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Rogobete AF, Sandesc D, Bedreag OH, Papurica M, Popovici SE, Bratu T, Popoiu CM, Nitu R, Dragomir T, AAbed HIM, Ivan MV. MicroRNA Expression is Associated with Sepsis Disorders in Critically Ill Polytrauma Patients. Cells 2018; 7:E271. [PMID: 30551680 PMCID: PMC6316368 DOI: 10.3390/cells7120271] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/06/2018] [Accepted: 12/06/2018] [Indexed: 12/16/2022] Open
Abstract
A critically ill polytrauma patient is one of the most complex cases to be admitted to the intensive care unit, due to both the primary traumatic complications and the secondary post-traumatic interactions. From a molecular, genetic, and epigenetic point of view, numerous biochemical interactions are responsible for the deterioration of the clinical status of a patient, and increased mortality rates. From a molecular viewpoint, microRNAs are one of the most complex macromolecular systems due to the numerous modular reactions and interactions that they are involved in. Regarding the expression and activity of microRNAs in sepsis, their usefulness has reached new levels of significance. MicroRNAs can be used both as an early biomarker for sepsis, and as a therapeutic target because of their ability to block the complex reactions involved in the initiation, maintenance, and augmentation of the clinical status.
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Affiliation(s)
- Alexandru Florin Rogobete
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
- Clinic of Anesthesia and Intensive Care, Emergency County Hospital "Pius Brinzeu", 300723 Timisoara, Romania.
| | - Dorel Sandesc
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
- Clinic of Anesthesia and Intensive Care, Emergency County Hospital "Pius Brinzeu", 300723 Timisoara, Romania.
| | - Ovidiu Horea Bedreag
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
- Clinic of Anesthesia and Intensive Care, Emergency County Hospital "Pius Brinzeu", 300723 Timisoara, Romania.
| | - Marius Papurica
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
- Clinic of Anesthesia and Intensive Care, Emergency County Hospital "Pius Brinzeu", 300723 Timisoara, Romania.
| | - Sonia Elena Popovici
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
| | - Tiberiu Bratu
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
| | - Calin Marius Popoiu
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
| | - Razvan Nitu
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
| | - Tiberiu Dragomir
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
| | - Hazzaa I M AAbed
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
| | - Mihaela Viviana Ivan
- Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
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Rogobete AF, Sandesc D, Papurica M, Stoicescu ER, Popovici SE, Bratu LM, Vernic C, Sas AM, Stan AT, Bedreag OH. The influence of metabolic imbalances and oxidative stress on the outcome of critically ill polytrauma patients: a review. BURNS & TRAUMA 2017; 5:8. [PMID: 28286784 PMCID: PMC5341432 DOI: 10.1186/s41038-017-0073-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 02/23/2017] [Indexed: 05/03/2023]
Abstract
The critically ill polytrauma patient presents with a series of associated pathophysiologies secondary to the traumatic injuries. The most important include systemic inflammatory response syndrome (SIRS), sepsis, oxidative stress (OS), metabolic disorders, and finally multiple organ dysfunction syndrome (MODS) and death. The poor outcome of these patients is related to the association of the aforementioned pathologies. The nutrition of the critically ill polytrauma patient is a distinct challenge because of the rapid changes in terms of energetic needs associated with hypermetabolism, sepsis, SIRS, and OS. Moreover, it has been proven that inadequate nutrition can prolong the time spent on a mechanical ventilator and the length of stay in an intensive care unit (ICU). A series of mathematical equations can predict the energy expenditure (EE), but they have disadvantages, such as the fact that they cannot predict the EE accurately in the case of patients with hypermetabolism. Indirect calorimetry (IC) is another method used for evaluating and monitoring the energy status of critically ill patients. In this update paper, we present a series of pathophysiological aspects associated with the metabolic disaster affecting the critically ill polytrauma patient. Furthermore, we present different non-invasive monitoring methods that could help the intensive care physician in the adequate management of this type of patient.
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Affiliation(s)
- Alexandru Florin Rogobete
- Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Str. Eftimie Murgu Nr. 2, Timisoara, 300041 Timis Romania
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, Bd. Liviu Rebreanu Nr.156, Timisoara, 300736 Timis Romania
| | - Dorel Sandesc
- Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Str. Eftimie Murgu Nr. 2, Timisoara, 300041 Timis Romania
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, Bd. Liviu Rebreanu Nr.156, Timisoara, 300736 Timis Romania
| | - Marius Papurica
- Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Str. Eftimie Murgu Nr. 2, Timisoara, 300041 Timis Romania
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, Bd. Liviu Rebreanu Nr.156, Timisoara, 300736 Timis Romania
| | - Emil Robert Stoicescu
- Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Str. Eftimie Murgu Nr. 2, Timisoara, 300041 Timis Romania
| | - Sonia Elena Popovici
- Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Str. Eftimie Murgu Nr. 2, Timisoara, 300041 Timis Romania
| | - Lavinia Melania Bratu
- Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Str. Eftimie Murgu Nr. 2, Timisoara, 300041 Timis Romania
| | - Corina Vernic
- Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Str. Eftimie Murgu Nr. 2, Timisoara, 300041 Timis Romania
| | - Adriana Mariana Sas
- Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Str. Eftimie Murgu Nr. 2, Timisoara, 300041 Timis Romania
| | - Adrian Tudor Stan
- Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, Str. Eftimie Murgu Nr. 2, Timisoara, 300041 Timis Romania
| | - Ovidiu Horea Bedreag
- Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Str. Eftimie Murgu Nr. 2, Timisoara, 300041 Timis Romania
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, Bd. Liviu Rebreanu Nr.156, Timisoara, 300736 Timis Romania
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Tavladaki T, Spanaki AM, Dimitriou H, Briassoulis G. Alterations in metabolic patterns in critically ill patients-is there need of action? Eur J Clin Nutr 2017; 71:431-433. [PMID: 28176774 DOI: 10.1038/ejcn.2016.278] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 11/28/2016] [Indexed: 01/01/2023]
Affiliation(s)
- T Tavladaki
- Pediatric Intensive Care Unit, University Hospital, Medical School, University of Crete, Heraklion, Greece
| | - A M Spanaki
- Pediatric Intensive Care Unit, University Hospital, Medical School, University of Crete, Heraklion, Greece
| | - H Dimitriou
- Pediatric Hematology - Oncology, Medical School, University of Crete, Heraklion, Greece
| | - G Briassoulis
- Pediatric Intensive Care Unit, University Hospital, Medical School, University of Crete, Heraklion, Greece
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