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Definition of sepsis and septic shock

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https://www.readbyqxmd.com/read/29351007/timing-of-renal-support-and-outcome-of-septic-shock-and-acute-respiratory-distress-syndrome
#1
Stéphane Gaudry, David Hajage, Frédérique Schortgen, Laurent Martin-Lefevre, Charles Verney, Bertrand Pons, Eric Boulet, Alexandre Boyer, Guillaume Chevrel, Nicolas Lerolle, Dorothée Carpentier, Nicolas de Prost, Alexandre Lautrette, Anne Bretagnol, Julien Mayaux, Saad Nseir, Bruno Megarbane, Marina Thirion, Jean-Marie Forel, Julien Maizel, Hodane Yonis, Philippe Markowicz, Guillaume Thiery, Florence Tubach, Jean-Damien Ricard, Didier Dreyfuss
RATIONALE: The optimal strategy for initiation of renal replacement therapy (RRT) in patients with severe acute kidney injury in the context of septic shock and acute respiratory distress syndrome (ARDS) is unknown. OBJECTIVE: To examine the effect of an early compared to a delayed RRT initiation strategy on 60-day mortality according to the baseline sepsis status, ARDS status and severity. METHODS: Post-hoc analysis of the AKIKI (Artificial-Kidney-Initiation in Kidney-Injury) trial...
January 19, 2018: American Journal of Respiratory and Critical Care Medicine
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/29320362/predictive-value-of-serum-gelsolin-and-gc-globulin-in-sepsis-a-pilot-study
#3
Zoltán Horváth-Szalai, Péter Kustán, Balázs Szirmay, Ágnes Lakatos, Per Hjort Christensen, Tamás Huber, Beáta Bugyi, Diána Mühl, Andrea Ludány, Attila Miseta, Gábor L Kovács, Tamás Kőszegi
BACKGROUND: Simultaneous determination of the two main actin scavenger proteins in sepsis has not been investigated until now. In our pilot study, we elucidated the predictive values of Gc globulin and gelsolin (GSN) in sepsis by comparing them to classic laboratory and clinical parameters. METHODS: A 5-day follow-up was performed, including 46 septic patients, 28 non-septic patients and 35 outpatients as controls. Serum Gc globulin and GSN levels were determined by automated immune turbidimetric assay on a Cobas 8000/c502 analyzer...
January 10, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29280926/critical-illness-related-corticosteroid-insufficiency-in-cardiogenic-shock-patients-prevalence-and-prognostic-role
#4
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/29227368/septic-cardiomyopathy
#5
Sarah J Beesley, Gerhard Weber, Todd Sarge, Sara Nikravan, Colin K Grissom, Michael J Lanspa, Sajid Shahul, Samuel M Brown
OBJECTIVES: To describe, with an emphasis on clinical applications, what is known about the pathophysiology, management, and implications of septic cardiomyopathy in the adult ICU. DATA SOURCES AND STUDY SELECTION: A PubMed literature review was performed for relevant articles. Only articles in English that studied human adults with sepsis were included. DATA EXTRACTION AND DATA SYNTHESIS: Multiple competing definitions for septic cardiomyopathy hinder understanding of this entity...
December 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29201798/adrenal-insufficiency-in-cirrhosis-patients-evaluation-of-108-case-series
#6
Hali Rakici
Aim: Adrenal insufficiency (AI) in cirrhosis is an issue that has recently gained momentum. It can be seen in both stable and critically ill (sepsis, septic shock, and gastrointestinal system bleeding) cirrhotic patients. Its prevalence exists in a wide range since standardization of diagnostic methods is lacking. We aimed to scrutinize this issue in a 108 case series. Materials and methods: We studied the presence of AI and its stage in patients with cirrhosis and its complications by using cross-sectional study...
July 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29132513/sepsis-and-septic-shock-strategies
#7
REVIEW
Bracken A Armstrong, Richard D Betzold, Addison K May
Three therapeutic principles most substantially improve organ dysfunction and survival in sepsis: early, appropriate antimicrobial therapy; restoration of adequate cellular perfusion; timely source control. The new definitions of sepsis and septic shock reflect the inadequate sensitivity, specify, and lack of prognostication of systemic inflammatory response syndrome criteria. Sequential (sepsis-related) organ failure assessment more effectively prognosticates in sepsis and critical illness. Inadequate cellular perfusion accelerates injury and reestablishing perfusion limits injury...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29121281/epidemiology-of-sepsis-and-septic-shock-in-critical-care-units-comparison-between-sepsis-2-and-sepsis-3-populations-using-a-national-critical-care-database
#8
M Shankar-Hari, D A Harrison, G D Rubenfeld, K Rowan
Background: New sepsis and septic shock definitions could change the epidemiology of sepsis because of differences in criteria. We therefore compared the sepsis populations identified by the old and new definitions. Methods: We used a high-quality, national, intensive care unit (ICU) database of 654 918 consecutive admissions to 189 adult ICUs in England, from January 2011 to December 2015. Primary outcome was acute hospital mortality. We compared old (Sepsis-2) and new (Sepsis-3) incidence, outcomes, trends in outcomes, and predictive validity of sepsis and septic shock populations...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29116997/hospital-differences-drive-antibiotic-delays-for-black-patients-compared-with-white-patients-with-suspected-septic-shock
#9
Stephanie Parks Taylor, Colleen H Karvetski, Megan A Templin, Brice T Taylor
OBJECTIVE: Evaluate racial disparities in sepsis processes of care. DESIGN: Observational cohort study. SETTING: Nine hospitals in the Southeastern United States between 2014 and 2016. PATIENTS: Two thousand two hundred twenty-one white and 707 black patients treated in the emergency department through "code sepsis" pathway for suspected septic shock. MEASUREMENTS AND MAIN RESULTS: Black patients were less likely to receive timely antibiotics than were white patients using multiple definitions (1 hr from code sepsis activation [odds ratio, 0...
February 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29023361/procalcitonin-and-mr-proadrenomedullin-combination-with-sofa-and-qsofa-scores-for-sepsis-diagnosis-and-prognosis-a-diagnostic-algorithm
#10
Silvia Spoto, Eleonora Cella, Marina de Cesaris, Luciana Locorriere, Silvia Mazzaroppi, Edoardo Nobile, Arcangela M Lanotte, Lucia Pedicino, Marta Fogolari, Sebastiano Costantino, Giordano Dicuonzo, Massimo Ciccozzi, Silvia Angeletti
PURPOSE: The third Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as an organ dysfunction consequent to infection. A SOFA score ≥2 identifies sepsis. In this study, PCT and MR-proADM were evaluated along with SOFA and qSOFA scores in patients with sepsis or septic shock. METHODS: One hundred and nine septic patients and 50 patients with non-infectious disease admitted at the Department of Internal Medicine and General Surgery of the University Hospital Campus Bio-Medico of Rome were enrolled...
October 11, 2017: Shock
https://www.readbyqxmd.com/read/28991051/association-between-cardiac-surgery-and-mortality-among-patients-with-infective-endocarditis-complicated-by-sepsis-and-septic-shock
#11
Vladimir Krajinovic, Stipe Ivancic, Petar Gezman, Bruno Barsic
BACKGROUND: Sepsis and septic shock are common presentations of infective endocarditis (IE), but little is known about clinical characteristics in this group of patients, use of surgical treatment, and their associations with outcome. We sought to determine the influence of cardiac surgery (CS) on the outcome of patients with IE in different stages of sepsis severity. METHODS: Two hundred ninety four patients with definite IE native or prosthetic valve IE admitted between 2000 and 2011...
October 4, 2017: Shock
https://www.readbyqxmd.com/read/28980501/correction-to-driessen-et%C3%A2-al-the-influence-of-a-change-in-septic-shock-definitions-on-intensive-care-epidemiology-and-outcome-comparison-of-sepsis-2-and-sepsis-3-definitions
#12
(no author information available yet)
No abstract text is available yet for this article.
October 5, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28953635/sequential-organ-failure-assessment-predicts-outcomes-of-pulse-indicator-contour-continuous-cardiac-output-directed-goal-therapy-a-prospective-study
#13
Wei Zhang, Quzhen Danzeng, Xiaoting Feng, Xing Cao, Weiwei Chen, Yan Kang
According to the new sepsis definitions, septic shock is defined as a subset of sepsis in which the underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. We evaluated the predictive efficacy of the Sequential Organ Failure Assessment (SOFA) score in critically ill patients with septic shock undergoing pulse indicator contour continuous cardiac output (PiCCO)-directed goal therapy (PDGT).We conducted a single-center, prospective, observational study of 52 patients with septic shock undergoing PDGT...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28950786/the-influence-of-a-change-in-septic-shock-definitions-on-intensive-care-epidemiology-and-outcome-comparison-of-sepsis-2-and-sepsis-3-definitions
#14
Rob G H Driessen, Marcel C G van de Poll, Marianne F Mol, Walther N K A van Mook, Ronny M Schnabel
BACKGROUND: Clear definitions for septic shock assist clinicians regarding recognition, treatment and standardized reporting of characteristics and outcome of this entity. Sepsis-3 definition of septic shock incorporates a new criterion, a lactate level >2 mmol/L. Differences in epidemiology and outcome of septic shock based upon both definitions were studied in an intensive care (ICU) population of septic patients. METHODS: We analyzed a prospectively collected cohort of data in the ICU of the Maastricht University Medical Centre...
September 26, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28933172/-development-of-views-on-pathophysiology-of-sepsis
#15
Jiří Beneš
Sepsis was understood as a disease caused by an invasive bacterial infection associated with deluging of organism with bacterial toxins (blood poisoning). Schottmüllers definition emphasized the existence of a focus as the source of invading bacteria. Further research led to the discovery of the cytokine cascade and to the recognition that sepsis is induced by our own endogenous mediators. The dysfunction or failure of various organs in sepsis can be explained both by hemodynamic disorders which originate in the altered microcapillars but also by a complex transformation of metabolism...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28916973/myeloperoxidase-can-differentiate-between-sepsis-and-non-infectious-sirs-and-predicts-mortality-in-intensive-care-patients-with-sirs
#16
Irene T Schrijver, Hans Kemperman, Mark Roest, Jozef Kesecioglu, Dylan W de Lange
BACKGROUND: Systemic inflammatory response syndrome (SIRS) is a clinical syndrome following inflammation. Clinically, it is difficult to distinguish SIRS following an infection, i.e., sepsis, from non-infectious SIRS. Myeloperoxidase is a hemeprotein stored in the neutrophil azurophilic granules and is one of the main pillars of neutrophil attack. Therefore, we hypothesized that myeloperoxidase can differentiate between sepsis and non-infectious SIRS in patients with systemic inflammatory response syndrome in the intensive care unit (ICU)...
September 15, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28903154/incidence-and-trends-of-sepsis-in-us-hospitals-using-clinical-vs-claims-data-2009-2014
#17
COMPARATIVE STUDY
Chanu Rhee, Raymund Dantes, Lauren Epstein, David J Murphy, Christopher W Seymour, Theodore J Iwashyna, Sameer S Kadri, Derek C Angus, Robert L Danner, Anthony E Fiore, John A Jernigan, Greg S Martin, Edward Septimus, David K Warren, Anita Karcz, Christina Chan, John T Menchaca, Rui Wang, Susan Gruber, Michael Klompas
Importance: Estimates from claims-based analyses suggest that the incidence of sepsis is increasing and mortality rates from sepsis are decreasing. However, estimates from claims data may lack clinical fidelity and can be affected by changing diagnosis and coding practices over time. Objective: To estimate the US national incidence of sepsis and trends using detailed clinical data from the electronic health record (EHR) systems of diverse hospitals. Design, Setting, and Population: Retrospective cohort study of adult patients admitted to 409 academic, community, and federal hospitals from 2009-2014...
October 3, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28882016/new-sepsis-criteria-do-they-replace-or-complement-what-is-known-in-the-approach-to-the-infectious-patient
#18
REVIEW
J González Del Castillo, C Clemente, F J Candel, F J Martín-Sánchez
There have recently been profound changes in both the definitions of sepsis and septic shock and the diagnostic criteria established for daily clinical practice. In addition, a new screening tool known as qSOFA has been introduced to identify patients at risk of a poor short-term outcome. This score has been accompanied by some controversy due to presenting a lower sensitivity than the systemic inflammatory response criteria previously used to identify such patients. In this article, we shall summarise and analyse the most important recently published studies in relation to these new criteria...
September 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28876571/duodenectomy-managing-the-fistula
#19
M Govender, O Matsevych, F Ghoor, N Singh, C Molenaar
BACKGROUND: Duodenectomy is rarely indicated, however, in certain circumstances may have be performed. Enterocutaneous fistula (ECF) is the main cause of serious adverse outcomes. Its management remains challenging. METHOD: Two cases of emergency duodenectomy are presented. The management of ECF is described and discussed. RESULTS: Case 1: A 22-year-old male presented in septic shock with perforated duodenal ulcer, suffered two cardiac arrests before index surgery...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28874949/sepsis-definitions-the-search-for-gold-and-what-cms-got-wrong
#20
REVIEW
Annahieta Kalantari, Haney Mallemat, Scott D Weingart
On October 1, 2015, the United States Centers for Medicare and Medicaid Services (CMS) issued a core measure addressing the care of septic patients. These core measures are controversial among healthcare providers. This article will address that there is no gold standard definition for sepsis, severe sepsis or septic shock and the CMS-assigned definitions for severe sepsis and septic shock are premature and inconsistent with evidence-based definitions.
August 2017: Western Journal of Emergency Medicine
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