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Sepsis guidelines

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https://www.readbyqxmd.com/read/29145711/timing-of-antibiotics-in-the-management-of-community-acquired-sepsis-can-a-randomised-controlled-trial-of-prehospital-therapy-provide-answers
#1
Andrew A Udy, Karen Smith, Stephen Bernard
Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. In contrast, microbiological resistance is an ever increasing global problem, with many advocating for a more restricted, culture-driven approach to antibiotic prescription. Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29140968/end-tidal-carbon-dioxide-use-for-tracheal-intubation-analysis-from-the-national-emergency-airway-registry-for-children-near4kids-registry
#2
Melissa L Langhan, Beth L Emerson, Sholeen Nett, Matthew Pinto, Ilana Harwayne-Gidansky, Kyle J Rehder, Conrad Krawiec, Keith Meyer, John S Giuliano, Erin B Owen, Keiko M Tarquinio, Ron C Sanders, Michael Shepherd, Gokul Kris Bysani, Asha N Shenoi, Natalie Napolitano, Sandeep Gangadharan, Simon J Parsons, Dennis W Simon, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVE: Waveform capnography use has been incorporated into guidelines for the confirmation of tracheal intubation. We aim to describe the trend in waveform capnography use in emergency departments and PICUs and assess the association between waveform capnography use and adverse tracheal intubation-associated events. DESIGN: A multicenter retrospective cohort study. SETTING: Thirty-four hospitals (34 ICUs and nine emergency departments) in the National Emergency Airway Registry for Children quality improvement initiative...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29134932/outbreak-of-pichia-kudriavzevii-fungaemia-in-a-neonatal-intensive-care-unit
#3
T Nagarathnamma, Sneha K Chunchanur, Shivaprakash M Rudramurthy, K R Vineetha, Karthik Ramamurthy, Jillwin Joseph, R Ambica
PURPOSE: Fungaemia is associated with substantial morbidity and mortality in neonates admitted to neonatal intensive care units (NICUs). We report an outbreak of fungaemia in a NICU due to rare yeast, Pichia kudriavzevii (a teleomorph of Candida krusei). To the best of our knowledge, this is the first report of neonatal sepsis due to P. kudriavzevii. METHODOLOGY: Between August and September 2014, blood cultures from nine neonates diagnosed with late-onset sepsis in the NICU yielded yeast-like organisms...
November 14, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29125257/improving-door-to-needle-times-for-patients-with-suspected-neutropenic-sepsis
#4
Tracy Wild
Neutropenic sepsis is a potentially life-threatening complication of chemotherapy and has an associated mortality of 2% to 21%. Patients can deteriorate rapidly and are usually advised to attend their local emergency department (ED) for urgent assessment and antibiotic therapy within one hour of arrival. Delivery of this emergency care is, however, inconsistent, and at times suboptimal, due to a lack of awareness of the condition and of clinical expertise. This article discusses a collaborative project between an acute oncology service and an ED, which has improved and sustained compliance with this standard through a range of initiatives, including revised and integrated sepsis guidelines, education, sepsis champions and a fast-track patient pathway...
November 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29119848/management-of-community-acquired-pneumonia-in-immunocompetent-adults-updated-swedish-guidelines-2017
#5
Simon Athlin, Christer Lidman, Anders Lundqvist, Pontus Naucler, Anna C Nilsson, Carl Spindler, Kristoffer Strålin, Jonas Hedlund
Based on expert group work, Swedish recommendations for the management of community-acquired pneumonia in adults are here updated. The management of sepsis-induced hypotension is addressed in detail, including monitoring and parenteral therapy. The importance of respiratory support in cases of acute respiratory failure is emphasized. Treatment with high-flow oxygen and non-invasive ventilation is recommended. The use of statins or steroids in general therapy is not found to be fully supported by evidence. In the management of pleural infection, new data show favourable effects of tissue plasminogen activator and deoxyribonuclease installation...
November 9, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/29112541/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-cardiovascular-and-thoracic-surgery
#6
Aamer B Ahmed, Andreas Koster, Marcus Lance, David Faraoni
: None of the predictive models for venous thromboembolism (VTE) prophylaxis have been designed for and validated in patients undergoing cardiothoracic and vascular surgery. The presence of one or more risk factors [age over 70 years old, transfusion of more than 4 U of red blood cells/fresh frozen plasma/cryoprecipitate, mechanical ventilation lasting more than 24 h, postoperative complication (e.g. acute kidney injury, infection/sepsis, neurological complication)] should place the cardiac population at high risk for VTE...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29110667/a-complex-intervention-to-improve-implementation-of-world-health-organization-guidelines-for-diagnosis-of-severe-illness-in-low-income-settings-a-quasi-experimental-study-from-uganda
#7
Matthew J Cummings, Elijah Goldberg, Savio Mwaka, Olive Kabajaasi, Eric Vittinghoff, Adithya Cattamanchi, Achilles Katamba, Nathan Kenya-Mugisha, Shevin T Jacob, J Lucian Davis
BACKGROUND: To improve management of severely ill hospitalized patients in low-income settings, the World Health Organization (WHO) established a triage tool called "Quick Check" to provide clinicians with a rapid, standardized approach to identify patients with severe illness based on recognition of abnormal vital signs. Despite the availability of these guidelines, recognition of severe illness remains challenged in low-income settings, largely as a result of infrequent vital sign monitoring...
November 6, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29102324/prolonged-versus-short-term-intravenous-infusion-of-antipseudomonal-%C3%AE-lactams-for-patients-with-sepsis-a-systematic-review-and-meta-analysis-of-randomised-trials
#8
Konstantinos Z Vardakas, Georgios L Voulgaris, Athanasios Maliaros, George Samonis, Matthew E Falagas
BACKGROUND: The findings of randomised controlled trials (RCT), observational studies, and meta-analyses vary regarding the effectiveness of prolonged β-lactam infusion. We aimed to identify the effectiveness of prolonged versus short-term infusion of antipseudomonal β-lactams in patients with sepsis. METHODS: We did a systematic review and meta-analysis to compare prolonged versus short-term intravenous infusion of antipseudomonal β-lactams in patients with sepsis...
October 25, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29097178/delayed-versus-early-umbilical-cord-clamping-for-preterm-infants-a-systematic-review-and-meta-analysis
#9
Michael Fogarty, David A Osborn, Lisa Askie, Anna Lene Seidler, Kylie Hunter, Kei Lui, John Simes, William Tarnow-Mordi
OBJECTIVE: To compare the effects of delayed versus early cord clamping on hospital mortality (primary outcome) and morbidity in preterm infants using Cochrane Collaboration Neonatal Review Group methodology. DATA SOURCES: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Chinese articles, cross-referencing citations, expert informants and trial registries to 31 July 2017. STUDY ELIGIBILITY: RCTs of delayed (≥ 30 seconds) vs early (<30 seconds) clamping in infants born <37 weeks gestation...
October 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29096709/strategies-for-preventing-group-b-streptococcal-infections-in-newborns-a-nation-wide-survey-of-italian-policies
#10
Chryssoula Tzialla, Alberto Berardi, Claudio Farina, Pierangelo Clerici, Alessandro Borghesi, Elsa Viora, Paolo Scollo, Mauro Stronati
BACKGROUND: There are no Italian data regarding the strategies for preventing neonatal group B streptococcal (GBS) infection. We conducted a national survey in order to explore obstetrical, neonatal and microbiological practices for the GBS prevention. METHODS: Three distinct questionnaires were sent to obstetricians, neonatologists and microbiologists. Questionnaires included data on prenatal GBS screening, maternal risk factors, intrapartum antibiotic prophylaxis, microbiological information concerning specimen processing and GBS antimicrobial susceptibility...
November 2, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29088995/a-multicenter-survey-of-house-staff-knowledge-about-sepsis-and-the-surviving-sepsis-campaign-guidelines-for-management-of-severe-sepsis-and-septic-shock
#11
Richard R Watkins, Nairmeen Haller, Melinda Wayde, Keith B Armitage
BACKGROUND: We aimed to assess the knowledge, attitudes, and perceptions of resident physicians regarding sepsis in general and the Surviving Sepsis Campaign Guidelines in particular. METHODS: After institutional review board approval, we surveyed internal medicine (IM) and emergency medicine (EM) house staff from 3 separate institutions. House staff were notified of the survey via e-mail from their residency director or chief resident. The survey was Internet-based (using http://www...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29079487/what-is-the-preferred-resuscitation-fluid-for-patients-with-severe-sepsis-and-septic-shock
#12
Michael E Winters, Robert Sherwin, Gary M Vilke, Gabriel Wardi
BACKGROUND: Current guidelines for the management of patients with severe sepsis and septic shock recommend crystalloids as the initial fluid solution of choice in the resuscitation of these patients. In recent years, there have been numerous studies published on the type of fluid used in the resuscitation of patients with sepsis. The primary goal of this article is to determine the preferred intravenous fluid for the resuscitation of patients with severe sepsis and septic shock. METHODS: A MEDLINE literature review was completed to identify studies that investigated the type of resuscitation fluid in the management of patients with severe sepsis and septic shock...
October 24, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29078714/impact-of-a-combination-antibiotic-bag-on-compliance-with-surviving-sepsis-campaign-goals-in-emergency-department-patients-with-severe-sepsis-and-septic-shock
#13
Michael P Lorenzo, Lindsay MacConaghy, Christopher D Miller, Gregory Meola, Luke A Probst, Brian Pratt, Jeff Steele, Robert W Seabury
BACKGROUND: Severe sepsis and septic shock represent common presentations in the emergency department (ED) and have high rates of mortality. Guideline-recommended goals of care have been shown to benefit these patients, but can be difficult to provide. OBJECTIVE: To determine whether the use of a premixed bag consisting of 2 g cefepime and 1 g vancomycin in 1000 mL of normal saline increases the probability of patients receiving Surviving Sepsis Campaign (SSC) recommendations for the initiation of antimicrobials and fluid challenge...
October 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29074716/antimicrobial-resistance-in-uk-neonatal-units-neonin-infection-surveillance-network
#14
Benjamin Cailes, Christina Kortsalioudaki, Jim Buttery, Santosh Pattnayak, Anne Greenough, Jean Matthes, Alison Bedford Russell, Nigel Kennea, Paul T Heath
OBJECTIVE: To define the susceptibilities of the common causative pathogens of neonatal sepsis in the UK. DESIGN: Retrospective analysis of the prospectively collected neonIN infection surveillance network data between 2005 and 2014. SETTING: 30 neonatal units in the UK. PATIENTS: Newborns admitted to participating neonatal units who return a positive blood, cerebrospinal fluid or urine culture and are treated with at least 5 days of appropriate antibiotics...
October 26, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29071855/-analysis-of-reporting-specification-about-sepsis-practice-guideline-based-on-right-standard
#15
Ren-Bo Chen, Yao-Long Chen, Guo-Zhong Gai, Yan-Ming Xie, Yong-Yan Wang
At present, the study of clinical practice guide focuses on the quality of the guide, but not enough attention to the reporting standards of the practice guide, so how to standardize the report is an urgent problem in the field of evidence-based medicine. This paper uses the latest practice guidance reporting tool RIGHT standard, analyzes the latest two sepsis practice guidelines at home and abroad, and found that there are few problems in the basic information, recommendations and other information in 7 major areas, and many deficiencies in background, evidence, review and quality assurance, funding and declaration and management of interests, in particular, domestic guidance...
April 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29065784/effect-of-vancomycin-initial-dosing-on-time-to-systemic-inflammatory-response-syndrome-resolution-in-patients-with-methicillin-resistant-staphylococcus-aureus-bacteremia
#16
Jessica Lynn Wesolek, Kelly McNorton, George Delgado, Christopher Alan Giuliano
Current guidelines suggest using vancomycin-loading doses for complicated infections despite a lack of evidence to support this practice. To address this gap, we performed a single-centre cohort study of 124 patients with sepsis due to methicillin-resistant Staphylococcus aureus bacteremia. Patients were allocated into two groups based on initial dose of vancomycin, <20 mg/kg or ≥20 mg/kg, and evaluated for time to resolution of systemic inflammatory response syndrome (SIRS). Among a cohort of 124 patients, 87 received vancomycin initial doses <20 mg/kg and 37 received ≥20 mg/kg...
October 25, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/29063210/late-onset-sepsis-due-to-urinary-tract-infection-in-very-preterm-neonates-is-not-uncommon
#17
Alexander B Mohseny, Veerle van Velze, Sylke J Steggerda, Vivianne E H J Smits-Wintjens, Vincent Bekker, Enrico Lopriore
Urinary tract infection (UTI) is a common cause of sepsis in infants. Premature infants hospitalized at a neonatal intensive care unit often have risk factors for infection. In this group, the risk of UTI is not clearly known, and guidelines for urine analysis are not unanimous. We aimed to identify the risk of UTI in premature infants with central lines, suspected of late-onset sepsis. We analyzed all 1402 infants admitted to our hospital between 2006 and 2014 with a gestational age less than 32 weeks. Six hundred sixty-two episodes of sepsis evaluations were found with an unknown source of infection based on clinical symptoms...
October 23, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29049422/thoracic-trauma-now-and-then-a-10-year-experience-from-16-773-severely-injured-patients
#18
Klemens Horst, Hagen Andruszkow, Christian D Weber, Miguel Pishnamaz, Christian Herren, Qiao Zhi, Matthias Knobe, Rolf Lefering, Frank Hildebrand, Hans-Christoph Pape
BACKGROUND AND PURPOSE: Thoracic trauma remains to be a relevant injury to the polytraumatised patient. However, literature regarding how far changes in clinical guidelines for pre- and in-hospital trauma management and diagnostic procedures affect the outcome of multiple injured patients with severe chest injury during a long-term observation period is sparse. METHODS: Multiple traumatised patients (age≥16y) documented in the TraumaRegister DGU® (TR-DGU) from January 1st 2005 to December 31st 2014 with severe chest trauma (AIS≥3) were included in this study...
2017: PloS One
https://www.readbyqxmd.com/read/29046941/-sepsis-3-what-has-been-confirmed-in-therapy
#19
REVIEW
S David, F M Brunkhorst
Hugo Schottmüller realized already over 100 years ago that sepsis is a syndrome that occurs as a consequence of an infection defined by a systemic overreaction to a periodic invasion of bacilli. Consistent with this old concept, the term "systemic inflammatory response syndrome" (SIRS) was coined about 25 years ago and has been regularly used ever since. In 2016, a sepsis task force was formed to re-evaluate the current definition on a scientific basis. The task force suggested a third definition (sepsis-3) of the disease that now focuses both on the pathological host response and on organ dysfunction as obligatory key features to diagnose sepsis...
October 18, 2017: Der Internist
https://www.readbyqxmd.com/read/29044341/the-use-of-antimicrobials-in-septic-patients-with-acute-kidney-injury
#20
Fernanda Moreira de Freitas, Welder Zamoner, Durval Sampaio de Souza Garms, Mariele Gobo de Oliveira, André Luis Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and it may be associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administrate antimicrobials in dosis to achieve adequate serum levels, preventing overdosis and drug toxicity or underdosing and risk for resistance to antibiotics and higher mortality. To date, there aren't validated guidelines on antibiotic dosis adjustment in septic patients with AKI and the recommendations are extrapolated from studies conducted in non-critical patients with chronic kidney disease in end stage receiving chronic renal replacement therapy...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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