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Sepsis guidelines

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https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#1
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29780599/perioperative-blood-transfusion-is-associated-with-post-operative-infectious-complications-in-patients-with-crohn-s-disease
#2
Nan Lan, Luca Stocchi, Yi Li, Bo Shen
Background: We have previously demonstrated that blood transfusion (BT) was associated with post-operative complications in patients undergoing surgery for Crohn's disease (CD), based on our institutional data registry. The aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Methods: All CD patients undergoing surgery between 2005 and 2013 were identified from NSQIP...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29771353/predictors-for-identifying-burn-sepsis-and-performance-versus-existing-criteria
#3
David M Hill, Matthew D Percy, Sai R Velamuri, Julio Lanfranco, Ivan Romero Legro, Scott E Sinclair, William L Hickerson
Sepsis is the largest cause of mortality in thermally injured patients. Traditional SIRS criteria do not aid diagnosis of sepsis in burn centers. Studies have attempted identification of the best indicators of sepsis in the thermal injured patient, but predictive variables are inconsistent across the various studies. Currently, consensus guidelines lack evidential support as to which patients will benefit most from prompt antimicrobial therapy. The purpose of our study was to evaluate novel diagnostic parameters for thermal injured patients with known sepsis and compare these parameters with existing diagnostic criteria...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29766208/-adequate-anti-infective-treatment-importance-of-individual-dosing-and-application
#4
A Brinkmann, A C Röhr, A Köberer, T Fuchs, W A Krüger, C König, D Richter, M A Weigand, O R Frey
Sepsis-induced changes in pharmacokinetic parameters are a well-known problem in intensive care medicine. Dosing of antibiotics in this setting is therefore challenging. Alterations to the substance-specific kinetics of anti-infective substances have an effect on the distribution and excretion processes in the body. Increased clearance and an increased distribution volume (Vd ) and particularly compromized organ function with reduced antibiotic elimination are often encountered in patients with sepsis. Renal replacement treatment, which is frequently used in intensive care medicine, represents a substantial intervention in this system...
May 15, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29749778/barriers-to-implementing-the-sepsis-six-guidelines-in-an-acute-hospital-setting
#5
Sarah-Jane Breen, Sharon Rees
AIM: To identify the barriers to implementation of the Sepsis Six pathway. BACKGROUND: Research has suggested that compliance with the Sepsis Six pathway remains low. METHODS: A convenience sample of doctors and nurses from one emergency department, two medical wards and two surgical wards were asked to complete a survey questionnaire. RESULTS: Data from 108 respondents were available for analysis. Doctors and nurses agreed that lack of sepsis recognition during observation rounds and failure to associate sepsis with deranged temperature and blood results acted as barriers to the identification of sepsis...
May 10, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29740793/immune-checkpoint-receptors-homeostatic-regulators-of-immunity
#6
REVIEW
Antonio Riva, Shilpa Chokshi
Alcoholic liver disease (ALD) is an escalating global problem accounting for more than 3 million deaths annually. Bacterial infections are diagnosed in 25-47% of hospitalized patients with cirrhosis and represent the most important trigger for acute decompensation, multi-organ failure, septic shock and death. Current guidelines recommend intensive antibiotic therapy, but this has led to the emergence of multi-drug resistant bacteria, which are associated with increased morbidity and mortality rates. As such, there is a pressing need to explore new paradigms for anti-infective therapy and host-directed immunomodulatory therapies are a promising approach...
May 8, 2018: Hepatology International
https://www.readbyqxmd.com/read/29740065/comparison-of-first-line-and-second-line-terlipressin-versus-sole-norepinephrine-in-fulminant-ovine-septic-shock
#7
Tim G Kampmeier, Philip H Arnemann, Michael Hessler, Laura M Seidel, Karsten Becker, Andrea Morelli, Sebastian W Rehberg, Christian Ertmer
The Surviving Sepsis Guidelines suggest the use of vasopressin in case of catecholamine-refractory septic shock. Terlipressin (TP) as a V1 -selective AVP analogue is a potential alternative, though data regarding the first-line administration in septic shock are scarce. The present study explored and compared the effects of first-line vs. second-line infusion of TP or sole norepinephrine regarding organ function, fluid and norepinephrine requirements and survival in fulminant ovine septic shock. Peritoneal sepsis was induced in 23 ewes after laparotomy and faecal withdrawal from the caecum...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29727522/development-of-a-short-course-on-management-of-critically-ill-patients-with-acute-respiratory-infection-and-impact-on-clinician-knowledge-in-resource-limited-icus
#8
Janet V Diaz, Justin R Ortiz, Paula Lister, Nahoko Shindo, Neill K J Adhikari
BACKGROUND: The 2009 influenza A (H1N1) pandemic caused surges of patients in intensive care units (ICUs) in resource-limited settings. Several Ministries of Health requested clinical management guidance from the World Health Organization (WHO), which had not previously developed guidance regarding critically ill patients. OBJECTIVE: To assess the acceptability and impact on knowledge of a short course about the management of critically ill patients with acute respiratory infections complicated by sepsis or acute respiratory distress syndrome delivered to clinicians in resource-limited ICUs...
May 4, 2018: Influenza and Other Respiratory Viruses
https://www.readbyqxmd.com/read/29727410/improved-diagnosis-and-treatment-of-bone-and-joint-infections-using-an-evidence-based-treatment-guideline
#9
Rachel D Quick, John Williams, Marisol Fernandez, Hilton Gottschalk, Peter Cosgrove, Kyle Kahlden, Kathryn Merkel, Lynn Thoreson, Patrick Boswell, Sarmistha B Hauger
BACKGROUND: Our institution created a multidisciplinary guideline for treatment of acute hematogenous osteomyelitis (AHO) and septic arthritis (SA) in response to updates in evidence-based literature in the field and existing provider variability in treatment. This guideline aims to improve the care of these patients by standardizing diagnosis and treatment and incorporating up to date evidence-based research into practice. The primary objective of this study is to compare cases before versus after the implementation of the guideline to determine concrete effects the guideline has had in the care of patients with AHO and SA...
May 2, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29699503/comparison-of-the-incidence-clinical-features-and-outcomes-of-invasive-candidiasis-in-children-and-neonates
#10
Jen-Fu Hsu, Mei-Yin Lai, Chiang-Wen Lee, Shih-Ming Chu, I-Hsyuan Wu, Hsuan-Rong Huang, I-Ta Lee, Ming-Chou Chiang, Ren-Huei Fu, Ming-Horng Tsai
BACKGROUND: Invasive candidiasis differs greatly between children and neonates. We aimed to investigate the different therapeutic approaches and their effects on treatment outcomes of these two groups. METHODS: Episodes of neonatal invasive candidiasis were compared with non-neonatal pediatric episodes during a 12-year cohort study. Clinical isolates were documented by matrix-assisted laser desorption/ionization-time of flight mass spectrometry and DNA sequencing, and antifungal susceptibility testing was performed...
April 24, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29697828/feasibility-and-efficacy-of-sepsis-management-guidelines-in-a-pediatric-intensive-care-unit-in-saudi-arabia-a-quality-improvement-initiative
#11
Gamal M Hasan, Ayman A Al-Eyadhy, Mohamed-Hani A Temsah, Ali A Al-Haboob, Mohammad A Alkhateeb, Fahad Al-Sohime
Objectives: Evaluation of feasibility and effectiveness of Surviving Sepsis Campaign (SSC) Guidelines implementation at a Pediatric Intensive Care Unit (PICU) in Saudi Arabia to reduce severe sepsis associated mortality. Design: Retrospective data analysis for a prospective quality improvement (QI) initiative. Settings: PICU at King Saud University Medical City, Saudi Arabia. Participants: Children ≤14 years of age admitted to the PICU from July 2010 to March 2011 with suspected or proven sepsis...
April 25, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29686180/chromobacterium-violaceum-the-deadly-sepsis
#12
Guntur Darmawan, R N Yasmin Kusumawardhani, Bachti Alisjahbana, Trinugroho Heri Fadjari
Chromobacterium violaceum is a Gram-negative facultatively anaerobic, oxidase-positive bacterium producing a dark violet antioxidant pigment called violacein. It is an opportunistic pathogen and has an ubiquitous distribution, mainly resides in water and soil of tropical and subtropical regions.An-18-year-old man referred to the emergency room with a 5-day history of progressively worsening swelling of the right cheek. He sought consult and hospitalized at another institution for three days prior this admission; however, his condition deteriorated...
January 2018: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29684391/a-randomized-control-trial-of-preoperative-prophylactic-antibiotics-prior-to-percutaneous-nephrolithotomy-in-low-infectious-risk-population-a-report-from-the-edge-consortium
#13
Ben H Chew, Nicole L Miller, Joel E Abbott, Dirk Lange, Mitchell R Humphreys, Vernon M Pais, Manoj Monga, Amy E Krambeck, Roger L Sur
INTRODUCTION: Single institution studies suggest a benefit of a week of preoperative antibiotics prior to percutaneous nephrolithotomy (PCNL). These studies are limited by lower quality methodology such as the inclusion of heterogeneous populations or the use of non-standard definitions of sepsis. The American Urological Association (AUA) Best Practice Statement recommends <24 hours of IV antibiotics, but no other data exist about the duration/benefit of preoperative antibiotics. We sought to perform a rigorous (using CONSORT guidelines), multi-institutional trial to assess preoperative antibiotics in PCNL patients at low risk of developing infections...
April 20, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29678565/simplification-of-first-line-antibacterial-regimen-for-complicated-appendicitis-in-children-was-associated-with-better-adherence-to-guidelines-and-reduced-use-of-antibiotics
#14
Marion Taleb, Nicolas Nardi, Alexis Arnaud, Nathalie Costet, Pierre-Yves Donnio, Charlotte Engrand, Edouard Habonimana, Eric Wodey, Pierre Tattevin
Acute appendicitis in children requires early surgery, and a short course of antibiotics active on Enterobacteriaceae and anaerobes. Although aminoglycoside-containing 3-drug regimen have been used successfully for decades, simpler regimens with similar efficacy are increasingly used. We aimed to evaluate the impact of a switch from the combination of cefotaxime, metronidazole, and gentamicin (regimen 1), to piperacillin-tazobactam (regimen 2), as first-line regimen for complicated acute appendicitis in children...
April 17, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29678190/neonatal-and-congenital-malaria-a-case-series-in-malaria-endemic-eastern-uganda
#15
Peter Olupot-Olupot, Emma I E Eregu, Ketty Naizuli, Julie Ikiror, Linda Acom, Kathy Burgoine
BACKGROUND: Congenital malaria is the direct infection of an infant with malaria parasites from their mother prior to or during birth. Neonatal malaria is due to an infective mosquito bite after birth. Neonatal and congenital malaria (NCM) are potentially life-threatening conditions that are believed to occur at relatively low rates in malaria endemic regions. However, recent reports suggest that the number of NCM cases is increasing, and its epidemiology remains poorly described. NCM can mimic other neonatal conditions and because it is thought to be rare, blood film examinations for malaria are not always routinely performed...
April 20, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29675402/poor-compliance-with-sepsis-guidelines-in-a-tertiary-care-children-s-hospital-emergency-room
#16
Benjamin Louis Moresco, Clinton Woosley, Morris Sauter, Utpal Bhalala
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29674562/newborn-early-onset-sepsis-guidelines-the-not-so-simple-truth
#17
Julie H Shakib
No abstract text is available yet for this article.
April 19, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29674201/placental-histopathological-lesions-in-correlation-with-neonatal-outcome-in-preeclampsia-with-and-without-severe-features
#18
Eran Weiner, Ohad Feldstein, Liliya Tamayev, Ehud Grinstein, Elad Barber, Jacob Bar, Letizia Schreiber, Michal Kovo
OBJECTIVE: We aimed to compare pregnancy outcome and placental histopathology in women with preeclampsia (PE) with and without severe features. METHODS: The medical records and placental pathology reports of all pregnancies complicated by PE during 2008-2016, were reviewed. Results were compared between those with and without severe features (severe PE vs. mild PE groups), according to current ACOG guidelines. Placental lesions were classified to maternal/fetal vascular supply lesions, and maternal/fetal inflammatory responses...
February 7, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#19
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29670404/evaluation-of-vancomycin-therapy-in-the-adult-icus-of-a-teaching-hospital-in-southern-iran
#20
Afsaneh Vazin, Motahare Mahi Birjand, Masoud Darake
Background: Vancomycin resistance in intensive care units (ICUs) accounts for significant morbidity and excess costs. The objective of the present study was to determine the appropriateness of vancomycin use in the various ICUs of Nemazee Hospital, Shiraz, Iran. Methods: This prospective study was performed on 95 critically ill patients (48 males and 47 females) who were treated with vancomycin for at least 3 subsequent doses in 6 ICUs during 12 months. Required demographic, clinical, and paraclinical data were collected by a pharmacist...
2018: Drug, Healthcare and Patient Safety
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