reduced mortality. In parallel, we will investigate the impact of this initial approach in the development of the endoplasmic reticulum stress and its correlation with hemodynamic variables, myocardial dysfunction, blood volume, laboratory findings and mortality. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

SANTOS, THIAGO M.; FRANCI, DANIEL; GONTIJO-COUTINHO, CAROLINA M.; OZAHATA, TATIANA MIRABETTI; GUERRA GRANGEIA, TIAGO DE ARAUJO; MATOS-SOUZA, JOSE R.; CARVALHO-FILHO, MARCO A.. Inflammatory lung edema correlates with echocardiographic estimation of capillary wedge pressure in newly diagnosed septic patients. JOURNAL OF CRITICAL CARE, v. 44, p. 392-397, APR 2018. (11/13785-0)