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https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#1
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28101605/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#2
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuk Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
January 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28100110/mortality-in-patients-with-septic-shock-by-multidrug-resistant-bacteria
#3
Stefano Busani, Giulia Serafini, Elena Mantovani, Claudia Venturelli, Maddalena Giannella, Pierluigi Viale, Cristina Mussini, Andrea Cossarizza, Massimo Girardis
BACKGROUND: Patients with septic shock by multidrug resistant (MDR) microorganism maybe considered a specific population of critical patients at very high risk of death in whom the effects of standard sepsis treatment has never been assessed. The objective of this retrospective analysis was to evaluate the risk factors for 30-day mortality and the impact of sepsis management in patients with septic shock caused by MDR bacteria. METHODS: Patients with septic shock by MDR bacteria admitted to the mixed intensive care unit (ICU) of Modena University Hospital during a 6-year period were studied...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28099689/effectiveness-and-safety-of-procalcitonin-evaluation-for-reducing-mortality-in-adults-with-sepsis-severe-sepsis-or-septic-shock
#4
REVIEW
Brenda Ng Andriolo, Regis B Andriolo, Reinaldo Salomão, Álvaro N Atallah
BACKGROUND: Serum procalcitonin (PCT) evaluation has been proposed for early diagnosis and accurate staging and to guide decisions regarding patients with sepsis, severe sepsis and septic shock, with possible reduction in mortality. OBJECTIVES: To assess the effectiveness and safety of serum PCT evaluation for reducing mortality and duration of antimicrobial therapy in adults with sepsis, severe sepsis or septic shock. SEARCH METHODS: We searched the Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE (1950 to July 2015); Embase (Ovid SP, 1980 to July 2015); Latin American Caribbean Health Sciences Literature (LILACS via BIREME, 1982 to July 2015); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO host, 1982 to July 2015), and trial registers (ISRCTN registry, ClinicalTrials...
January 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28099645/mechanical-ventilation-in-coffin-lowry-syndrome-a-case-report
#5
Edmilson Bastos de Moura, Érica Leal Teixeira de Moura, Fábio Ferreira Amorim, Vânia Maria Oliveira
We describe a 27-year-old patient with Coffin-Lowry syndrome with severe community pneumonia, septic shock and respiratory failure. We summarize both the mechanical ventilatory assistance and the hospitalization period in the intensive care unit.
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099643/balanced-crystalloids-for-septic-shock-resuscitation
#6
Thiago Domingos Corrêa, Alexandre Biasi Cavalcanti, Murillo Santucci Cesar de Assunção
Timely fluid administration is crucial to maintain tissue perfusion in septic shock patients. However, the question concerning which fluid should be used for septic shock resuscitation remains a matter of debate. A growing body of evidence suggests that the type, amount and timing of fluid administration during the course of sepsis may affect patient outcomes. Crystalloids have been recommended as the first-line fluids for septic shock resuscitation. Nevertheless, given the inconclusive nature of the available literature, no definitive recommendations about the most appropriate crystalloid solution can be made...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099233/primary-outcome-measures-in-pediatric-septic-shock-trials-a-systematic-review
#7
Kusum Menon, James Dayre McNally, Jerry J Zimmerman, Michael S D Agus, Katie O'Hearn, R Scott Watson, Hector R Wong, Mark Duffett, David Wypij, Karen Choong
OBJECTIVE: To evaluate all published pediatric randomized controlled trials of patients with septic shock from any cause to examine the outcome measures used, the strengths and limitations of these measurements and whether the trial outcomes met feasibility criteria. DATA SOURCES: We used a previously published database of pediatric critical care randomized controlled trials (PICUtrials.net) derived from searches of MEDLINE, EMBASE, LILACS, and CENTRAL. STUDY SELECTION: We included randomized controlled trials of interventions to children admitted to a PICU with septic or dengue hemorrhagic shock which were published in English...
January 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28098900/endothelial-microparticles-activate-endothelial-cells-to-facilitate-the-inflammatory-response
#8
Yiyun Liu, Ruyuan Zhang, Hongping Qu, Jun Wu, Lei Li, Yaoqing Tang
Endothelial microparticles (EMPs) and endothelial cells (ECs) are involved in the pathophysiological mechanisms of sepsis and septic shock. EMPs are small vesicles released by ECs and are considered biomarkers for endothelial cell function and mediators for intercellular information exchange. However, the effect of EMPs on their parental ECs remains unknown. The present study collected tumor necrosis factor‑α‑derived EMPs and detected the proinflammatory cytokines released from unstimulated and EMP‑stimulated ECs by proteome profiler array...
January 12, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28098629/right-dose-right-now-customized-drug-dosing-in-the-critically-ill
#9
Jason A Roberts, Anand Kumar, Jeffrey Lipman
Drugs are key weapons that clinicians have to battle against the profound pathologies encountered in critically ill patients. Antibiotics in particular are commonly used and can improve patient outcomes dramatically. Despite this, there are strong opportunities for further reducing the persisting poor outcomes for infected critically ill patients. However, taking these next steps for improving patient care requires a new approach to antibiotic therapy. Giving the right dose is highly likely to increase the probability of clinical cure from infection and suppress the emergence of resistant pathogens...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098591/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#10
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuk Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012." DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
January 17, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28097649/hospital-variation-in-utilization-of-life-sustaining-treatments-among-patients-with-do-not-resuscitate-orders
#11
Allan J Walkey, Janice Weinberg, Renda Soylemez Wiener, Colin R Cooke, Peter K Lindenauer
OBJECTIVE: To determine between-hospital variation in interventions provided to patients with do not resuscitate (DNR) orders. DATA SOURCES/SETTING: United States Agency of Healthcare Research and Quality, Healthcare Cost and Utilization Project, California State Inpatient Database. STUDY DESIGN: Retrospective cohort study including hospitalized patients aged 40 and older with potential indications for invasive treatments: in-hospital cardiac arrest (indication for CPR), acute respiratory failure (mechanical ventilation), acute renal failure (hemodialysis), septic shock (central venous catheterization), and palliative care...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28097288/secondary-analysis-of-an-electronic-surveillance-system-combined-with-multi-focal-interventions-for-early-detection-of-sepsis
#12
Bonnie L Westra, Sean Landman, Pranjul Yadav, Michael Steinbach
: To conduct an independent secondary analysis of a multi-focal intervention for early detection of sepsis that included implementation of change management strategies, electronic surveillance for sepsis, and evidence based point of care alerting using the POC AdvisorTM application. METHODS: Propensity score matching was used to select subsets of the cohorts with balanced covariates. Bootstrapping was performed to build distributions of the measured difference in rates/means...
18, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28096577/the-effect-of-atrial-natriuretic-peptide-infusion-on-intestinal-injury-in-septic-shock
#13
Ghada F Elbaradey, Nagat Sayed Elshmaa, Hossam Hodeib
BACKGROUND AND AIMS: The aim of this study is to assess the effect of atrial natriuretic peptide (ANP) on intestinal ischemia-reperfusion injury in septic shock. MATERIAL AND METHODS: A prospective randomized controlled, observer-blinded study was carried out in surgical Intensive Care Unit (ICU), University Hospital. Forty adult patients in septic shock were randomly divided into two groups, control group (Group C) received normal saline and ANP group (Group A) patients received ANP in the form of 1...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28096229/disseminated-melioidosis-in-the-head-and-neck
#14
Tze Ling Loh, Sergios Latis, Graeme Crossland, Hemi Patel
A 35-year-old man was admitted to an intensive care unit with unilateral facial swelling and septic shock after multiple presentations to the emergency department with non-specific unilateral pain over the parotid area. A CT scan of his neck showed diffuse right-sided facial soft tissue infection, mastoid effusion and temporal lobe cerebritis. The upper lobes of his lungs had cannonball lesions that were suggestive of septic lung metastases. Blood cultures and ear canal swabs were positive for Burkholderia pseudomallei The temporal lobe cerebritis eventually developed into an abscess, necessitating a cortical mastoidectomy, craniectomy and temporal lobectomy...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28096226/disseminated-adenovirus-infection-causing-severe-ards
#15
Steven J Campbell, Jessica A Kynyk, John A Davis
A previously healthy young man with a rare genetic condition presented with severe acute respiratory distress syndrome secondary to pneumonia with septic shock. He did not improve with conventional therapy for his known causal organism thus prompting further workup. He was found to be profoundly immunosuppressed raising our suspicion for atypical organisms. A bronchoalveolar lavage sample was positive via PCR for adenovirus which we suspect exacerbated a pre-existing bacterial pneumonia and led to a severe and non-responsive respiratory failure...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28094175/septic-shock-in-low-cardiac-output-patients-with-heart-and-lung-transplantation-diagnosis-and-management-dilemma
#16
Ajay Kumar Jha, Shrinivas Krisna Hittalmani
No abstract text is available yet for this article.
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28094172/interval-changes-in-myocardial-performance-index-predict-outcome-in-severe-sepsis
#17
Junaid Nizamuddin, Feroze Mahmood, Avery Tung, Ariel Mueller, Samuel M Brown, Shahzad Shaefi, Michael O'Connor, Daniel Talmor, Sajid Shahul
OBJECTIVES: Septic cardiomyopathy is a well-described consequence of septic shock and is associated with increased sepsis-related mortality. The myocardial performance index (MPI), a parameter derived from echocardiographic tissue Doppler measurements, allows for a more sensitive assessment of global cardiac function than do traditional metrics for cardiac function. The authors hypothesized that changes in left ventricular MPI in patients with severe sepsis would be associated with a higher 90-day mortality...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28094141/intravenous-zanamivir-or-oral-oseltamivir-for-hospitalised-patients-with-influenza-an-international-randomised-double-blind-double-dummy-phase-3-trial
#18
Francisco M Marty, Joan Vidal-Puigserver, Carol Clark, Sandeep K Gupta, Esperanza Merino, Denis Garot, Marianne J Chapman, Frédérique Jacobs, Eduardo Rodriguez-Noriega, Petr Husa, Denise Shortino, Helen A Watson, Phillip J Yates, Amanda F Peppercorn
BACKGROUND: Neuraminidase inhibitors are effective for the treatment of acute uncomplicated influenza. However, there is an unmet need for intravenous treatment for patients admitted to hospital with severe influenza. We studied whether intravenous zanamivir was a suitable treatment in this setting. METHODS: In this international, randomised, double-blind, double-dummy, phase 3 trial, we recruited patients aged 16 years or older with severe influenza admitted to 97 hospitals from 26 countries...
January 13, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28093424/strongyloides-hyperinfection-syndrome-and-vre-pneumonia
#19
Mohannad Abu Omar, Mouhanna Abu Ghanimeh, Sola Kim, Gregory Howell
Immunocompromised patients have high risk of infections from bacteria, viruses, fungi and parasites. One of these infections is those caused by Strongyloides stercoralis Immunocompromised patients are at risk of hyperinfection syndrome which is characterised with more systemic manifestation and a higher risk of morbidity and mortality. This can be complicated by coinfection with enteric organisms, specifically Gram-negative. Enterococci are Gram-positive cocci which are inhabitants of the human gastrointestinal tract...
January 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28092497/polymyxin-b-hemoperfusion-for-sepsis-and-septic-shock-a-systematic-review-and-meta-analysis
#20
Takero Terayama, Kazuma Yamakawa, Yutaka Umemura, Morio Aihara, Satoshi Fujimi
BACKGROUND: To evaluate the efficacy and safety of direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) therapy in patients with sepsis. DESIGN: A systematic review and meta-analysis of four major databases: Cochrane Central Register of Controlled Trials, MEDLINE, Scopus, and Science Citation Index Expanded. STUDY SELECTION: Randomized controlled trials comparing PMX-DHP with conventional therapy on the outcome of mortality in patients with severe sepsis/septic shock...
January 16, 2017: Surgical Infections
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