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Critical care sepsis

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https://www.readbyqxmd.com/read/29334496/oxygen-in-the-critically-ill-friend-or-foe
#1
Elisa Damiani, Abele Donati, Massimo Girardis
PURPOSE OF REVIEW: To examine the potential harmful effects of hyperoxia and summarize the results of most recent clinical studies evaluating oxygen therapy in critically ill patients. RECENT FINDINGS: Excessive oxygen supplementation may have detrimental pulmonary and systemic effects because of enhanced oxidative stress and inflammation. Hyperoxia-induced lung injury includes altered surfactant protein composition, reduced mucociliary clearance and histological damage, resulting in atelectasis, reduced lung compliance and increased risk of infections...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#2
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29324733/antibiotics-dispensed-to-privately-insured-pregnant-women-with-urinary-tract-infections-united-states-2014
#3
Elizabeth C Ailes, April D Summers, Emmy L Tran, Suzanne M Gilboa, Kathryn E Arnold, Dana Meaney-Delman, Jennita Reefhuis
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4)...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29324628/ulinastatin-protects-against-lps-induced-acute-lung-injury-by-attenuating-tlr4-nf-%C3%AE%C2%BAb-pathway-activation-and-reducing-inflammatory-mediators
#4
Chao Cao, Chengfen Yin, Songtao Shou, Jun Wang, Lechang Yu, Xuening Li, Yanfen Chai
Acute lung injury (ALI) and its severe form, acute respiratory distress syndrome (ARDS), remain the leading causes of morbidity and mortality in intensive care units. Ulinastatin (UTI), a serine protease inhibitor, possesses anti-inflammatory properties and has been suggested to modulate lipopolysaccharide (LPS)-induced sepsis; thus, it is now widely used in the treatment of pancreatitis, sepsis, and septic shock. Toll-like receptor 4 (TLR4), an essential LPS signaling receptor, plays a critical role in the activation of innate immunity...
January 10, 2018: Shock
https://www.readbyqxmd.com/read/29319760/acute-kidney-injury-in-critically-ill-obstetric-patients-a-cross-sectional-study-in-an-intensive-care-unit-in-northeast-brazil
#5
Geraldo Bezerra da Silva Junior, Suzanne Vieira Saintrain, Gabriel de Castro Castelo, Vanessa Ribeiro de Vasconcelos, Juliana Gomes Ramalho de Oliveira, Amanda Maria Timbó Rocha, Adolfo Gomes Vasconcelos Júnior, Maria Vieira de Lima Saintrain, Elizabeth De Francesco Daher
INTRODUCTION: Acute kidney injury (AKI) is a complication still poorly studied in the setting of obstetric patients, which is associated with increased mortality. Objective: The aim of this study was to investigate the frequency and risk factors of AKI among critically ill obstetric patients. METHODS: A cross-sectional study was conducted with all patients admitted to an intensive care unit (ICU) due to obstetric complications, in Fortaleza, Brazil, in the period between January 2012 and December 2014...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29319247/infection-associated-secondary-hemophagocytic-lymphohistiocytosis-in-sepsis-syndromes-a-tip-of-an-iceberg
#6
Arun Agarwal, Aakanksha Agarwal
Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare, underdiagnosed, fatal and devastating hyperinflammatory syndrome that has gained increasing recognition over the past decade. Patients with HLH present with clinical and laboratory evidence of uncontrolled inflammation. Delay in diagnosis and management inevitably leads to a rapidly progressive and fatal course. In this case series, we present 7 cases of secondary HLH (sHLH) in adults with their presentation, course, and outcomes...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29315320/association-of-day-4-cumulative-fluid-balance-with-mortality-in-critically-ill-patients-with-influenza-a-multicenter-retrospective-cohort-study-in-taiwan
#7
Wen-Cheng Chao, Chien-Hua Tseng, Ying-Chun Chien, Chau-Chyun Sheu, Ming-Ju Tsai, Wen-Feng Fang, Yu-Mu Chen, Kuo-Chin Kao, Han-Chung Hu, Wann-Cherng Perng, Kuang-Yao Yang, Wei-Chih Chen, Shinn-Jye Liang, Chieh-Liang Wu, Hao-Chien Wang, Ming-Cheng Chan
BACKGROUND: Fluid balance is a fundamental management of patients with sepsis, and this study aimed to investigate the impact of cumulative fluid balance on critically ill patients with influenza admitted to an intensive care unit (ICU). METHODS: This multicenter retrospective cohort study was conducted by the Taiwan Severe Influenza Research Consortium (TSIRC) which includes eight medical centers. Patients with virology-proven influenza infection admitted to ICUs between October 2015 and March 2016 were included for analysis...
2018: PloS One
https://www.readbyqxmd.com/read/29314320/patient-agitation-and-its-management-in-adult-critical-care-a-systematic-review-and-narrative-synthesis
#8
REVIEW
Samantha Freeman, Janelle Yorke, Paul Dark
AIM: To critically review the evidence relating to the management of agitation within the Adult Critical Care Unit (ACCU) environment and identify any risks and benefits of current management strategies. BACKGROUND: Admission to an ACCU can be traumatic and potentially life altering for the patient. Patient agitation is common in ACCUs and is associated with the potential for harm. Despite inherent safety risks, there is a paucity of evidence-based guidance underpinning the care of agitation in patients with critical illness...
January 4, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29310974/sepsis-in-tropical-regions-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#9
Steven McGloughlin, Guy A Richards, Mohd Basri Mat Nor, Shirish Prayag, Tim Baker, Pravin Amin
Sepsis and septic shock in the tropics are caused by a wide array of organisms. These infections are encountered mainly in low and middle-income countries (LMIC) where a lack of infrastructure and medical facilities contribute to the high morbidity and mortality. Published sepsis guidelines are based on studies primarily performed in high income countries and as such recommendations may or may not be relevant to practice in the tropics. Failure to adhere to guidelines, particularly among non-intensive care specialists even in high-income countries, is an area of concern for sepsis management...
December 30, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29310566/analysis-of-oxidative-stress-related-markers-in-critically-ill-polytrauma-patients-an-observational-prospective-single-center-study
#10
Mihai Sandesc, Alexandru Florin Rogobete, Ovidiu Horea Bedreag, Anca Dinu, Marius Papurica, Carmen Alina Cradigati, Mirela Sarandan, Sonia Elena Popovici, Lavinia Melania Bratu, Tiberiu Bratu, Adrian Tudor Stan, Dorel Sandesc
Critically ill polytrauma patients have increased production of free radicals (FRs) and consequent alterations in biochemical pathways, as well as disruption of cellular integrity, due to increased lipid peroxidation. The aim of this study was to investigate several biomarkers associated with increased oxidative stress in critically ill polytrauma patients, and to evaluate the effect of antioxidant treatment on the clinical outcome in these patients. A total of 67 polytrauma patients from an intensive care unit met the selection criteria...
January 9, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29304308/acute-kidney-injury-and-sepsis
#11
Steven J Skube, Stephen A Katz, Jeffrey G Chipman, Christopher J Tignanelli
BACKGROUND: Worldwide, both acute kidney injury (AKI) and sepsis are significant clinical complications, particularly in critical care patients. Sepsis is an important cause of AKI, and AKI is a common complication of sepsis. METHODS: We reviewed the literature, including current practice guidelines, on sepsis-associated AKI. RESULTS: We assessed causes of renal failure, potential mechanisms of sepsis-associated acute kidney injury, current practice guidelines, diagnostic criteria and methods, prevention strategies, treatment options, and outcomes...
January 5, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29297399/the-coming-era-of-precision-medicine-for-intensive-care
#12
REVIEW
Jean-Louis Vincent
Recent advances in technology and better understanding of mechanisms underlying disease are beginning to enable us to better characterize critically ill patients. Instead of using nonspecific syndromic groupings, such as sepsis or acute respiratory distress syndrome, we can now classify individual patients according to various specific characteristics, such as immune status. This "personalized" medicine approach will enable us to distinguish patients who have similar clinical presentations but different cellular and molecular responses that will influence their need for and responses (both negative and positive) to specific treatments...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29286945/an-interpretable-machine-learning-model-for-accurate-prediction-of-sepsis-in-the-icu
#13
Shamim Nemati, Andre Holder, Fereshteh Razmi, Matthew D Stanley, Gari D Clifford, Timothy G Buchman
OBJECTIVES: Sepsis is among the leading causes of morbidity, mortality, and cost overruns in critically ill patients. Early intervention with antibiotics improves survival in septic patients. However, no clinically validated system exists for real-time prediction of sepsis onset. We aimed to develop and validate an Artificial Intelligence Sepsis Expert algorithm for early prediction of sepsis. DESIGN: Observational cohort study. SETTING: Academic medical center from January 2013 to December 2015...
December 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29284316/profile-of-genmark-s-eplex%C3%A2-blood-culture-identification-fungal-pathogen-panel
#14
Danièle Maubon, Céline Dard, Cécile Garnaud, Muriel Cornet
Fungemia presents high morbi-mortality and thus rapid microbiological diagnosis may contribute to appropriate patient management. In the last decade, kits based on molecular technologies have become available and health care institutes are increasingly facing critical investment choices. Although all these tools aim to achieve rapid fungal detection and species identification, they display different inherent characteristics. Areas covered: Considering technologies allowing detection and identification of fungal species in a sepsis context, the market proposes either tests on positive blood culture or tests on patient's whole blood...
December 28, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29280926/critical-illness-related-corticosteroid-insufficiency-in-cardiogenic-shock-patients-prevalence-and-prognostic-role
#15
Nicolas Ducrocq, Pascal Biferi, Nicolas Girerd, Ichraq Latar, Simon Lemoine, Pierre Perez, Carine Thivilier, Bruno Levy, Antoine Kimmoun
BACKGROUND: Cardiogenic shock shares with septic shock common hemodynamic features, inflammatory patterns and most likely similar complications such as critical illness-related corticosteroid insufficiency. The aim of this study was to evaluate the prevalence of critical illness-related corticosteroid insufficiency in cardiogenic shock patients and to secondarily assess its prognostic value on 90-day mortality. METHODS: A single-centre prospective observational study conducted over a three-year period and including all patients with cardiogenic shock...
December 26, 2017: Shock
https://www.readbyqxmd.com/read/29251709/benchmarking-clinical-outcomes-and-the-immunocatabolic-phenotype-of-chronic-critical-illness-after-sepsis-in-surgical-intensive-care-unit-patients
#16
Julie A Stortz, Juan C Mira, Steven L Raymond, Tyler J Loftus, Tezcan Ozrazgat-Baslanti, Zhongkai Wang, Gabriela L Ghita, Christiaan Leeuwenburgh, Mark S Segal, Azra Bihorac, Babette A Brumback, Alicia M Mohr, Philip A Efron, Lyle L Moldawer, Frederick A Moore, Scott C Brakenridge
BACKGROUND: A growing number of patients survive sepsis but remain chronically critically ill. We sought to define clinical outcomes and incidence of chronic critical illness (CCI) after sepsis and to determine whether selected biomarkers of inflammation, immunosuppression, and catabolism differ between these patients and those that rapidly recover (RAP). METHODS: This three-year prospective observational cohort study (NCT02276417) evaluated 145 surgical intensive care unit patients with sepsis for the development of CCI (≥14 days of ICU resource utilization with persistent organ dysfunction)...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29248138/pathophysiology-of-aki
#17
REVIEW
Marlies Ostermann, Kathleen Liu
Acute kidney injury (AKI) is common in the perioperative and intensive care setting. Although AKI is usually multifactorial, haemodynamic instability, sepsis and drug toxicity are commonly implicated. Independent of the exact aetiology, several different pathophysiologic processes occur simultaneously and in sequence, including endothelial dysfunction, alteration of the microcirculation, tubular injury, venous congestion and intrarenal inflammation. A multitude of different immune cells from within the kidney and the systemic circulation play a role in the development, maintenance and recovery phase of AKI...
September 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29242524/clinical-implications-of-the-plasma-epha2-receptor-level-in-critically-ill-patients-with-septic-shock
#18
Su Hwan Lee, Ju Hye Shin, Joo Han Song, Ah Young Leem, Moo Suk Park, Young Sam Kim, Joon Chang, Kyung Soo Chung
The Eph/ephrin receptor ligand system is known to play a role in inflammation induced by infection, injury, and inflammatory diseases. The present study aimed to evaluate plasma EphA2 receptor levels in critically ill patients with sepsis. This study was a prospective cohort study evaluating samples and clinical data from the medical intensive care unit (MICU) of a 2000-bed university tertiary referral hospital in South Korea. Positive correlations of the plasma EphA2 receptor level with the acute physiology and chronic health evaluation (APACHE) II score and the sequential organ failure assessment (SOFA) score were observed...
December 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29241382/causes-of-mortality-in-icu-acquired-weakness
#19
Linda van Wagenberg, Esther Witteveen, Luuk Wieske, Janneke Horn
BACKGROUND: Intensive care unit-acquired weakness (ICU-AW) is a common complication of critical illness and is associated with increased mortality, longer mechanical ventilation and longer hospital stay. Little is known about the causes of mortality in patients with ICU-AW. In this study, we aimed to give an overview of the causes of death in a population diagnosed with ICU-AW during hospital admission. METHODS: Data from a prospective cohort study in the mixed medical-surgical ICU of the Academic Medical Center in Amsterdam were used...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29237472/supply-kits-for-antenatal-and-childbirth-care-a-systematic-review
#20
REVIEW
Alicia Aleman, Giselle Tomasso, María Luisa Cafferata, Mercedes Colomar, Ana Pilar Betran
INTRODUCTION: It is critical to increase the uptake of interventions proven to be effective to improve maternal and perinatal outcomes. Supply kits have been suggested to be a feasible strategy designed to ensure timely availability and effective follow-up of care. OBJECTIVE: We conducted a systematic review to summarize the evidence on the uptake, effectiveness and safety of supply kits for maternal care. SEARCH STRATEGY: MEDLINE, the Cochrane Pregnancy and Childbirth Group's Trials Register, Campbell Collaboration, Lilacs, Embase and unpublished studies were searched...
December 13, 2017: Reproductive Health
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