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Severe sepsis,sepsis ,septic shock

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https://www.readbyqxmd.com/read/29162885/an-increased-chloride-level-in-hypochloremia-is-associated-with-decreased-mortality-in-patients-with-severe-sepsis-or-septic-shock
#1
Hyung Jung Oh, Seung Jun Kim, Yong Chan Kim, Eun Jin Kim, In Young Jung, Dong Hyun Oh, Su Jin Jeong, Nam Su Ku, Sang Hoon Han, Jun Yong Choi, Young Goo Song, Dong-Ryeol Ryu, June Myung Kim
Only a few observational studies investigated the association between hypochloremia and mortality in critically ill patients, and these studies included small number of septic patients. Also, no study has evaluated the effect of an increase in chloride (Cl(-)) concentration in hypochloremia on the mortality. A total of 843 Korean septic patients were divided into three groups based on their baseline Cl(-) level, and Cox analyses were performed to evaluate the 28-day mortality. Moreover, the change in Cl(-) level (ΔCl) from baseline to 24, 48, or 72 hour was determined, and Cox analyses were also conducted to evaluate the relationship of ΔCl with mortality...
November 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29138849/elevated-serum-levels-of-lipoprotein%C3%A2-associated-phospholipase%C3%A2-a2-predict-mortality-rates-in-patients-with-sepsis
#2
Zhongwei Huang, Haiyan Jiang, Xiaohui Cui, Guiwen Liang, Yu Chen, Ting Wang, Zhichao Sun, Lei Qi
Sepsis remains one of the leading contributors to mortality rates in the intensive care unit (ICU) and emergency intensive care unit (EICU). Therefore, any treatments against the agents which produce sepsis in a medical emergency, are welcome. Elevated serum levels of lipoprotein‑associated phospholipase A2 (Lp‑PLA2) have been reported in a small cohort of patients with inflammation. The present study evaluated serum levels of Lp‑PLA2 in patients with sepsis and investigated the role of Lp‑PLA2 in sepsis...
November 13, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#3
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137405/necroptosis-regulated-proteins-expression-is-an-early-prognostic-biomarker-in-patient-with-sepsis-a-prospective-observational-study
#4
Bing Wang, Jian Li, Hong-Mei Gao, Ying-Hong Xing, Zhu Lin, Hong-Jie Li, Yong-Qiang Wang
Background and aim: Increasing researchers indicate that necroptosis is playing an important role in the regulation of systemic inflammatory response syndrome. The current study was to investigate the prognostic biomarker of the regulated proteins of necroptosis in sepsis patients. Results: One hundred and twenty-four patients were divided into three groups: 43 patients (34.68%) with sepsis, 39 patients (31.45%) with severe sepsis, and 42 patients (33.87%) with septic shock...
October 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/29136126/risk-of-subsequent-sepsis-within-90-days-of-a-previous-hospital-stay-by-type-of-antibiotic-exposure
#5
James Baggs, Johm A Jernigan, Alison Laufer Halpin, Lauren H Epstein, Kelly M Hatfield, L Clifford McDonald
Background: We examined the risk of sepsis within 90 days after discharge from a previous hospital stay by type of antibiotic received during the previous stay. Methods: We retrospectively identified a cohort of hospitalized patients from the Truven Health MarketScan Hospital Drug Database. We examined the association between the use of certain antibiotics, determined a priori, during the initial hospital stay and risk of post-discharge sepsis controlling for potential confounding factors in a multivariable logistic regression model...
November 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29133071/red-blood-cell-distribution-width-is-associated-with-mortality-in-elderly-patients-with-sepsis
#6
An-Yi Wang, Hon-Ping Ma, Wei-Fong Kao, Shin-Han Tsai, Cheng-Kuei Chang
INTRODUCTION: RDW is a prognostic biomarker and associated with mortality in cardiovascular disease, stroke and metabolic syndrome. For elderly patients, malnutrition and multiple comorbidities exist, which could affect the discrimination ability of RDW in sepsis. The main purpose of our study was to evaluate the prognostic value of RDW in sepsis among elderly patients. METHODS: This was a retrospective cohort study conducted in emergency department intensive care units (ED-ICU) between April 2015 and November 2015...
November 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29133025/perivalvular-mitral-abscess-fistulised-to-the-pericardial-cavity-revealing-staphylococcal-endocarditis
#7
Paul Desaint, Anthony Chauvat, Thomas Garaud, Olivier Andremont, Gaëtan Plantefève, Hervé Mentec, Damien Contou
BACKGROUND: Fistula to the pericardial cavity is a very rare complication of perivalvular abscess during infective endocarditis, with Staphylococcus aureus being the most commonly associated microorganism. METHODS: We report a fatal septic shock due to a mitral endocarditis revealed by a myocardial abscess fistulised toward the pericardial cavity. RESULTS: A 66-year-old female without previous valvular disease was admitted to intensive care for severe sepsis...
October 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29131318/a-critical-role-of-pentraxin-3-in-severe-sepsis-and-septic-shock
#8
Federico Carbone, Fabrizio Montecucco, Fabio Rigamonti
As already done in the past three years, the Council of the European Society of Clinical Investigation (ESCI) will award at the next Scientific Meeting in Barcelona (May 30(th) -Juin 1(st) 2018) the best clinical research article published in the European Journal of Clinical Investigation (EJCI) from November 2016 to October 2017. In the final selection round, five clinical articles were selected based on their outstanding scientific value [1-5]. Among those finalists, the article by Caironi and co-workers obtained the highest consideration and was selected as the winner of the 2018 ESCI Award for the Best EJCI Basic Research Article [3]...
November 13, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29126416/adjunctive-use-of-physostigmine-salicylate-anticholium%C3%A2-in-perioperative-sepsis-and-septic-shock-study-protocol-for-a-randomized-double-blind-placebo-controlled-monocentric-trial-anticholium%C3%A2-per-se
#9
Johannes B Zimmermann, Nadine Pinder, Thomas Bruckner, Monika Lehmann, Johann Motsch, Thorsten Brenner, Torsten Hoppe-Tichy, Stefanie Swoboda, Markus A Weigand, Stefan Hofer
BACKGROUND: Severe sepsis and septic shock remain a major challenge, even in modern intensive care. In Germany, about 68,000 patients die annually because of septic diseases, characterized by a complex systemic inflammatory response. Causal treatment of the underlying infection is essential for successful management of sepsis, but the course can be positively influenced by supportive and adjuvant measures. The cholinergic anti-inflammatory pathway (CAP) represents a new approach to adjunctive therapy of septic diseases and can be pharmacologically activated by the acetylcholinesterase inhibitor physostigmine (Anticholium®)...
November 10, 2017: Trials
https://www.readbyqxmd.com/read/29123903/early-evaluation-of-severity-in-patients-with-severe-sepsis-a-comparison-with-septic-shock-subgroup-analysis-of-the-japanese-association-for-acute-medicine-sepsis-registry-jaam-sr
#10
Takehiko Tarui, Yoshihiro Yamaguchi, Koichiro Suzuki, Ryosuke Tsuruta, Hiroto Ikeda, Hiroshi Ogura, Shigeki Kushimoto, Joji Kotani, Shin-Ichiro Shiraishi, Yasushi Suzuki, Kiyotsugu Takuma, Naoshi Takeyama, Seitaro Fujishima, Toshihiko Mayumi, Yasuo Miki, Norio Yamashita, Naoki Aikawa, Satoshi Gando
Aim: The purpose of this subgroup analysis of a Japanese multicenter registry, the Japanese Association for Acute Medicine Sepsis Registry Advanced (JAAM-SR-Advanced), was to identify early outcome indicators for severe sepsis that are useful and more objective than "septic shock." Methods: Among 624 patients with severe sepsis registered in JAAM-SR-Advanced, 554 with valid serum lactate data were retrospectively studied. Hypotension before and after fluid resuscitation and the highest lactate values over the initial 24 h were compared for their ability to predict in-hospital mortality...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123901/respiratory-extracorporeal-membrane-oxygenation-for-severe-sepsis-and-septic-shock-in-adults-a-propensity-score-analysis-in-a-multicenter-retrospective-observational-study
#11
Shuhei Takauji, Mineji Hayakawa, Kota Ono, Hiroshi Makise
Aim: This multicenter retrospective observational study aimed to evaluate the efficacy of extracorporeal membrane oxygenation (ECMO) support for septic patients with severe respiratory failure using propensity score analyses. Methods: The data of severe sepsis patients from 42 intensive care units between January 2011 and December 2013 were retrospectively collected. Propensity score matching analyses were undertaken for severe respiratory failure patients with/without veno-venous ECMO support...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29121301/tissue-doppler-assessment-of-diastolic-function-and-relationship-with-mortality-in-critically-ill-septic-patients-a-systematic-review-and-meta-analysis
#12
F Sanfilippo, C Corredor, A Arcadipane, G Landesberg, A Vieillard-Baron, M Cecconi, N Fletcher
Background: Myocardial dysfunction may contribute to circulatory failure in sepsis. There is growing evidence of an association between left ventricular diastolic dysfunction (LVDD) and mortality in septic patients. Utilizing echocardiography, we know that tissue Doppler imaging (TDI) variables e' and E/e' are reliable predictors of LVDD and are useful measurements to estimate left ventricular (LV) filling pressures. Methods: We conducted a systematic review and meta-analysis to investigate the association of e' and E/e' with mortality of patients with severe sepsis or septic shock...
October 1, 2017: British Journal of Anaesthesia
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
#13
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/29121280/continuing-chronic-beta-blockade-in-the-acute-phase-of-severe-sepsis-and-septic-shock-is-associated-with-decreased-mortality-rates-up-to-90-days
#14
C Fuchs, S Wauschkuhn, C Scheer, M Vollmer, K Meissner, S-O Kuhn, K Hahnenkamp, A Morelli, M Gründling, S Rehberg
Background: There is growing evidence that beta-blockade may reduce mortality in selected patients with sepsis. However, it is unclear if a pre-existing, chronic oral beta-blocker therapy should be continued or discontinued during the acute phase of severe sepsis and septic shock. Methods: The present secondary analysis of a prospective observational single centre trial compared patient and treatment characteristics, length of stay and mortality rates between adult patients with severe sepsis or septic shock, in whom chronic beta-blocker therapy was continued or discontinued, respectively...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29118760/septic-shock-and-the-aging-process-a-molecular-comparison
#15
Fabiano Pinheiro da Silva, Marcel Cerqueira César Machado
Aging is a continuous process promoted by both intrinsic and extrinsic factors that each trigger a multitude of molecular events. Increasing evidence supports a central role for inflammation in this progression. Here, we discuss how the low-grade chronic inflammation that characterizes aging is tightly interconnected with other important aspects of this process, such as DNA damage, mitochondrial dysfunction, and epigenetic changes. Similarly, inflammation also plays a critical role in many morbid conditions that affect patients who are admitted to Intensive Care...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29109774/dual-functioned-pegylated-phospholipid-micelles-containing-cationic-antimicrobial-decapeptide-for-treating-sepsis
#16
Wonhwa Lee, Eun Ji Park, Gahee Min, Joonhyeok Choi, Dong Hee Na, Jong-Sup Bae
Despite intensive investigation of molecular mechanisms underlying the pathogenesis of sepsis, many aspects of sepsis remain unresolved; this hampers the development of appropriate therapeutics. In the present study, we developed a biologic nanomedicine containing a cationic antimicrobial decapeptide KSLW (KKVVFWVKFK), self-associated with biocompatible and biodegradable PEGylated phospholipid micelles (PLM), and analyzed its efficacy for treating sepsis. KSLW was modified with polyethylene glycol (PEG)-aldehyde or was conjugated with distearoylphosphatidylethanolamine (DSPE) -PEG-aldehyde...
2017: Theranostics
https://www.readbyqxmd.com/read/29109168/risk-factors-and-outcomes-for-ineffective-empiric-treatment-in-gram-negative-sepsis-stratification-by-onset-of-infection
#17
Scott T Micek, Nicholas Hampton, Marin Kollef
Sepsis and septic shock remain serious infections with reported mortality rates in excess of forty percent. Timely antibiotic therapy in sepsis and septic shock is recognized as an important determinant of outcome. However, the administration of ineffective empiric treatment (IET) (an initial antibiotic regimen that is not active against the identified pathogen(s) based on in vitro susceptibility testing) is associated with excess mortality compared to effective empiric treatment (EET). We examined all hospitalized patients between January 2010 and October 2015 at Barnes-Jewish Hospital with the presence of a sterile site (blood, or pleural, abdominal, cerebrospinal, synovial, and pericardial fluid) culture positive for Gram-negative (GN) bacteria combined with primary or secondary ICD-9-CM codes for severe sepsis (995...
November 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29106786/iatrogenic-perforation-of-hypopharynx-as-a-cause-of-severe-descending-necrotizing-mediastinitis-a-case-report
#18
(no author information available yet)
The authors present a case report of severe descending necrotizing mediastinitis (DNM) etiologically of unrecognized traumatic endotracheal intubation with hypopharynx-esophageal junction perforation. Patient was treated inadequately for seven days in local hospital what was the cause of sepsis progression into the septic shock with multiorgan dysfunction syndrome. Patient was transferred to specialized hospital and was immediately operated in general anaesthesia - combined transcervical approach and lateral thoracotomy was used for mediastinal drainage and debridement...
October 6, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/29104224/parameters-of-the-endocannabinoid-system-as-novel-biomarkers-in-sepsis-and-septic-shock
#19
REVIEW
J Daniel Lafreniere, Christian Lehmann
Sepsis represents a dysregulated immune response to infection, with a continuum of severity progressing to septic shock. This dysregulated response generally follows a pattern by which an initial hyperinflammatory phase is followed by a state of sepsis-associated immunosuppression. Major challenges in improving sepsis care include developing strategies to ensure early and accurate identification and diagnosis of the disease process, improving our ability to predict outcomes and stratify patients, and the need for novel sepsis-specific treatments such as immunomodulation...
November 1, 2017: Metabolites
https://www.readbyqxmd.com/read/29100618/incidence-and-evolution-of-sepsis-induced-cardiomyopathy-in-a-cohort-of-patients-with-sepsis-and-septic-shock
#20
I Narváez, A Canabal, C Martín, M Sánchez, A Moron, J Alcalá, S Giacoman, M Magro
OBJETIVE: The aim of this study was to establish the incidence of septic cardiomyopathy (SM) in patients with sepsis and septic shock, to describe its characteristics and testing its evolution. DESIGN: Prospective cohort study. PARTICIPANTS: We included 57 consecutive patients admitted to Intensive Care Unit, who met criteria of sepsis and septic shock. PRINCIPAL VARIABLES OF INTEREST: Clinical and biochemical variables were analyzed...
October 31, 2017: Medicina Intensiva
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