[7,8] Risk Factor Weightage, if any Age > 50 years 5 Female Gender 5 Organ Failure* 7 Malignancy 4 Preoperative duration of peritonitis >24 hours 4 Origin of sepsis not colonic 4 Diffuse generalised peritonitis 6 Exudates Clear 0 Cloudy, Purulent 6 Faecal 12 * Definitions of organ failure: Kidney: creatinine >177 pmol/L, urea >167 [micro]mol/L, oliguria <20 ml/h; Lung: pO2 <50 mmHg, pCO2 >50 mmHg; Shock: hypodynamic
or hyperdynamic; Intestinal obstruction (only if profound): Paralysis >24 h or complete mechanical ileus.
In this regard, the authors noted the need for comparable future studies in terms of normovolaemia at the time of the study, sympathetic block level (including or excluding cardioaccelerator nerves), defining the developmental stage of sepsis (early or hyperdynamic, late or hypodynamic
) and demonstration of a maintained sympathetic block (again the level including or excluding adrenal glands).
At approximately 16 hours, CLP-induced sepsis is marked by hypoglycemia, hypoinsulinemia, and hypodynamic
circulation along with markedly increased lactate levels .
Mannheim peritonitis index Risk factor Weighting if present Age >50 years 5 Female sex 5 Organ failure 7 Malignancy 4 preoperative duration of peritonitis >24 4 Origin of sepsis not colonic 4 Diffuse generalized peritonitis 6 Exudate Clear 0 Cloudy, purulent 6 Fecal 12 Definitions of organ failure Kidney Cratine level >177[micro]mol/L Urea level>167 mmol/L Oliguria <20 mL/h Lung P[O.sub.2]<50 mmHg PC[O.sub.2]>50 mmHg Shock Hypodynamic
or hyperdynamic Intestinal obstruction Paralysis >24 h or complete mechanical obstruction P[O.sup.2]: PC[O.sup.2] Table 2.
Conclusions: In the present study, we developed a novel porcine model of septic shock induced by ARDS due to severe MRSA pneumonia with characteristic hyperdynamic and hypodynamic
phases in 24 h, which mimicked the hemodynamic changing of septic shock in human.
Risk Factors Weightage 1 Age > 50 Years 5 2 Female sex 5 3 Organ failure * 7 4 Malignancy 4 5 Pre Operative duration 4 6 Origin of sepsis not colonic 4 7 Diffuse generalized peritonitis 6 8 Clear exudate 0 Cloudy exudate 6 Purulent exudate 12 Total score Max score of 47 Table 2: * Definition of organ failure for MPI Kidney Creatinine level > 177 [micro]mol/L > 2.31 mg/dl Urea level > 167 mmol/L > 467.78 mg/dl Oliguria <20 ml/h Lung P[O.sub.2] <50 mm Hg PC[O.sub.2] >50 mm Hg Shock Hypodynamic
or Hyperdynamic Intestinal Obstruction Paralysis > 24 hrs or (Only if profound) Complete mechanical ileus Figure 1: Age and sex distribution 16-30 31-45 46-60 >60 Males 11 24 25 6 Females 6 11 13 4 Note: Table made from bar graph.
At the late, hypodynamic
stage of sepsis (i.e., 18 hours after CLP) or sham operation, rats were anesthetized by inhaling 1-3% isoflurane and 40% oxygen.
Dambrauskas et al., "Early course of microcirculatory perfusion in eye and digestive tract during hypodynamic
sepsis," Critical Care, vol.
With respect to the mean error percentage, none of the methods tested were equivalent to TD, except Simpson's method in the hypodynamic
state (Table 1).
In preliminary experiments, we observed a hyperdynamic physiological state followed by a hypodynamic
physiological state, similar to hemodynamic alterations in septic patients.
This model produces a hyperdynamic, hypermetabolic state that can lead to a hypodynamic
, hypometabolic stage, and eventual death.
This combination, the thinking goes, results in the inability of hypodynamic
and hypovascular bone to meet increased demand for repair and remodeling, owing to the innate, continual physiologic stress (mastication), iatrogenic trauma (tooth extraction or denture injury), or dental infection within an environment laden with oral flora bacteria.