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sepsis resuscitation

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https://www.readbyqxmd.com/read/29628470/a-rare-case-of-rush-progression-of-purulent-pericarditis-by-escherichia-coli-in-a-patient-with-malignant-lymphoma
#1
Shunpei Horii, Hirotaka Yada, Kei Ito, Ayumu Osaki, Atsushi Sato, Toyokazu Kimura, Risako Yasuda, Takumi Toya, Takayuki Namba, Nobuyuki Masaki, Takeshi Adachi
Purulent pericarditis is a rare disease in the antibiotic era. The common pathogens of purulent pericarditis are gram-positive species such as Staphylococcus aureus. Streptococcus pneumoniae, Salmonella, Haemophilus, fungal pathogens/tuberculosis can also result in purulent pericarditis. We report an old male case of purulent pericarditis by Escherichia coli. He came to our hospital suffering from leg edema for 3 months. Echocardiography revealed the large amount of pericardial effusion, and he was admitted to test the cause of pericardial effusion without high fever, tachycardia, and shock vital signs...
April 6, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29626019/diagnosis-and-management-of-sepsis
#2
Tom Evans
Sepsis is a common condition with high morbidity and mortality. Although many patients may require critical care, this article considers the features of sepsis that are of most relevance to acute general physicians. Recently updated definitions of sepsis and septic shock have been proposed which better identify patients who are likely to have a poor outcome, and therefore give an opportunity to escalate care. Despite these advances, there is still no molecular signature able to diagnose sepsis. Pathogenesis is complex, with many immune and non-immune mediators involved...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29621117/cerebral-multimodal-monitoring-in-sepsis-an-experimental-study
#3
Pedro Kurtz, Joana C d'Avila, Darwin Prado, Caroline Madeira, Charles Vargas-Lopes, Rogerio Panizzutti, Luciano Cesar Pontes Azevedo, Fernando A Bozza
Acute brain dysfunction is a complication of sepsis and its pathophysiology remains poorly understood. We studied the brain metabolism in a resuscitated animal model of sepsis. Twelve anesthetized, mechanically ventilated and invasively monitored pigs were allocated to a sham procedure (N = 5) or sepsis (N = 7). Sepsis was induced through fecal inoculation in the peritoneum. Fluid resuscitation was maintained during the entire study period. Animals were observed until spontaneous death or for a maximum of 24 hours...
April 4, 2018: Shock
https://www.readbyqxmd.com/read/29617940/intraosseous-versus-intravenous-access-in-pediatric-septic-shock-patients-admitted-to-alexandria-university-pediatric-intensive-care-unit
#4
Ahmed A El-Nawawy, Omneya M Omar, Mona Khalil
The cornerstone of emergency management of sepsis is early, goal-directed therapy. The purpose of this study was to evaluate the effect of intraosseous (IO) vs. intravenous (IV) access for resuscitation of patients with septic shock admitted to pediatric intensive care unit. This prospective interventional randomized clinical trial study was conducted on 60 patients with septic shock who need rapid administration of fluids and drugs; 30 cases were randomly chosen for IO vascular access, while the other 30 were selected for IV access...
April 1, 2018: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29605724/timing-of-laparotomy-and-closure-in-burn-patients-with-abdominal-compartment-syndrome-effects-on-survival
#5
Jesus I Ramirez, Soman Sen, Tina L Palmieri, David G Greenhalgh
BACKGROUND: Survival of burned patients with abdominal compartment syndrome (ACS) is uniformly reported to be poor, averaging just 16% after laparotomy. We hypothesize that better outcomes may be achieved with a strategy of immediate laparotomy and early fascial closure. STUDY DESIGN: Patients with burn injury who were diagnosed with ACS between 2005 and 2016 were identified through a search of databases. Data was gathered from electronic medical records. Timing of laparotomy and closure were calculated for each patient...
March 29, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29593868/recommendations-for-active-correction-of-hypernatremia-in-volume-resuscitated-shock-or-sepsis-patients-should-be-taken-with-a-grain-of-salt-a-systematic-review
#6
REVIEW
Joseph W Quinn, Kerry Sewell, Dell E Simmons
Background: Healthcare-acquired hypernatremia (serum sodium >145 mEq/dL) is common among critically ill and other hospitalized patients and is usually treated with hypotonic fluid and/or diuretics to correct a "free water deficit." However, many hypernatremic patients are eu- or hypervolemic, and an evolving body of literature emphasizes the importance of rapidly returning critically ill patients to a neutral fluid balance after resuscitation. Objective: We searched for any randomized- or observational-controlled studies evaluating the impact of active interventions intended to correct hypernatremia to eunatremia on any outcome in volume-resuscitated patients with shock and/or sepsis...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29574427/septic-presentation-of-a-giant-fibroepithelial-polyp-of-the-vulva
#7
Arzoo Amin, Zohra Amin, Abdul Rahman Al Farsi
Fibroepithelial stromal polyps are mesenchymal lesions occurring typically in reproductive age women with a predilection for the vulvo-vaginal region. Malignancy may mimic this polyp in morphology, rendering further investigations including detailed histopathology mandatory. Histologically its characteristic features are stellate and multinucleate stromal cells identified near the epithelial-stromal interface. This case report discusses incidental finding of largest fibroepithelial polyp presented in a 31-year-old nulliparous woman...
March 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29573596/lemierre-s-syndrome-following-perianal-abscess-a-case-report
#8
Qusai Aljarrah, Yara Khazaleh, Mooath Al-Jarrah, Jordan W Oldbury, Ahmad K Abou-Foul
INTRODUCTION: Lemierre's syndrome (LS) is a rare and life-threatening condition characterized by suppurative thrombophlebitis of the internal jugular vein (IJV), and a history of head and neck (H&N) sepsis. LS is usually caused by Fusobacterium necrophorum, which is part of the normal flora in the oro-pharynx, and the digestive and urogenital tracts. We here report the first case of LS following perianal sepsis. PRESENTATION OF CASE: A 60-year-old man with a painful left neck swelling, dysphagia and worsening sepsis was referred from a peripheral unit where he had an incision and drainage of a perianal abscess a week earlier...
March 16, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29564922/recognition-and-management-of-idiopathic-systemic-capillary-leak-syndrome-an-evidence-based-review
#9
Noor Ul-Ain Baloch, Marvi Bikak, Abdul Rehman, Omar Rahman
INTRODUCTION: Idiopathic systemic capillary leak syndrome (SCLS) is a unique disorder characterized by episodes of massive systemic leak of intravascular fluid leading to volume depletion and shock. A typical attack of SCLS consists of prodromal, leak and post-leak phases. Complications, such as compartment syndrome and pulmonary edema, usually develop during the leak and post-leak phases respectively. Judicious intravenous hydration and early use of vasopressors is the cornerstone of management in such cases...
March 22, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29555789/targeting-skeletal-muscle-tissue-oxygenation-sto-2-in-adults-with-severe-sepsis-and-septic-shock-a-randomised-controlled-trial-oto-sts-study
#10
Olivier Nardi, Elizabeth Zavala, Claude Martin, Serafim Nanas, Thomas Scheeren, Andrea Polito, Xavi Borrat, Djillali Annane
OBJECTIVE: Evaluation of the ratio of oxyhaemoglobin to total haemoglobin in skeletal muscle (StO2 ) using near-infrared spectroscopy may aid in the monitoring of patients with sepsis. This study assessed the benefits and risks of targeting StO2 in adults with severe sepsis or septic shock. DESIGN: A European randomised controlled trial was performed on two parallel groups. SETTING: Five intensive care units (ICU) in France, Greece, Spain and Germany were used for the study...
March 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29548372/balanced-versus-unbalanced-crystalloids-in-initial-sepsis-fluid-resuscitation
#11
Kerry Kerr Fellows
No abstract text is available yet for this article.
March 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29530355/evaluation-for-occult-sepsis-incorporating-nirs-and-emergency-sonography
#12
Natalie Yu Yi Ng, Hannah Hui En Ang, Jacqueline Chieh Ling Tan, Weng Hoe Ho, Win Sen Kuan, Mui Teng Chua
PURPOSE: We aim to determine whether the combination of regional tissue oxygen saturation (StO2 ) measurement using near-infrared spectroscopy (NIRS), inferior vena cava (IVC) collapsibility and ejection fraction (EF) is able to detect occult sepsis. METHODS: We included adult patients in the emergency department with at least one of the following: fever; any one component of the quick sepsis-related organ function assessment (SOFA) score; heart rate≥100 beats per minute; or white cell count <4...
February 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29519240/lactate-clearance-as-a-prognostic-marker-of-mortality-in-severely-ill-febrile-children-in-east-africa
#13
A Aramburo, Jim Todd, Elizabeth C George, Sarah Kiguli, Peter Olupot-Olupot, Robert O Opoka, Charles Engoru, Samuel O Akech, Richard Nyeko, George Mtove, Diana M Gibb, Abdel G Babiker, Kathryn Maitland
BACKGROUND: Hyperlactataemia (HL) is a biomarker of disease severity that predicts mortality in patients with sepsis and malaria. Lactate clearance (LC) during resuscitation has been shown to be a prognostic factor of survival in critically ill adults, but little data exist for African children living in malaria-endemic areas. METHODS: In a secondary data analysis of severely ill febrile children included in the Fluid Expansion as Supportive Therapy (FEAST) resuscitation trial, we assessed the association between lactate levels at admission and LC at 8 h with all-cause mortality at 72 h (d72)...
March 9, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29518646/effect-of-delay-in-cord-clamping-45-versus-60-s-on-very-preterm-singleton-infants
#14
Arpitha Chiruvolu, Elise Elliott, Diana Rich, Genna Leal Stone, Huanying Qin, Robert W Inzer
BACKGROUND: In the range of timing suggested by American College of Obstetricians and Gynecologists 30 to 60 s, preterm infants may potentially derive more short and long-term benefits with delayed cord clamping (DCC) for at least 60 s. However, there are concerns with longer resuscitation delay in this vulnerable population. OBJECTIVE: To compare the clinical consequences of 45 versus 60 s delay in umbilical cord clamping in singleton infants born between 230/7 to 316/7 weeks gestation...
April 2018: Early Human Development
https://www.readbyqxmd.com/read/29502880/pulmonary-hypertension-associated-with-hypoxic-ischemic-encephalopathy-antecedent-characteristics-and-comorbidities
#15
Satyan Lakshminrusimha, Seetha Shankaran, Abbot Laptook, Scott McDonald, Martin Keszler, Krisa Van Meurs, Ronnie Guillet, Sanjay Chawla, Beena G Sood, Sonia Bonifacio, Abhik Das, Rosemary D Higgins
OBJECTIVE: To determine the characteristics of term infants with persistent pulmonary hypertension of the newborn (PPHN) associated with moderate or severe hypoxic ischemic encephalopathy (HIE). METHODS: We compared infants with and without PPHN enrolled in 2 randomized trials of therapeutic hypothermia: the induced hypothermia trial of cooling to 33.5°C for 72 hours vs normothermia, and the "usual-care" arm (33.5°C for 72 hours) of the optimizing cooling trial...
March 1, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29488356/p2x-7-receptor-antagonism-ameliorates-renal-dysfunction-in-a-rat-model-of-sepsis
#16
Nishkantha Arulkumaran, Marije L Sixma, Sean Pollen, Elias Ceravola, Elisa Jentho, Maria Prendecki, Paul S Bass, Frederick W K Tam, Robert J Unwin, Mervyn Singer
Sepsis is a major clinical problem associated with significant organ dysfunction and high mortality. The ATP-sensitive P2X7 receptor activates the NLRP3 inflammasome and is a key component of the innate immune system. We used a fluid-resuscitated rat model of fecal peritonitis and acute kidney injury (AKI) to investigate the contribution of this purinergic receptor to renal dysfunction in sepsis. Six and 24 h time-points were chosen to represent early and established sepsis, respectively. A selective P2X7 receptor antagonist (A-438079) dissolved in dimethyl sulfoxide (DMSO) was infused 2 h following induction of sepsis...
March 2018: Physiological Reports
https://www.readbyqxmd.com/read/29482906/applied-physiology-of-fluid-resuscitation-in-critical-illness
#17
REVIEW
Sabrina Arshed, Michael R Pinsky
Fluids during resuscitation from shock increase mean systemic pressure and venous return. The pressure gradient for venous return must increase. Mean systemic pressure is the amount of vascular space in unstressed and stressed volume, mostly unstressed. Shock states can decrease mean systemic pressure by increasing unstressed volume, decreasing total blood volume, or decreasing the pressure gradient for venous return. Crystalloids across bodily spaces restore normal volume, whereas colloids remain in the intravascular space...
April 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29475445/prognosis-of-patients-excluded-by-the-definition-of-septic-shock-based-on-their-lactate-levels-after-initial-fluid-resuscitation-a-prospective-multi-center-observational-study
#18
Byuk Sung Ko, Kyuseok Kim, Sung-Hyuk Choi, Gu Hyun Kang, Tae Gun Shin, You Hwan Jo, Seung Mok Ryoo, Jin Ho Beom, Woon Yong Kwon, Kap Su Han, Han Sung Choi, Sung Phil Chung, Gil Joon Suh, Tae Ho Lim, Won Young Kim
BACKGROUND: Septic shock can be defined both by the presence of hyperlactatemia and need of vasopressors. Lactate levels should be measured after volume resuscitation (as per the Sepsis-3 definition). However, currently, no studies have evaluated patients who have been excluded by the new criteria for septic shock. The aim of this study was to determine the clinical characteristics and prognosis of these patients, based on their lactate levels after initial fluid resuscitation. METHODS: This observational study was performed using a prospective, multi-center registry of septic shock, with the participation of 10 hospitals in the Korean Shock Society, between October 2015 and February 2017...
February 24, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29471107/pick1-deficiency-exacerbates-sepsis-associated-acute-lung-injury-and-impairs-glutathione-synthesis-via-reduction-of-xct
#19
Meizi Qian, Yingying Lou, Yixiu Wang, Minyuan Zhang, Qun Jiang, Yunchang Mo, Kunyuan Han, Shenhui Jin, Qinxue Dai, Yulong Yu, Zhen Wang, Junlu Wang
The role of oxidative stress has been well documented in the development of sepsis-induced acute lung injury (ALI). Protein interaction with C-kinase 1 (PICK1) participates in oxidative stress-related neuronal diseases. However, its function in lung infections and inflammatory diseases is not known. We therefore sought to investigate whether PICK1 is involved in sepsis-induced ALI. Cecal ligation and puncture (CLP) was performed in anesthetized wild type (WT) and PICK1 knock out (KO, PICK1-/- ) mice with C57BL/6 background...
February 19, 2018: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/29463168/associated-mortality-of-liberal-fluid-administration-in-sepsis
#20
Mathew R Johnson, T Patrick Reed, Denise K Lowe, William D Cahoon
Fluid resuscitation, to restore intravascular volume and improve oxygen delivery, is a crucial step in early resuscitation efforts of patients with sepsis or septic shock. The 2016 Surviving Sepsis Campaign guidelines suggest the use of dynamic versus static measures of fluid responsiveness and fluid resuscitation with at least 30 mL/kg of intravenous crystalloid within the first 3 hours followed by fluid administration if hemodynamic factors continue to improve. Despite these recommendations, risks to this practice may exist as multiple studies have demonstrated an association between a positive fluid balance and/or administration of large fluid volume and increase in mortality...
January 1, 2018: Journal of Pharmacy Practice
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