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sepsis resuscitation

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https://www.readbyqxmd.com/read/29910548/clinicoetiological-pattern-and-outcome-of-neonates-requiring-mechanical-ventilation-study-in-a-tertiary-care-centre
#1
Mohini Yadav, Gauri Chauhan, A K Bhardwaj, P D Sharma
The clinical and etiological pattern of ventilated newborns, their outcome in relation to morbidity and mortality was studied with 50 ventilated newborns, including outborns. M:f ratio was 2.1:1. The most common gestational age 28-36 weeks (60%) and mostly were appropriate for gestational age (66%). Survival rate 40% (20/50) being directly proportional to the gestational age and intrauterine growth pattern ( P < 0.01). Babies by LSCS Lower Segment Cessarian Section survived more than born by normal vaginal delivery (46...
May 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29904442/characteristics-and-factors-associated-with-the-mortality-of-hypotensive-patients-attending-the-emergency-department
#2
Kumpol Amnuaypattanapon, Suwimon Khansompop
Background: The prevalence of hypotension in emergency departments (EDs) is approximately 1-2%, but is associated with a mortality rate of 8-15%. There has never been a study in Thailand examining the epidemiology or the risk factors for early mortality of patients presenting with hypotension in the ED. Therefore, this study aimed to define the characteristics, mortality rate within 48 h and associated factors of hypotensive patients at ED. Methods: Data of patients with hypotension attending the ED of Thammasat University Hospital (TUH) were retrospectively studied...
July 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29889807/one-year-survival-after-inhospital-cardiac-arrest-does-prearrest-sepsis-matter
#3
Pia Koivikko, Olli Arola, Outi Inkinen, Minna Tallgren
AIM: Cardiac arrest is not a common complication of sepsis, although sepsis has been recognized as one condition behind cardiac arrest. Our aim was to evaluate the prevalence of sepsis among patients with inhospital cardiac arrest (IHCA), and to determine if sepsis is associated with inferior outcome after IHCA. METHODS: All consecutive emergency team dispatches in Turku University Hospital in 2011 to 2014 (n = 607) were retrospectively reviewed to identify the patients undergoing cardiopulmonary resuscitation (CPR) for IHCA (n = 301)...
July 2018: Shock
https://www.readbyqxmd.com/read/29885184/an-evaluation-of-management-of-transferred-paediatric-burn-patients
#4
Fatima Naumeri, Ali Ijaz Ahmad, Hafiz Mahmood Ahmad, Uzma Ahmad, Muhammad Zeeshan Sarwar
The aim of study was to evaluate whether adequate initial management and safe transfer of paediatric burn patients was carried out in our setup. Patients transferred from other hospitals/ cities to Paediatric Surgery Department, Mayo Hospital were evaluated in this prospective study. Data was entered in a proforma. Around 90.4% patients on presentation had discrepancy in their burn percentage calculation. No intravenous fluids were administered to 75.4% patients and 71.1% patients did not have any intravenous access...
May 2018: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/29882682/unintended-consequences-fluid-resuscitation-worsens-shock-in-an-ovine-model-of-endotoxemia
#5
Liam Byrne, Nchafatso G Obonyo, Sara D Diab, Kimble R Dunster, Margaret R Passmore, Ai-Ching Boon, Louise See Hoe, Sanne Pedersen, Mohd Hashairi Fauzi, Leticia Pretti Pimenta, Frank Van Haren, Christopher M Anstey, Louise Cullen, John-Paul Tung, Kiran Shekar, Kathryn Maitland, John F Fraser
BACKGROUND: Fluid resuscitation is widely considered a life saving intervention in septic shock however recent evidence has questioned both its safety and efficacy in sepsis. This study sought to compare fluid resuscitation with vasopressors with vasopressors alone in a hyperdynamic model of ovine endotoxemia. METHODS: Endotoxemic shock was induced in sixteen sheep after which they received fluid resuscitation with 40mls/kg of 0.9% saline or commenced haemodynamic support with protocolized noradrenaline and vasopressin...
June 8, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29872354/ultrasound-guided-central-venous-catheter-placement-in-the-emergency-department-experience-in-a-hospital-in-bogot%C3%A3-colombia
#6
German Devia Jaramillo, Jenny Torres Castillo, Freddy Lozano, Angélica Ramírez
Introduction: The use of central venous catheters (CVCs) in the emergency room (ER) is a valuable tool for the comprehensive management of critically ill patients; however, the positioning of these devices is not free of complications. Currently, the use of ultrasound is considered a useful and safe tool to carry out these procedures, but in Colombia, the number of emergency departments providing this tool is scarce and there is no literature describing the experience in our country. Objective: The objective of this study was to describe the experience regarding placement of ultrasound-guided CVCs by emergency physicians in an institution in Bogotá, as well as the associated complications...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29869623/toxoplasma-gondii-gra8-induces-atp5a1-sirt3-mediated-mitochondrial-metabolic-resuscitation-a-potential-therapy-for-sepsis
#7
Ye-Ram Kim, Jae-Sung Kim, Jin-Seung Yun, Sojin Kim, Sun Young Kim, Kiseok Jang, Chul-Su Yang
The intracellular parasite Toxoplasma gondii has unique dense granule antigens (GRAs) that are crucial for host infection. Emerging evidence suggests that GRA8 of T. gondii is a promising serodiagnostic marker in toxoplasmosis. However, little is known about the intracellular regulatory mechanisms involved in GRA8-induced host responses. We found that GRA8 interacts with host proteins involved in mitochondria activation and might be useful as a therapeutic strategy for sepsis. Here, we show that protein kinase-Cα (PKCα)-mediated phosphorylation of T...
March 30, 2018: Experimental & Molecular Medicine
https://www.readbyqxmd.com/read/29861371/procalcitonin-as-a-diagnostic-marker-for-sepsis-septic-shock-in-the-emergency-department-a-study-based-on-sepsis-3-definition
#8
Sun Ju Kim, Sumg Oh Hwang, Yong Won Kim, Jun Hyeok Lee, Kyoung-Chul Cha
INTRODUCTION: The recent definition of sepsis was modified based on a scoring system focused on organ failure (Sepsis-3). It would be a time-consuming process to detect the sepsis patient using Sepsis-3. Procalcitonin (PCT) is a well-known biomarker for diagnosing sepsis/septic shock and monitoring the efficacy of treatment. We conducted a study to verify the predictability of PCT for diagnosing sepsis based on Sepsis-3 definition. MATERIALS & METHODS: This is a retrospective cohort study...
May 26, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29849230/significant-lactic-acidosis-from-albuterol
#9
Maxwell Hockstein, Deborah Diercks
Lactic acidosis is a clinical entity that demands rapid assessment and treatment to prevent significant morbidity and mortality. With increased lactate use across many clinical scenarios, lactate values themselves cannot be interpreted apart from their appropriate clinical picture. The significance of Type B lactic acidosis is likely understated in the emergency department (ED). Given the mortality that sepsis confers, a serum lactate is an important screening study. That said, it is with extreme caution that we should interpret and react to the resultant elevated value...
May 2018: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29846206/sepsis-induced-myocardial-dysfunction
#10
Keith R Walley
PURPOSE OF REVIEW: Sepsis leads to a complex intramyocardial inflammatory response that results in sepsis-induced myocardial dysfunction. Here, recent findings are reviewed in a physiologic context. RECENT FINDINGS: Decreased systolic contractility during sepsis limits ventricular ejection and stroke volume. Initially, this effect is compensated for by increased diastolic filling during volume resuscitation. Reduced afterload due to arterial vasodilation also compensates so that cardiac output can be maintained or increased...
May 24, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29845974/effects-of-hydrocortisone-on-regulating-inflammation-hemodynamic-stability-and-preventing-shock-in-severe-sepsis-patients
#11
Yue Zhao, Cong Ding
BACKGROUND Severe sepsis is among the most common causes of death in Emergency Departments, with more than 30% mortality. Hydrocortisone is used in severe sepsis patients who were not responsive to fluid resuscitation and vasopressor therapy. However, the effect of hydrocortisone on regulating inflammation, hemodynamic stability, and preventing shock is still unclear in Chinese patients. MATERIAL AND METHODS In this prospective observational study, we included 105 severe sepsis patients. We measured the level of serum inflammatory cytokines, hemodynamic variables, and phagocytic ability of innate immune cells during the treatment...
May 30, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29791315/incidence-of-early-onset-sepsis-in-infants-born-to-women-with-clinical-chorioamnionitis
#12
Tara M Randis, Madeline Murguia Rice, Leslie Myatt, Alan T N Tita, Kenneth J Leveno, Uma M Reddy, Michael W Varner, John M Thorp, Brian M Mercer, Mara J Dinsmoor, Susan M Ramin, Marshall W Carpenter, Philip Samuels, Anthony Sciscione, Jorge E Tolosa, George Saade, Yoram Sorokin
OBJECTIVE: To determine the frequency of sepsis and other adverse neonatal outcomes in women with a clinical diagnosis of chorioamnionitis. METHODS: We performed a secondary analysis of a multi-center placebo-controlled trial of vitamins C/E to prevent preeclampsia in low risk nulliparous women. Clinical chorioamnionitis was defined as either the "clinical diagnosis" of chorioamnionitis or antibiotic administration during labor because of an elevated temperature or uterine tenderness in the absence of another cause...
May 23, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29789918/recent-experience-and-follow-up-after-surgical-closure-of-secundum-atrial-septal-defect-in-120-children
#13
Geoffroy de Beco, Natasha Mambour, Christophe Vô, Laetitia Vanhoutte, Stéphane Moniotte, Alain Poncelet, Thierry Sluysmans
While percutaneous catheter closure proves an effective treatment for secundum atrial septal defect (ASD2), some child patients require surgical closure. We assessed the risks associated with isolated surgical ASD2 closure by reviewing the outcomes of 120 children operated on between 1999 and 2011 (mean age 4.6 ± 3.9 years, mean weight 17 ± 12 kg). Direct sutures were performed in 4% and patch closures in 96%. The mean cardiopulmonary bypass duration was 38 ± 14 min, aortic cross-clamp time 19 ± 9 min, intensive care unit length of stay 1...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29788135/the-hepatic-glucocorticoid-receptor-is-crucial-for-cortisol-homeostasis-and-sepsis-survival-in-humans-and-male-mice
#14
Marc Jenniskens, Ruben Weckx, Thomas Dufour, Sarah Vander Perre, Lies Pauwels, Sarah Derde, Arno Téblick, Fabian Güiza, Greet Van den Berghe, Lies Langouche
Sepsis is hallmarked by hypercortisolemia, a stress response that is essential for survival. This elevation in plasma cortisol is partially brought about by suppressed hepatic cortisol breakdown. We now demonstrated that a controlled downregulation of the hepatic glucocorticoid receptor (hepatic GR) is crucial herein. In a mouse model of fluid-resuscitated, antibiotic-treated abdominal sepsis and in human ICU patients, sepsis reduced hepatic GR expression and signaling, but increased (free) plasma cortisol/corticosterone, explained by suppressed cortisol/corticosterone binding proteins and A-ring-reductases...
May 17, 2018: Endocrinology
https://www.readbyqxmd.com/read/29787743/persistence-of-central-venous-oxygen-desaturation-during-early-sepsis-is-associated-with-higher-mortality-a-retrospective-analysis-of-the-albios-trial
#15
Alessandro Protti, Serge Masson, Roberto Latini, Roberto Fumagalli, Marilena Romero, Carla Pessina, Giovanni Pasetti, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Pietro Caironi
BACKGROUND: Relevance of low (<70%) central venous oxygen saturation (ScvO2 ) during early sepsis has been recently questioned by three negative trials (ProCESS, ARISE and ProMISe) on early goal-directed therapy (EGDT). However, subjects included in those trials had ScvO2 at enrolment as high as 71±13%, 73±11% and 70±12%. Herein we assessed the association between ScvO2 <70% at six hours and 90-day mortality in subjects enrolled in the ALBIOS trial, focusing on those with initial ScvO2 <70%...
May 19, 2018: Chest
https://www.readbyqxmd.com/read/29783184/postoperative-outcomes-in-patients-with-a-do-not-resuscitate-dnr-order-undergoing-elective-procedures
#16
Ethan Y Brovman, Elisa C Walsh, Brittany N Burton, Christine E Kuo, Charlotta Lindvall, Rodney A Gabriel, Richard D Urman
STUDY OBJECTIVE: Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. DESIGN: Retrospective cohort study. SETTING: A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit...
May 18, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29779703/idiopathic-systemic-capillary-leak-syndrome-presenting-as-septic-shock-a-case-report
#17
Eamon P Raith, Joshua F Ihle, Jennifer Jamieson, Anna Kalff, Julian Bosco
BACKGROUND: Idiopathic capillary leak syndrome (Clarkson's Disease) is a rare angiopathy with a heterogenous phenotype that may present as distributive shock refractory to resuscitative management. OBJECTIVE: We report a case of idiopathic systemic capillary leak syndrome presenting as septic shock. METHODS: Structured case report and review of the literature. RESULTS: A 27-year old man admitted to our institution with coryzal symptoms rapidly deteriorated with presumed sepsis, leading to intensive care unit admission...
May 17, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29771701/dynamic-contrast-enhanced-ultrasound-identifies-microcirculatory-alterations-in-sepsis-induced-acute-kidney-injury
#18
Alexandre Lima, Tom van Rooij, Bulent Ergin, Michele Sorelli, Yasin Ince, Patricia A C Specht, Egbert G Mik, Leonardo Bocchi, Klazina Kooiman, Nico de Jong, Can Ince
OBJECTIVES: We developed quantitative methods to analyze microbubble kinetics based on renal contrast-enhanced ultrasound imaging combined with measurements of sublingual microcirculation on a fixed area to quantify early microvascular alterations in sepsis-induced acute kidney injury. DESIGN: Prospective controlled animal experiment study. SETTING: Hospital-affiliated animal research institution. SUBJECTS: Fifteen female pigs...
May 15, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29764541/-tianjin-characteristics-of-integrated-traditional-chinese-and-western-medicine-in-first-aid-medical-system
#19
Zhijun Li
Tianjin, as the earliest city to open up, the exchange of Chinese and Western cultures also started earlier. Therefore, today's emergency medicine system with integrated features of Chinese and Western medicine is formed. Professor Wang Jinda, who works in Tianjin First Center Hospital, makes the theory of "treating bronchitis and treating diseases" and "three methods of three syndromes" for the treatment of severe diseases such as sepsis. The surgical aspect is the treatment of acute abdomen with the combination of Chinese and Western medicine which is proposed by Academician Wu Xianzhong who worked in Tianjin Nankai Hospital...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29763385/pyruvate-enriched-resuscitation-for-shock
#20
Robert T Mallet, Albert H Olivencia-Yurvati, Rolf Bünger
This commentary addresses the recent retraction of an article which reported favorable outcomes in septic patients treated with intravenous pyruvate. The retracted report was cited in the authors' recent minireview on the cellular mechanisms and clinical application of pyruvate to improve cardiac performance. Because the retracted article reports pyruvate-enhanced resuscitation of critically ill patients, the authors wish to inform the readership, especially critical care providers, that this particular clinical application of pyruvate is not now supported by robust evidence...
May 2018: Experimental Biology and Medicine
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