Related Experiment Videos
Effect of corticosteroids on nuclear factor-kappaB activation and hemodynamics in late septic shock
H J van Leeuwen1, T van der Bruggen, B S van Asbeck
1Division of Internal Medicine and Dermatology, Department of Intensive Care and Clinical Toxicology, University Medical Center Utrecht, Utrecht, The Netherlands.
Objective:
To describe the underlying pathophysiologic mechanisms of the effect of corticosteroids in a patient with late septic shock.
Design:
Case report.
Setting:
The medical intensive care unit at University Medical Center Utrecht.
Patient:
An 86-yr-old female patient with late septic shock requiring mechanical ventilation and vasopressive agents.
Interventions:
Administration of hydrocortisone, 300 mg daily.
Measurements And Main Results:
Within 3 days of corticosteroid treatment, the patient could be weaned of vasopressive agents and mechanical ventilation. Serum C-reactive protein levels normalized. Nuclear factor-kappaB activation in unstimulated and in vitro lipopolysaccharide-stimulated peripheral blood mononuclear cells decreased to background level within 5 days. Repeated functional tests of the hypothalamic-pituitary-adrenal axis were normal.
Conclusion:
Our data suggest that the pathophysiologic mechanism behind the clinical effects of supraphysiologic doses of corticosteroids in late septic shock is directly related to the inhibition of nuclear factor-kappaB in peripheral blood mononuclear cells.
Related Concept Videos
02:26NF-κB-dependent Signaling Pathway
NF-κB-dependent Signaling Mechanism
The heterodimer of NF-κB...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:29Heart Failure II: Pathophysiology
01:29Acute Kidney Injury II: Pathophysiology
01:25Acute Inflammation III: Local and Systemic Effects