Authors: Colunga Biancatelli RM, Berrill M, Mohammed YH, Marik PE PMID: 32148926 PMCID: PMC7024751 DOI: 10.21037/jtd.2019.12.85 Abstract Sepsis affects 30 million people worldwide, leading to 6 million deaths every year (WHO), and despite decades of research, novel initiatives are drastically needed. According to the current literature, oxidative imbalance and mitochondrial dysfunction are common features of [...]

Sepsis affects 30 million people worldwide, leading to 6 million deaths every year (WHO), and despite decades of research, novel initiatives are drastically needed. According to the current literature, oxidative imbalance and mitochondrial dysfunction are common features of septic patients that can cause multiorgan failure and death. Melatonin, alongside its traditionally accepted role as the master hormonal regulator of the circadian rhythm, is a promising adjunctive drug for sepsis through its anti-inflammatory, antiapoptotic and powerful antioxidant properties. Several animal models of sepsis have demonstrated that melatonin can prevent multiorgan dysfunction and improve survival through restoring mitochondrial electron transport chain (ETC) function, inhibiting nitric oxide synthesis and reducing cytokine production. The purpose of this article is to review the current evidence for the role of melatonin in sepsis, review its pharmacokinetic profile and virtual absence of side effects. While clinical data is limited, we propose the adjunctive use of melatonin is patients with severe sepsis and septic shock.

Authors: Huang X, Han S, Liu x, Wang T, Xu H PMID: 32010252 PMCID: PMC6966138 DOI: 10.3892/etm.2019.8285 Abstract Sepsis commonly progresses to disseminated intravascular coagulation and induces the activation of heparanase (HPA) and the shedding of endothelial glycocalyx constituents, including syndecan-1 (SDC-1) and heparan sulphate (HS). However, the degradation of glycocalyx and its association with [...]

Authors: Howell AP, Parrett JL, Malcom DR PMID: 31766883 PMCID: PMC8256056 DOI: 10.1177/1932296819889638 Abstract Background: Intravenous vitamin C therapy has been associated with reduced mortality in patients with sepsis. Of potential concern with this therapy are falsely elevated point-of-care (POC) blood glucose values vs laboratory analyzed (LA) readings. The purpose of this study was to [...]

Auhtors: Marik PE PMID: 30441816 PMCID: PMC6265973 DOI: 10.3390/nu10111762 Abstract Sepsis is a devastating disease that carries an enormous toll in terms of human suffering and lives lost. Over 100 novel pharmacologic agents that targeted specific molecules or pathways have failed to improve the outcome of sepsis. Preliminary data suggests that the combination of Hydrocortisone, [...]

Authors: Marik PE PMID: 30441816 doi: 10.3390/nu10111762 Abstract Sepsis is a devastating disease that carries an enormous toll in terms of human suffering and lives lost. Over 100 novel pharmacologic agents that targeted specific molecules or pathways have failed to improve the outcome of sepsis. Preliminary data suggests that the combination of Hydrocortisone, Ascorbic Acid [...]

Authors: Marik PE PMID: 29684467 DOI: 10.1016/j.pharmthera.2018.04.007 Abstract Most vertebrates can synthesize vitamin C with synthesis increasing during stress. Humans, however, have lost the ability to synthesize vitamin C. Vitamin C is an important anti-oxidant and an enzyme cofactor for many important biological reactions. Sepsis results in the overwhelming production of reactive oxygen species with [...]

Authors: Riche F PMID: 29467023 PMCID: PMC5822646 DOI: 10.1186/s13054-017-1934-4 Abstract Background: Sepsis is a leading cause of mortality and critical illness worldwide and is associated with an increased mortality rate in the months following hospital discharge. The occurrence of persistent or new organ dysfunction(s) after septic shock raises questions about the mechanisms involved in the [...]

Authors: Lee CR, Zeldin DC PMID: 26605933 PMCID: PMC5512422 doi: 10.1056/NEJMcibr1511280 Abstract Severe sepsis remains a major public health problem associated with poor clinical outcomes and substantial health care expenditures. Although the number of sepsis cases in the United States exceeds 750,000 per year and sepsis is associated with an estimated mortality rate of 20–30%, [...]

Authors: Marik PE, Khangoora V, Rivera R, Hooper MH, Catravas J PMID: 27940189 DOI: 10.1016/j.chest.2016.11.036 Abstract Background: The global burden of sepsis is estimated as 15 to 19 million cases annually, with a mortality rate approaching 60% in low-income countries. Methods: In this retrospective before-after clinical study, we compared the outcome and clinical course of [...]