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Critical care sepsis

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https://www.readbyqxmd.com/read/28542440/plasma-kallistatin-in-critically-ill-patients-with-severe-sepsis-and-septic-shock
#1
Wei-Chieh Lin, Chang-Wen Chen, Lee Chao, Julie Chao, Yee-Shin Lin
Kallistatin, an endogenous serine proteinase inhibitor, is protective against sepsis in animal models. The aim of this study was to determine the plasma concentration of kallistatin in intensive care unit (ICU) patients with severe sepsis and septic shock and to determine their potential correlation with disease severity and outcomes. We enrolled 86 ICU patients with severe sepsis and septic shock. Their plasma concentrations of kallistatin, kallikrein, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-8 were measured by enzyme-linked immunosorbent assay...
2017: PloS One
https://www.readbyqxmd.com/read/28529913/critical-care-management-and-intensive-care-unit-outcomes-following-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#2
Sumit Kapoor, Adel Bassily-Marcus, Rafael Alba Yunen, Parissa Tabrizian, Sabrine Semoin, Joseph Blankush, Daniel Labow, John Oropello, Anthony Manasia, Roopa Kohli-Seth
AIM: To study the early postoperative intensive care unit (ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Our study is a retrospective, observational study performed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28524040/-a-case-of-the-severe-human-infection-by-avian-influenza-h7n9-was-rescued-successfully-by-the-sepsis-bundle
#3
Shaohong Wang, Jintao Liu, Haili Luo, Xianguo Pan, Tongmei Yuan, Xuemei Long
One confirmed diagnosis case of severe human infection by avian influenza H7N9 admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Guizhou Medical University on January 12th, 2017 was reported. The patient was treated with the sepsis bundle, and recovered finally, including a series of comprehensive treatments, such as respiratory support, circulation support, antiviral, anti-inflammation, immunization enhancement, critical nursing, fluid management, nutritional support and treatment of complications...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28521598/malnutrition-critical-illness-survivors-and-postdischarge-outcomes-a-cohort-study
#4
Kris M Mogensen, Clare M Horkan, Steven W Purtle, Takuhiro Moromizato, James D Rawn, Malcolm K Robinson, Kenneth B Christopher
BACKGROUND: We hypothesized that preexisting malnutrition in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed an observational cohort study in 1 academic medical center in Boston. We studied 23,575 patients, aged ≥18 years, who received critical care between 2004 and 2011 and survived hospitalization. RESULTS: The exposure of interest was malnutrition determined at intensive care unit (ICU) admission by a registered dietitian using clinical judgment and on data related to unintentional weight loss, inadequate nutrient intake, and wasting of muscle mass and/or subcutaneous fat...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28520694/metabolic-inflammatory-complex-in-sepsis-septic-cachexia-as-a-novel-potential-therapeutic-target
#5
Masao Kaneki
Despite several decades of focused investigation, sepsis remains a major cause of mortality in critically ill patients. Advancements in intensive care have enabled more patients to survive the acute phase of sepsis than previously, but a growing number of them progress to chronic critical illness. The failure of previous randomized clinical trials of anti-inflammatory agents to show any pro-survival benefit in septic patients underscores current thought that simple anti-inflammatory strategies are ineffective because the inhibitory effect of anti-inflammatory agents undermines the immune response to pathogens...
May 17, 2017: Shock
https://www.readbyqxmd.com/read/28518095/use-of-a-central-venous-line-for-fluids-drugs-and-nutrient-administration-in-a-mouse-model-of-critical-illness
#6
Sarah Derde, Steven Thiessen, Chloë Goossens, Thomas Dufour, Greet Van den Berghe, Lies Langouche
This protocol describes a centrally catheterized mouse model of prolonged critical illness. We combine the cecal ligation and puncture method to induce sepsis with the use of a central venous line for fluids, drugs and nutrient administration to mimic the human clinical setting. Critically ill patients require intensive medical support in order to survive. While the majority of patients will recover within a few days, about a quarter of the patients need prolonged intensive care and are at high risk of dying from non-resolving multiple organ failure...
May 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28515603/correlation-of-serum-vitamin-d-level-with-mortality-in-patients-with-sepsis
#7
Prakash Vipul, Consul Shuchi, Agarwal Avinash, Gutch Manish, Kumar Sukriti, Prakash Ved
BACKGROUND: Sepsis is the leading cause of mortality in the critically ill. Recently, it has been found in many studies that many trace elements and nutrients do have an effect on human body and if supplemented can improve the prognosis in patients with sepsis. AIM AND OBJECTIVES: Primary objective: Whether low Vitamin D is associated with mortality. Secondary objective: To find out association of low Vitamin D levels and morbidity in terms of length of hospital and Intensive Care Unit (ICU) stay...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28509730/american-college-of-critical-care-medicine-clinical-practice-parameters-for-hemodynamic-support-of-pediatric-and-neonatal-septic-shock
#8
Alan L Davis, Joseph A Carcillo, Rajesh K Aneja, Andreas J Deymann, John C Lin, Trung C Nguyen, Regina S Okhuysen-Cawley, Monica S Relvas, Ranna A Rozenfeld, Peter W Skippen, Bonnie J Stojadinovic, Eric A Williams, Tim S Yeh, Fran Balamuth, Joe Brierley, Allan R de Caen, Ira M Cheifetz, Karen Choong, Edward Conway, Timothy Cornell, Allan Doctor, Marc-Andre Dugas, Jonathan D Feldman, Julie C Fitzgerald, Heidi R Flori, James D Fortenberry, Ana Lia Graciano, Bruce M Greenwald, Mark W Hall, Yong Yun Han, Lynn J Hernan, Jose E Irazuzta, Elizabeth Iselin, Elise W van der Jagt, Howard E Jeffries, Saraswati Kache, Chhavi Katyal, Niranjan Tex Kissoon, Alexander A Kon, Martha C Kutko, Graeme MacLaren, Timothy Maul, Renuka Mehta, Fola Odetola, Kristine Parbuoni, Raina Paul, Mark J Peters, Suchitra Ranjit, Karin E Reuter-Rice, Eduardo J Schnitzler, Halden F Scott, Adalberto Torres, Jacki Weingarten-Abrams, Scott L Weiss, Jerry J Zimmerman, Aaron L Zuckerberg
OBJECTIVES: The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shock." DESIGN: Society of Critical Care Medicine members were identified from general solicitation at Society of Critical Care Medicine Educational and Scientific Symposia (2006-2014)...
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28508384/endoscopic-management-of-benign-esophageal-ruptures-and-leaks
#9
REVIEW
Milena Di Leo, Roberta Maselli, Elisa Chiara Ferrara, Laura Poliani, Sameer Al Awadhi, Alessandro Repici
Esophageal leaks (EL) and ruptures (ER) are rare conditions associated with a high risk of mortality and morbidity. Historically, EL and ER have been surgically treated, but current treatment options also include conservative management and endoscopy. Over the last decades, interventional endoscopy has evolved as an effective and less invasive alternative to primary surgery in these cases. A variety of techniques are currently available to re-establish the continuity of the digestive tract, prevent or treat infection related to the leak/rupture, prevent further contamination, drain potential collections, and provide nutritional support...
May 15, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28506711/screening-for-sepsis-in-general-hospitalised-patients-a-systematic-review
#10
REVIEW
Laura Alberto, Andrea P Marshall, Rachel Walker, Leanne M Aitken
INTRODUCTION: Sepsis is a common condition observed outside critical care areas. The purpose of this review was to examine the application of sepsis screening tools for early recognition of sepsis in general hospitalised patients to: (i) identify the accuracy of these tools; (ii) determine the outcomes associated with their implementation and; (iii) describe the implementation process. METHOD: A systematic review method was used. PubMed, CINAHL, COCHRANE, SCOPUS, Web of Science and EMBASE databases were systematically searched for primary articles, published from January 1990 to June 2016, that investigated screening tools or alert mechanisms for early identification of sepsis in adult general hospitalized patients...
May 12, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28505020/the-role-of-thioredoxin-1-in-suppression-sepsis-through-inhibiting-mitochondrial-induced-apoptosis-in-spleen
#11
Guobing Chen, Xiang Li, Mengbing Huang, Xiaoshuang Zhou, Ye Li, Xiaoqin Mao, Jie Bai
Sepsis is a serious public health issue and the leading cause of death in critically ill patients in intensive care units. Thioredoxin-1 (Trx-1) is a protein of regulating redox, as well as a modulator of inflammation and apoptosis. Our previous study reported that Trx-1 decreased endoplasmic reticulum-mediated inflammation involved in lung in a model of experimental sepsis. However, its effect on mitochondrial-mediated apoptosis in spleen has not been reported. We studied whether Trx-1 could prevent spleen cells apoptosis in sepsis...
June 2017: Shock
https://www.readbyqxmd.com/read/28491923/risk-factors-for-death-in-bangladeshi-children-under-5-years-of-age-hospitalized-for-diarrhea-and-severe-respiratory-distress-in-an-urban-critical-care-ward
#12
Tahmina Alam, Tahmeed Ahmed, Monira Sarmin, Lubaba Shahrin, Farzana Afroze, Sharifuzzaman, Shamima Akhter, K M Shahunja, Abu Sadat Mohammad Sayeem Bin Shahid, Pradip Kumar Bardhan, Mohammod Jobayer Chisti
Children with diarrhea hospitalized for respiratory distress often have fatal outcome in resource-limited settings, although data are lacking on risk factors for death in such children. We sought to evaluate clinical predictors for death in such children. In this prospective cohort study, we enrolled under-5 children with diarrhea admitted with severe respiratory distress to the intensive care unit of Dhaka Hospital of International Centre for Diarhoeal Disease Research, Bangladesh, from September 2014 through September 2015...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28487809/the-level-of-oxidative-neutrophil-response-when-determining-endotoxin-activity-assay-a-new-biomarker-for-defining-the-indications-and-effectiveness-of-intensive-care-in-patients-with-sepsis
#13
Michael Yaroustovsky, Ekaterina Rogalskaya, Marina Plyushch, Ludmila Klimovich, Nataliya Samsonova, Marina Abramyan
Background. To analyse the clinical informativity of the neutrophil oxidative response level ("Response") during an Endotoxin Activity Assay (EAA) as a new biomarker defining the indications and effectiveness of intensive care in cardiac surgical patients with septic complications. Methods. Blood samples were taken from 198 adult patients who were admitted to the ICU after cardiac surgery (SIRS: 34, MODS: 36, and sepsis: 128). The composite of laboratory studies included CRP, PCT, EAA with "Response" level, and presepsin...
2017: International Journal of Inflammation
https://www.readbyqxmd.com/read/28487003/examining-the-utility-of-the-hamilton-early-warning-scores-hews-at-triage-retrospective-pilot-study-in-a-canadian-emergency-department
#14
Steven Skitch, Benjamin Tam, Michael Xu, Laura McInnis, Anthony Vu, Alison Fox-Robichaud
OBJECTIVES: Early warning scores use vital signs to identify patients at risk of critical illness. The current study examines the Hamilton Early Warning Score (HEWS) at emergency department (ED) triage among patients who experienced a critical event during their hospitalization. HEWS was also evaluated as a predictor of sepsis. METHODS: The study population included admissions to two hospitals over a 6-month period. Cases experienced a critical event defined by unplanned intensive care unit admission, cardiopulmonary resuscitation, or death...
May 10, 2017: CJEM
https://www.readbyqxmd.com/read/28484052/chronic-critical-illness-from-sepsis-is-associated-with-an-enhanced-tcr-response
#15
Farina Borken, Robby Markwart, Robert P Requardt, Katja Schubert, Michal Spacek, Miroslav Verner, Stefan Rückriem, André Scherag, Frank Oehmichen, Frank M Brunkhorst, Ignacio Rubio
Sepsis is characterized by a disproportionate host response to infection that often culminates in multiple organ failure. Current concepts invoke a deregulated immune reaction involving features of hyperinflammation, as well as protracted immune suppression. However, owing to the scarcity of human data, the precise origin of a long-term suppression of adaptive immunity remains doubtful. We report on an explorative clinical study of chronic critical illness (CCI) patients aimed at assessing the long-term consequences of sepsis on T cell function...
May 8, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28472045/persistent-low-serum-zinc-is-associated-with-recurrent-sepsis-in-critically-ill-patients-a-pilot-study
#16
Janine Hoeger, Tim-Philipp Simon, Thorben Beeker, Gernot Marx, Hajo Haase, Tobias Schuerholz
Zinc is an essential trace element for both pathogens and hosts. Hypozincemia is a well known phenomenon in sepsis patients and represents the innate immune systems attempt to deprive pathogens of zinc. However little is known about course, restitution and prognostic value of serum zinc levels in sepsis patients. We performed a prospective observational single-center study set in a tertiary care university hospital intensive care unit. Serum zinc levels were singularly measured of healthy controls and sequentially of surgical sepsis patients and surgical patients over a 8-day period...
2017: PloS One
https://www.readbyqxmd.com/read/28469892/chasing-the-golden-hour-lessons-learned-from-improving-initial-neutropenic-sepsis-management
#17
Caroline Forde, Paula Scullin
Neutropenic sepsis remains a time critical and potentially fatal complication of systemic anti-cancer therapy. A target 'door to needle' time of one hour for first dose empirical intravenous antibiotics continues to be promoted nationally. A baseline audit (June 2011) highlighted shortfalls in care in the Belfast Trust, with only 15% of patients receiving antibiotics within sixty minutes. A multi-professional group within the Trust was established to try and initiate the improvements in neutropenic sepsis recognition and initial management that were urgently required...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28466289/-personalised-pharmacotherapy-in-intensive-care-unit-patients
#18
R Bellmann
Critically ill patients need fast, effective and safe pharmacotherapy. The pharmacokinetics and pharmacodynamics of the administered drugs are influenced by numerous individual conditions. Genetic factors mainly determines drug metabolism. However, therapeutic decisions are not yet guided by genetic analyses. In elderly patients, the volume of distribution can be altered and renal elimination may be delayed. Drug-drug interactions involving current medications can increase the incidence of adverse effects from treatment in the intensive care unit...
May 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28464841/the-impact-of-continuous-renal-replacement-therapy-on-renal-outcomes-in-dialysis-requiring-acute-kidney-injury-may-be-related-to-the-baseline-kidney-function
#19
Marisa Aparecida de Souza Oliveira, Thais Oliveira Claizoni Dos Santos, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão
BACKGROUND: Many controversies exist regarding the management of dialysis-requiring acute kidney injury (D-AKI). No clear evidence has shown that the choice of dialysis modality can change the survival rate or kidney function recovery of critically ill patients with D-AKI. METHODS: We conducted a retrospective study investigating patients (≥16 years old) admitted to an intensive care unit with D-AKI from 1999 to 2012. We analyzed D-AKI incidence, and outcomes, as well as the most commonly used dialysis modality over time...
May 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28452907/in-a-mouse-model-of-sepsis-hepcidin-ablation-ameliorates-anemia-more-effectively-than-iron-and-erythropoietin-treatment
#20
Eeman Khorramian, Eileen Fung, Kristine Chua, Victoria Gabayan, Tomas Ganz, Elizabeta Nemeth, Airie Kim
Intensive Care Unit (ICU) anemia is an extreme version of anemia of inflammation (AI) that occurs commonly in critically ill patients and is associated with increased morbidity and mortality. Currently available therapies for ICU anemia have shown inconsistent efficacies in clinical trials. We conducted a systematic study of the effects of early versus delayed iron (Fe) and/or erythropoietin (EPO) therapy in our previously characterized mouse model of ICU anemia based on an injection of heat-killed Brucella abortus (BA)...
April 27, 2017: Shock
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