Sepsis group

Coordinator: Miklós Lipcsey, miklos.lipcsey@surgsci.uu.se

The liver's immune barrier function in experimental septic shock

Septic shock is commonly called blood poisoning. In this condition bacteria, fungi or viruses enter the bloodstream and cause an infection with major impact on the body, including inflammation, disturbed blood circulation, blood and tissue oxygenation and decreased level of consciousness. Septic shock is commonly seen in intensive care, and is associated with high mortality and is associated with high health care costs. Although septic shock may occur suddenly in previously healthy people, it is more common in people with multiple illnesses and underlying infections.

According to estimates, the intestines contain 1-2 kg of microbes. These potentially dangerous microorganisms are isolated from the circulation, where they could induce sepsis, through various barrier systems and the immune system. One of the mechanisms is probably that the circulation from the intestines passes the liver containing the body's largest amount of cells of the innate immune system through the mononuclear phagocytic system (MPS). Our hypothesis is that the MPS works less efficient in systemic inflammation as in blood poisoning, allowing microbes or their fragments to reach systemic circulation with activation / maintenance of the systemic inflammatory response. In an experimental model of blood poisoning, we investigate whether MPS function in systemic inflammation is actually depressed, and what parts of MPS are affected and also if there are pharmacological methods to affect the impaired function in MPS.

Members of the group 2018
Miklós Lipcsey, Principal Investigator, Associate Professor, Hedenstierna Laboratory, Anaesthesiology and Intensive Care, Department of Surgical Sciences
Katja Hanslin, PhD student, Anaesthesiology and Intensive Care, Department of Surgical Sciences
Anders Larsson, Professor, Clinical Chemistry, Department of Medical Sciences
Jan Sjölin, Professor, Infectious Diseases, Department of Medical Sciences

Intensive care epidemiology - sepsis

Patients in intensive care units have reversible failure in one or more organ systems. They also often have a several other chronic illnesses. Considering that intensive care is demanding for patients, and generates high costs for society, it is important that outcomes for patients are followed up after intensive care. One way to do this is through the Swedish Intensive Care Register that collects data from all general intensive care units in Sweden. The project investigates mortality, complications and quality of life after sepsis.

Members of the group
Miklós Lipcsey, Principal Investigator, Associate Professor, Hedenstierna Laboratory
Björn Ahlström, PhD student
Ing-Marie Larsson, PhD
Gunnar Strandberg, PhD
Mats Eriksson, Associate Professor

All above are affiliated to Anaesthesiology and Intensive Care, Department of Surgical Sciences.

Blood antibiotic concentrations in intensive care patients

The outcome of patients with severe infections is determined by whether correct antibiotics are administered quickly and in the correct dose. The effect of the right antibiotics at the right dose should be greatest during the first day, as the bacterial burden is greatest then. The knowledge about the pharmacokinetics of antibiotics is based on studies with healthy volunteers. Antibiotic concentration in the blood of critically ill patients is the first day is unknown. In the ACCIS study, blood samples have been collected from patients in 7 intensive care units. In addition to descriptive studies, data will be used for pharmacological models for optimal antibiotic dosing and development of bedside measurement of blood antibiotic concentration.

Members of the group 2018
Miklós Lipcsey, Principal Investigator, Associate Professor, Hedenstierna Laboratory, Anaesthesiology and Intensive Care, Department of Surgical Sciences
Anna-Karin Smekal, PhD student, Anaesthesiology and Intensive Care, Department of Surgical Sciences
Mia Furebring, PhD, Infectious Diseases, Department of Medical Sciences
Jan Sjölin, Professor, Infectious Diseases, Department of Medical Sciences
Elisabet Nilsen, Associate Professor, Pharmacometry, Department of Pharmaceutical Biosciences
Anders Larsson, Professor, Clinical Chemistry, Department of Medical Sciences

Eggs antibodies against severe infections

Treatment of severe infections is largely based on antibiotics today. With increasing antibiotic resistance problems, other treatment options are needed. After immunization of hens against bacteria, chicken eggs contain polyclonal antibodies against the bacterium with which immunization was done. This is a cheap and effective method of producing antibodies. In this project, we investigate antibodies against bacteria that cause severe and difficult to treat intensive care infections are evaluated in an experimental pneumonia model.

Members of the group 2018
Miklós Lipcsey, Principal Investigator, Associate Professor, Hedenstierna Laboratory, Anaesthesiology and Intensive Care, Department of Surgical Sciences
Alexander Otterbeck, PhD student, Anaesthesiology and Intensive Care, Department of Surgical Sciences
Anders Larsson, Professor, Clinical Chemistry, Department of Medical Sciences
Johan Stålberg, Immunsystems AB
Hans Hjelmqvist, Professor, Anesthesia and Intensive Care, Örebro University

Studies of fluid therapy

Fluid treatment is one of the most common means of treatment during with surgery and in intensive care. The project investigates the factors that impact on fluid treatment, the effects of this treatment, and how restrictive fluid therapy affects the physiology of patients after surgery and in intensive care.

Members of the group
Miklós Lipcsey, Principal Investigator, Associate Professor, Hedenstierna Laboratory
Sandra Horst, PhD student
Raphael Kawati, PhD
Egidijus Semenas, PhD

All above are affiliated to Anaesthesiology and Intensive Care, Department of Surgical Sciences.

Prophylaxis with Intraosseed Needles

With life-threatening injuries, especially in children, creating access to the bloodstream can be challenging, and when such accesses are obtained fluid infusions are prioritized. Getting blood samples is of course also very important in the acute situation. Obtaining clinically relevant blood samples for laboratory analysis quickly and thereby being able to initiate adequate therapy can be lifesaving in for these severely ill patients. Special needles, so-called intraosseous needles, can be drilled into the marrow in bones and used for fluid substitution, drug delivery and sampling. Unfortunately, there is a widespread misconception that intraosseous needles are not suitable for sampling because the samples contain bone marrow particles which can damage the analytical instruments. Since laboratory technology has developed, analyses can be performed bedside and intraosseous samples can now be analysed in a cuvette that does not come into direct contact with the assay instrument, the method of sampling from intravenous needles needs to be re-evaluated. Studies in this project investigate the reliability of samples taken from an intraosseous needle and also the reliability administration of drugs through an intraosseous needle.

Members of the group 2018
Mats Eriksson, Principal Investigator, Associate Professor, mats.eriksson@surgsci.uu.se, Anaesthesiology and Intensive Care, Department of Surgical Sciences
Miklós Lipcsey, Associate Professor, Hedenstierna Laboratory, Anaesthesiology and Intensive Care, Department of Surgical Sciences
Gunnar Strandberg, PhD, Anaesthesiology and Intensive Care, Department of Surgical Sciences
Anders Larsson, Professor, Clinical Chemistry, Department of Medical Sciences
 

Last modified: 2021-04-15