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hydrocortisone and neonatal septic shock

K A Hart, M H Barton, D C Ferguson, R Berghaus, N M Slovis, G L Heusner, D J Hurley
BACKGROUND: Relative cortisol insufficiency occurs in septic foals and impacts survival. Serum free (biologically available) cortisol concentration might be a better indicator of physiologic cortisol status than serum total cortisol concentration in foals. HYPOTHESES: In septic foals, (1) low free cortisol concentration correlates with disease severity and survival and (2) predicts disease severity and outcome better than total cortisol concentration. ANIMALS: Fifty-one septic foals; 11 healthy foals; 6 healthy horses...
March 2011: Journal of Veterinary Internal Medicine
James L Wynn, Hector R Wong
Neonatal septic shock is a devastating condition associated with high morbidity and mortality. Definitions for the sepsis continuum and treatment algorithms specific for premature neonates are needed to improve studies of septic shock and assess benefit from clinical interventions. Unique features of the immature immune system and pathophysiologic responses to sepsis, particularly those of extremely preterm infants, necessitate that clinical trials consider them as a separate group. Keen clinical suspicion and knowledge of risk factors will help to identify those neonates at greatest risk for development of septic shock...
June 2010: Clinics in Perinatology
K A Hart, N M Slovis, M H Barton
BACKGROUND: Transient hypothalamic-pituitary-adrenal (HPA) axis dysfunction occurs frequently in critically ill humans and impacts survival. The prevalence and impact of HPA axis dysfunction in critically ill neonatal foals are not well characterized. HYPOTHESES: (1) HPA axis dysfunction occurs in hospitalized neonatal foals, and is characterized by inappropriately low basal serum cortisol concentration or inadequate cortisol response to exogenous adrenocorticotropic hormone (ACTH); (2) hospitalized foals with HPA axis dysfunction have more severe disease and are less likely to survive than hospitalized foals with normal HPA axis function...
July 2009: Journal of Veterinary Internal Medicine
Joe Brierley, Joseph A Carcillo, Karen Choong, Tim Cornell, Allan Decaen, Andreas Deymann, Allan Doctor, Alan Davis, John Duff, Marc-Andre Dugas, Alan Duncan, Barry Evans, Jonathan Feldman, Kathryn Felmet, Gene Fisher, Lorry Frankel, Howard Jeffries, Bruce Greenwald, Juan Gutierrez, Mark Hall, Yong Y Han, James Hanson, Jan Hazelzet, Lynn Hernan, Jane Kiff, Niranjan Kissoon, Alexander Kon, Jose Irazuzta, Jose Irazusta, John Lin, Angie Lorts, Michelle Mariscalco, Renuka Mehta, Simon Nadel, Trung Nguyen, Carol Nicholson, Mark Peters, Regina Okhuysen-Cawley, Tom Poulton, Monica Relves, Agustin Rodriguez, Ranna Rozenfeld, Eduardo Schnitzler, Tom Shanley, Saraswati Kache, Sara Skache, Peter Skippen, Adalberto Torres, Bettina von Dessauer, Jacki Weingarten, Timothy Yeh, Arno Zaritsky, Bonnie Stojadinovic, Jerry Zimmerman, Aaron Zuckerberg
BACKGROUND: The Institute of Medicine calls for the use of clinical guidelines and practice parameters to promote "best practices" and to improve patient outcomes. OBJECTIVE: 2007 update of the 2002 American College of Critical Care Medicine Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shock. PARTICIPANTS: Society of Critical Care Medicine members with special interest in neonatal and pediatric septic shock were identified from general solicitation at the Society of Critical Care Medicine Educational and Scientific Symposia (2001-2006)...
February 2009: Critical Care Medicine
F Ughetto, O Paut, C Mareau, A Charpentier
Steroids are indicated in paediatric intensive care as anti-inflammatory drugs or for substitutive treatment. During septic shock, the incidence of adrenal insufficiency (AI) varies between 18 à 52%, depending on the relative or absolute nature of the AI. Contrary to adults, for whom long courses of low doses of corticosteroids were shown to reduce mortality and increased shock reversibility, particularly in those with a negative synacthene test, no study provided sufficient evidence to show a benefit of steroids in terms of outcome in children with septic shock...
June 2007: Annales Françaises D'anesthèsie et de Rèanimation
Yong Y Han, Joseph A Carcillo, Michelle A Dragotta, Debra M Bills, R Scott Watson, Mark E Westerman, Richard A Orr
OBJECTIVE: Experimental and clinical studies of septic shock support the concept that early resuscitation with fluid and inotropic therapies improves survival in a time-dependent manner. The new American College of Critical Care Medicine-Pediatric Advanced Life Support (ACCM-PALS) Guidelines for hemodynamic support of newborns and children in septic shock recommend this therapeutic approach. The objective of this study was to determine whether early septic shock reversal and use of resuscitation practice consistent with the new ACCM-PALS Guidelines by community physicians is associated with improved outcome...
October 2003: Pediatrics
K Frenzel, G Burda, G Fürst, J Golej, M Hermon, G Trittenwein, A Pollak
Adrenalin insufficiency associated with adrenal hemorrhage, is a rare complication after cardiac surgery in neonates. A boy suffering from transposition of the great arteries, who had an arterial switch-operation on day three of his life, acquired a bilateral adrenal hemorrhage. Clinically the situation resembled a septic shock. Despite large doses of catecholamines, he continued to have severe arterial hypotension, anuria, and kyperkalemia. The clinical condition did not change, although sepsis specific therapy was initiated...
January 1997: Klinische Pädiatrie
J M Loggie, P J Privitera, S Sugarman, T E Gaffney
No abstract text is available yet for this article.
May 1968: Proceedings of the Society for Experimental Biology and Medicine
S Kurata, Y Hirose, Y Abe
No abstract text is available yet for this article.
April 1968: Horumon to Rinsho. Clinical Endocrinology
H Togari, S Sugiyama, T Ogino, S Suzuki, T Ito, T Ichiki, K Kamiya, I Watanabe, Y Ogawa, Y Wada
CRP, alpha 1-acid glycoprotein and haptoglobin were studied in 13 septic shock neonates. Endotoxin was recovered from eight infants. Serum cortisol concentration from infants with endotoxemia (917 +/- 596 ng/ml) was significantly higher than that from infants without endotoxemia (398 +/- 239 ng/ml). Serum cortisol correlated well with immature neutrophil counts defined as the unit "band/neutrophil". Increased cortisol level and immature neutrophil counts preceded the elevation of CRP, alpha 1-acid glycoprotein and haptoglobin in four extremely premature neonates...
January 1986: Acta Paediatrica Scandinavica
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