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https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#1
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28199348/presentation-management-and-outcomes-of-sepsis-in-adults-and-children-admitted-to-a-rural-ugandan-hospital-a-prospective-observational-cohort-study
#2
Kristina E Rudd, Leonard K Tutaryebwa, T Eoin West
OBJECTIVES: Limited data are available on sepsis in low-resource settings, particularly outside of urban referral centers. We conducted a prospective observational single-center cohort study in May 2013 to assess the presentation, management and outcomes of adult and pediatric patients admitted with sepsis to a community hospital in rural Uganda. METHODS: We consecutively screened all patients admitted to medical wards who met sepsis criteria. We evaluated eligible patients within 24 hours of presentation and 24-48 hours after admission, and followed them until hospital discharge...
2017: PloS One
https://www.readbyqxmd.com/read/28168816/lactate-levels-and-pneumonia-severity-index-are-good-predictors-of-in-hospital-mortality-in-pneumonia
#3
Bulut Demirel
INTRODUCTION: Pneumonia is an inflammatory disease caused by micro-organisms. The pneumonia severity index (PSI) and CURB_65 scores are widely used to predict the mortality risk. We wanted to calculate the value of lactic acid level in predicting the mortality risk. MATERIAL AND METHODS: This prospective cross-sectional study performed in a third level education and research hospital. The pneumonia diagnosis was determined by symptoms, physical examination findings, and radiological findings...
February 7, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28153301/electrochemiluminescence-bipolar-electrode-array-for-the-multiplexed-detection-of-glucose-lactate-and-choline-based-on-a-versatile-enzymatic-approach
#4
Yi Xiao, Linru Xu, Lian-Wen Qi
A simple, efficient and versatile biosensing platform capable of the multiplexed detection for glucose, lactate and choline was developed by the integration of bipolar electrochemistry and electrochemiluminescence (ECL) imaging. The sensing bipolar electrodes (BPEs) were simply modified via a one-step method adaptable to different enzymes. The biorecognition event happening between the substrate and the corresponding enzyme could be directly reported by the ECL emitted on the same pole from luminol and in situ generated H2O2...
April 1, 2017: Talanta
https://www.readbyqxmd.com/read/28151948/model-for-end-stage-liver-disease-excluding-inr-meld-xi-score-in-critically-ill-patients-easily-available-and-of-prognostic-relevance
#5
Bernhard Wernly, Michael Lichtenauer, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Uta C Hoppe, Malte Kelm, Christian Jung
PURPOSE: MELD-XI, an adapted version of Model for End-stage Liver Disease (MELD) score excluding INR, was reported to predict outcomes e.g. in patients with acute heart failure. We aimed to evaluate MELD-XI in critically ill patients admitted to an intensive care unit (ICU) for prognostic relevance. METHODS: A total of 4381 medical patients (66±14 years, 2862 male) admitted to a German ICU between 2004 and 2009 were included and retrospectively investigated. Admission diagnoses were e...
2017: PloS One
https://www.readbyqxmd.com/read/28144779/focused-cardiac-ultrasound-in-the-early-resuscitation-of-severe-sepsis-and-septic-shock-a-prospective-pilot-study
#6
Hiroshi Sekiguchi, Yohei Harada, Hector R Villarraga, Sunil V Mankad, Ognjen Gajic
PURPOSE: Point-of-care ultrasonography has been increasingly used in the care of critically ill patients; however, reports on its use during active resuscitation are limited. The aim of this study was to investigate the true impact of focused cardiac ultrasound (FCU) during the management of sepsis with early (6-h) resuscitation. METHODS: A prospective pilot observational study was conducted at an academic medical center from March 2011 through July 2012. Patients undergoing resuscitation for severe sepsis or septic shock were prospectively enrolled at medical and combined medical-surgical intensive care units...
January 31, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28121217/qsofa-has-poor-sensitivity-for-prehospital-identification-of-severe-sepsis-and-septic-shock
#7
Maia Dorsett, Melissa Kroll, Clark S Smith, Phillip Asaro, Stephen Y Liang, Hawnwan P Moy
OBJECTIVES: Sepsis is a common and deadly disease process for which early recognition and intervention can significantly improve clinical outcomes. Despite this, sepsis remains underrecognized and therefore undertreated in the prehospital setting. Recent recommendations by the Society of Critical Care and European Society of Intensive Care Medicine advocate use of the qSOFA (quick Sequential [Sepsis-related] Organ Failure Assessment) score in non-ICU settings to screen for septic patients at greater risk for poor outcomes...
January 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28109962/endothelial-permeability-and-hemostasis-in-septic-shock-results-from-the-process-trial
#8
Peter Hou, Michael Filbin, Henry Wang, Long Ngo, David T Huang, William C Aird, Donald M Yealy, Derek C Angus, John A Kellum, Nathan I Shapiro
BACKGROUND: We studied patients from the Protocolized Care in Early Septic Shock (ProCESS) trial to determine: the effects of alternative resuscitation strategies on circulating markers of endothelial cell permeability and hemostasis, and; the association between biomarkers and mortality. METHODS: Prospective study of biomarkers of endothelial cell permeability (vegf, sflt-1, ang-2) and hemostasis (vwf, thrombomodulin, tpa) in 605 of the 1341 ProCESS participants in a derivation cohort and 305 in validation...
January 18, 2017: Chest
https://www.readbyqxmd.com/read/28091737/impact-of-pelvic-fractures-on-the-early-clinical-outcomes-of-severely-injured-trauma-patients
#9
K Almahmoud, R Pfeifer, K Al-Kofahi, A Hmedat, W Hyderabad, F Hildebrand, A B Peitzman, H-C Pape
BACKGROUND: Pelvic fractures contribute to morbidity and mortality following injury. We sought to study the impact of pelvic fractures on the clinical course and outcomes of trauma patients with a pelvic fracture in comparison to patients with similar injury severity without pelvic fracture to identify potential parameters to track patients' clinical course post-injury. METHODS: A cohort of 206 consecutive blunt trauma survivors, studied over a 5-year period in a level I trauma center of which 75 patients (36...
January 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28053267/assessment-of-resuscitation-as-measured-by-markers-of-metabolic-acidosis-and-features-of-injury
#10
D S Weinberg, A S Narayanan, T A Moore, H A Vallier
AIMS: The best time for definitive orthopaedic care is often unclear in patients with multiple injuries. The objective of this study was make a prospective assessment of the safety of our early appropriate care (EAC) strategy and to evaluate the potential benefit of additional laboratory data to determine readiness for surgery. PATIENTS AND METHODS: A cohort of 335 patients with fractures of the pelvis, acetabulum, femur, or spine were included. Patients underwent definitive fixation within 36 hours if one of the following three parameters were met: lactate < 4...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/27974919/brief-report-serial-capillary-lactate-measurement-predict-the-evolution-of-early-sepsis
#11
REVIEW
A Purcarea, A Bourgarit, A Sovaila, C Ghiura, P Diemunsch, E Andres
OBJECTIVE: In intensive care settings, blood lactate level measurement proved to be an excellent predictor of outcomes. In patients requiring less urgent treatment, the arterial blood lactate is less sensitive and its usefulness remains to be proven. Capillary blood lactate dosing, an emergent point-of-care technique readily available should be more sensitive to changes in these settings. METHOD: prospective, observational, monocentric study conducted in a polyvalent internal medicine ward in a French University Hospital...
January 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27935627/clinical-evaluation-of-statstrip-%C3%A2-lactate-for-use-in-fetal-scalp-blood-sampling
#12
Ayesha Heinis, Jeroen van Dillen, Janine Oosting, Sarah Rhöse, Frank Vandenbussche, Joris Van Drongelen
INTRODUCTION: Point-of-care testing of fetal scalp blood lactate is used as an alternative for pH analysis in fetal scalp blood sampling (FBS) during labor. Lactate measurements are not standardized and values vary with each device used. The aim of this study was to evaluate StatStrip Lactate (SSL) in the clinical setting in comparison to lactate (RLL) and pH (RLpH) by RapidLab. MATERIALS AND METHODS: We obtained 323 FBS samples from 139 women. Parallel sampling of SSL and RLL/RLpH was performed in 247 samples...
December 9, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27907960/multimodality-monitoring-illuminating-the-comatose-human-brain
#13
Charles L Francoeur, Margaret Pain, Stephan A Mayer
The field of neurocritical care has evolved tremendously in recent years, a development explained vastly by the advent of neurophysiological monitoring. From basic intracranial pressure measurements to brain tissue oxygenation, microdialysis, cerebral blood flow (CBF), and surface and intracortical electroencephalography (EEG), our ability to detect and control physiologic endpoints of brain function in comatose patients has grown substantially. The integration of these data gave birth to the concept of multimodality monitoring (MMM)...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27881199/intestinal-permeability-induced-by-lipopolysaccharide-and-measured-by-lactulose-rhamnose-and-mannitol-sugars-in-chickens
#14
S Gilani, G S Howarth, S M Kitessa, C D Tran, R E A Forder, R J Hughes
Increased intestinal permeability (IP) can lead to compromised health. Limited in vivo IP research has been conducted in chickens. The objectives of the current study were to develop a model of increased IP utilizing lipopolysaccharide (LPS Escherichia coli O55:B5) and to evaluate IP changes using the lactulose, mannitol and rhamnose (LMR) sugar permeability test. In addition, fluorescein isothiocyanate dextran (FITC-d), d-lactate, zonula occludens (ZO-1) and diamine oxidase (DAO) permeability tests were employed...
November 24, 2016: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/27867135/comparison-of-capillary-and-arterial-lactate-levels-in-patients-with-shock
#15
Olivier Collange, Vincent Garcia, Michel Kindo, Nicolas Meyer, Thomas Lavaux, Paul Michel Mertes, Girish P Joshi, Pierre Diemunsch
OBJECTIVE: Several guidelines recommend point-of-care lactate measurements for therapeutic decision-making in patients with shock. The aim of the study was to validate capillary lactate measurements with a bedside micromethod in patients with shock. STUDY DESIGN: Prospective observational study. PATIENTS AND MEASUREMENTS: Capillary lactate levels measured by a micromethod (CAPI) and arterial lactate levels measured by a standard laboratory method (ARTs) were simultaneously and repeatedly assayed in consecutive ICU patients with shock...
November 17, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27862979/cerebral-tissue-oxygenation-index-and-lactate-at-24-hours-postoperative-predict-survival-and-neurodevelopmental-outcome-after-neonatal-cardiac-surgery
#16
Safwat A Aly, David Zurakowski, Penny Glass, Kami Skurow-Todd, Richard A Jonas, Mary T Donofrio
IMPORTANCE: There are no well-established noninvasive biomarkers for identifying patients at risk for poor outcome after surgery for congenital heart disease. Few studies have assessed prognostic accuracy of cerebral tissue oxygenation index (cTOI) measured by near infrared spectroscopy (NIRS). OBJECTIVE: To assess the utility of noninvasive NIRS monitoring as a predictor of outcomes after neonatal cardiac surgery through measurement of cTOI. To examine the utility of noninvasive NIRS monitoring in combination with lactate concentration and inotropic score in prediction of outcomes after neonatal cardiac surgery...
November 10, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27861824/lactation-support-services-and-breastfeeding-initiation-evidence-from-the-affordable-care-act
#17
Kandice A Kapinos, Lindsey Bullinger, Tami Gurley-Calvez
OBJECTIVE: Despite substantial evidence of the benefits of breastfeeding for both mothers and children, rates of sustained breastfeeding in the United States are quite low. This study examined whether mandated coverage of lactation support services under the Affordable Care Act (ACA) affects breastfeeding behavior. DATA SOURCE: We studied the census of U.S. births included in the National Vital Statistics System from 2009 to 2014. STUDY DESIGN: We used regression-adjusted difference-in-differences (DD) to examine changes in breastfeeding rates for privately insured mothers relative to those covered by Medicaid...
November 10, 2016: Health Services Research
https://www.readbyqxmd.com/read/27843178/the-handheld-blood-lactate-analyser-versus-the-blood-gas-based-analyser-for-measurement-of-serum-lactate-and-its-prognostic-significance-in-severe-sepsis
#18
Shivinder Singh, Abhishek Bhardawaj, Ratnesh Shukla, Trimbak Jhadav, Anoop Sharma, D Basannar
BACKGROUND: This study was done to compare the accuracy of the Lactate Pro LT 1710 (Arkray Inc., Kyoto, Japan) with the Combiline Plus (Eschweiler GmbH & Co. KG Holzkoppelweg, Kiel, Germany), and also, to analyze the prognostic significance of serum lactates and Simplified Acute Physiology Score 3 (SAPS 3) in patients of severe sepsis. METHODS: 106 patients of severe sepsis admitted to the ICU were screened. The serum lactate from an arterial sample analyzed in both the machines was recorded at admission and at 48 h...
October 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27836621/analytical-performance-of-three-whole-blood-point-of-care-lactate-devices-compared-to-plasma-lactate-comparison-methods-and-a-flow-injection-mass-spectrometry-method
#19
Nicole V Tolan, Amy M Wockenfus, Christopher D Koch, Bridgit O Crews, Dennis J Dietzen, Brad S Karon
OBJECTIVES: Point of care (POC) whole blood lactate testing may facilitate rapid detection of sepsis. We evaluated three POC methods against both plasma lactate comparison methods and a flow-injection mass spectrometric (MS) method. DESIGN AND METHODS: Nova StatStrip, Abbott i-STAT CG4+ and Radiometer ABL90 POC lactate methods were evaluated against the mean of Cobas Integra 400 and Vitros 350 plasma lactate. POC methods were also compared to a flow-injection mass spectrometric assay measuring lactate in ZnSO4-precipitated whole blood extracts...
November 9, 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27783141/emergency-abdominal-surgery-in-the-elderly-can-we-predict-mortality
#20
Anna E Sharrock, Jenny McLachlan, Robert Chambers, Ian S Bailey, James Kirkby-Bott
BACKGROUND: The United Kingdom population is ageing. Half of patients requiring an emergency laparotomy are aged over 70, 20 % die within 30 days, and less than half receive good care. Frailty and delay in management are associated with poor surgical outcomes. P-POSSUM risk scoring is widely accepted, but its validity in patients aged over 70 undergoing emergency laparotomy is unclear. AIMS: To assess if P-POSSUM risk stratification reliably predicts inpatient mortality in this group and establish whether those who died within 30 days received delayed care...
February 2017: World Journal of Surgery
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