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https://www.readbyqxmd.com/read/28914215/-treatment-of-sepsis-in-perspective-what-have-25-years-of-sepsis-definition-brought-us
#1
M J M M van der Steen, P Dieperink, P Pickkers
The first official definition of sepsis was published in 1992. Last year, in 2016, the third version was published. In this article we discuss the various definitions, the evolving insights into pathophysiology and several of the treatments that have been implemented over the last 25 years.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28876598/spectrum-of-disease-and-outcome-of-primary-amputation-for-diabetic-foot-sepsis
#2
S Cheddie, C Manneh, H Zulu
BACKGROUND: Guillotine amputation for diabetic foot sepsis followed by an elective refashioning of the stump is regarded as standard practice. Primary amputation is associated with higher reamputation rates. METHOD: A prospective cohort study of 85 patients who underwent surgery for diabetic foot sepsis from 2014 to 2016 at Madadeni Provincial Hospital, KwaZulu-Natal was done. Ethical approval was granted. The Wagner classification (Wag) was used to classify disease severity...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28841902/markers-of-acute-kidney-injury-in-patients-with-sepsis-the-role-of-soluble-thrombomodulin
#3
Shinshu Katayama, Shin Nunomiya, Kansuke Koyama, Masahiko Wada, Toshitaka Koinuma, Yuya Goto, Ken Tonai, Jun Shima
BACKGROUND: Endothelial activation and damage occur early during sepsis, with activated coagulopathy and playing a major role in the pathophysiology of sepsis-induced acute kidney injury (AKI). The aim of this study was to compare the various biomarkers of endothelial injury with the biomarkers of coagulation and inflammation and to determine a significant predictor of AKI in patients with sepsis. METHODS: We conducted a single-center, retrospective, observational study on patients with sepsis fulfilling the Third International Consensus Definitions for Sepsis and Septic Shock criteria admitted to an adult intensive care unit (ICU) at a university hospital from June 2011 to December 2016...
August 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28795138/retransplantation-in-late-hepatic-artery-thrombosis-graft-access-and-transplant-outcome
#4
Bettina M Buchholz, Shakeeb Khan, Miruna D David, Bridget K Gunson, John R Isaac, Keith J Roberts, Paolo Muiesan, Darius F Mirza, Dhiraj Tripathi, M Thamara P R Perera
BACKGROUND: Definitive treatment for late hepatic artery thrombosis (L-HAT) is retransplantation (re-LT); however, the L-HAT-associated disease burden is poorly represented in allocation models. METHODS: Graft access and transplant outcome of the re-LT experience between 2005 and 2016 was reviewed with specific focus on the L-HAT cohort in this single-center retrospective study. RESULTS: Ninety-nine (5.7%) of 1725 liver transplantations were re-LT with HAT as the main indication (n = 43; 43%) distributed into early (n = 25) and late (n = 18) episodes...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28789803/preliminary-performance-on-the-new-cms-sepsis-1-national-quality-measure-early-insights-from-the-emergency-quality-network-e-qual
#5
Arjun K Venkatesh, Todd Slesinger, Jessica Whittle, Tiffany Osborn, Emily Aaronson, Craig Rothenberg, Nalani Tarrant, Pawan Goyal, Donald M Yealy, Jeremiah D Schuur
STUDY OBJECTIVE: We describe current hospital-level performance for the Centers for Medicare & Medicaid Services' Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) quality measure and qualitatively assess emergency department (ED) sepsis quality improvement best practice implementation. METHODS: Using a standardized Web-based submission portal, we surveyed quality improvement data from volunteer hospital-based EDs participating in the Emergency Quality Network Sepsis Initiative...
August 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28783810/adaptation-and-validation-of-a-pediatric-sequential-organ-failure-assessment-score-and-evaluation-of-the-sepsis-3-definitions-in-critically-ill-children
#6
Travis J Matics, L Nelson Sanchez-Pinto
Importance: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) uses the Sequential Organ Failure Assessment (SOFA) score to grade organ dysfunction in adult patients with suspected infection. However, the SOFA score is not adjusted for age and therefore not suitable for children. Objectives: To adapt and validate a pediatric version of the SOFA score (pSOFA) in critically ill children and to evaluate the Sepsis-3 definitions in patients with confirmed or suspected infection...
October 2, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28752002/changing-definitions-of-sepsis
#7
REVIEW
Fethi Gül, Mustafa Kemal Arslantaş, İsmail Cinel, Anand Kumar
Sepsis is one of the main causes of morbidity and mortality in critically ill patients despite the use of modern antibiotics and resuscitation therapies. Outcomes in sepsis have improved overall, probably because of an enhanced focus on early diagnosis and other improvements in supportive care, but mortality rates still remain unacceptably high. The diagnosis and definition of sepsis is a critical problem due to the heterogeneity of this disease process. Although it is apparent that much more needs to be done to advance our understanding, sepsis and related terms remain difficult to define...
June 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28697503/update-of-sepsis-in-the-intensive-care-unit
#8
Kelly Roveran Genga, James A Russell
Sepsis, the most common cause of admission to an intensive care unit (ICU), has had an increased incidence and prevalence over the last years with a simultaneous decrease in its short-term mortality. Sepsis survivors are more frequently discharged from hospital and often experience long-term outcomes such as late mortality, immune dysfunction, secondary infections, impaired quality of life, and unplanned readmissions. Early recognition and management of sepsis have challenged emergency care and critical care physicians and nurses...
2017: Journal of Innate Immunity
https://www.readbyqxmd.com/read/28696597/-sepsis-particularities-in-the-elderly-patients
#9
Xavier Roux, Benedikt Huttner, Jérôme Pugin, Virginie Prendki, Jean-Luc Reny
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to an infection. The clinical presentation of sepsis in the elderly is very variable and sepsis is therefore challenging to diagnose in this population. The new sepsis definitions published in 2016, which are based on objective clinical and biological scores, should lead to earlier recognition and diagnosis. Treatment should start as soon as possible because the specific pathophysiological changes of aging increase the risk of a sudden deterioration to septic shock...
November 9, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28694665/pancreas-preserving-distal-duodenectomy-a-versatile-operation-for-a-range-of-infra-papillary-pathologies
#10
W Kyle Mitchell, Pradeep F Thomas, Abed M Zaitoun, Adam J Brooks, Dileep N Lobo
AIM: To investigate the range of pathologies treated by pancreas preserving distal duodenectomy (PPDD) and present the outcome of follow-up. METHODS: Neoplastic lesions of the duodenum are treated conventionally by pancreaticoduodenectomy. Lesions distal to the major papilla may be suitable for a pancreas-preserving distal duodenectomy, potentially reducing morbidity and mortality. We present our experience with this procedure. Selective intraoperative duodenoscopy assessed the relationship of the papilla to the lesion...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28639605/-the-definition-of-sepsis-25-year-experience-of-concept-development
#11
V P Sazhin, A M Karsanov, S S Maskin, O V Remizov
The review, presented in chronological order the stages of formation of the modern definition of sepsis syndrome, since the recommendations of the conciliation conference ACCP/SCCM (1991), the experience of the practical use of which has been extensively critically assessed in future studies. As a result, it formed a strong opinion that the global challenge of early diagnosis of sepsis, under the previously proposed definitive categories have not been solved, moreover, in the scientific community formed a firm belief in the need to make fundamental changes in the definition of the term 'sepsis'...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28611227/lung-injury-etiology-and-other-factors-influencing-the-relationship-between-dead-space-fraction-and-mortality-in-ards
#12
Richard H Kallet, Hanjing Zhuo, Kelly Ho, Michael S Lipnick, Antonio Gomez, Michael A Matthay
BACKGROUND: In ARDS, elevated pulmonary dead-space fraction (VD/VT) is a particularly strong indicator of mortality risk. Whether the magnitude of VD/VT is modified by the underlying etiology of ARDS and whether this influences the strength of its association with mortality remains unknown. We sought to elucidate the impact of ARDS etiology on VD/VT and also to determine whether ARDS severity, as classified by the Berlin definition, has correspondence with changes in VD/VT. METHODS: This single-center, retrospective, observational study (2010-2016) measured VD/VT in 685 subjects with ARDS as part of clinical management with lung-protective ventilation...
June 13, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28601273/potential-impact-of-the-2016-consensus-definitions-of-sepsis-and-septic-shock-on-future-sepsis-research
#13
Sandra L Peake, Anthony Delaney, Michael Bailey, Rinaldo Bellomo
STUDY OBJECTIVE: The influence of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) on the conduct of future sepsis research is unknown. We seek to examine the potential effect of the new definitions on the identification and outcomes of patients enrolled in a sepsis trial. METHODS: This was a post hoc analysis of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial of early goal-directed therapy that recruited 1,591 adult patients presenting to the emergency department (ED) with early septic shock diagnosed by greater than or equal to 2 systemic inflammatory response syndrome criteria and either refractory hypotension or hyperlactatemia...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28572520/clinical-management-of-sepsis
#14
S M Lam, A Cw Lau, R Pk Lam, W W Yan
Sepsis is a common cause of hospital admission worldwide and contributes significantly to morbidity and mortality. The definition of sepsis has evolved from the 1991 American College of Chest Physicians/Society of Critical Care Medicine definition based on the criteria of systemic inflammatory response syndrome, to the 2016 Sepsis-3 definition that incorporates the Sequential Organ Failure Assessment score. The landmark trial on protocolised early goal-directed therapy was published in 2001, but three subsequent multicentre randomised controlled trials (ProCESS, ARISE, and ProMISe) in 2014-2015 did not confirm a survival benefit with protocolised care...
June 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28558733/towards-a-consensus-definition-of-maternal-sepsis-results-of-a-systematic-review-and-expert-consultation
#15
REVIEW
Mercedes Bonet, Vicky Nogueira Pileggi, Marcus J Rijken, Arri Coomarasamy, David Lissauer, João Paulo Souza, Ahmet Metin Gülmezoglu
BACKGROUND: There is a need for a clear and actionable definition of maternal sepsis, in order to better assess the burden of this condition, trigger timely and effective treatment and allow comparisons across facilities and countries. The objective of this study was to review maternal sepsis definitions and identification criteria and to report on the results of an expert consultation to develop a new international definition of maternal sepsis. METHODS: All original and review articles and WHO documents, as well as clinical guidelines providing definitions and/or identification criteria of maternal sepsis were included...
May 30, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28525923/a-national-implementation-project-to-prevent-catheter-associated-urinary-tract-infection-in-nursing-home-residents
#16
MULTICENTER STUDY
Lona Mody, M Todd Greene, Jennifer Meddings, Sarah L Krein, Sara E McNamara, Barbara W Trautner, David Ratz, Nimalie D Stone, Lillian Min, Steven J Schweon, Andrew J Rolle, Russell N Olmsted, Dale R Burwen, James Battles, Barbara Edson, Sanjay Saint
Importance: Catheter-associated urinary tract infection (UTI) in nursing home residents is a common cause of sepsis, hospital admission, and antimicrobial use leading to colonization with multidrug-resistant organisms. Objective: To develop, implement, and evaluate an intervention to reduce catheter-associated UTI. Design, Setting, and Participants: A large-scale prospective implementation project was conducted in community-based nursing homes participating in the Agency for Healthcare Research and Quality Safety Program for Long-Term Care...
August 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28500500/-epistemology-in-the-intensive-care-unit-what-is-the-purpose-of-a-definition-paradigm-shift-in-sepsis-research
#17
P Dickmann, A Scherag, S M Coldewey, C Sponholz, F M Brunkhorst, M Bauer
The adoption of the new sepsis definition in early 2016 introduced a new paradigm for the clinical picture of sepsis. Up until now, sepsis was defined as a systemic inflammatory reaction (systemic inflammatory response syndrome, SIRS) to an infection. Based on a better understanding of the molecular mechanisms, the focus of the new definition is no longer the inflammatory response, but rather the tissue damage and impairment of organ function which this induces. The paradigm thus moves away from the infection and the systemic inflammatory response, and toward that which makes sepsis so dangerous in terms of both disease dynamics and outcome: organ failure due to a dysregulated host response to an infection...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28497242/-new-sepsis-3-definition-do-we-have-to-treat-sepsis-before-we-can-diagnose-it-from-now-on
#18
T Schmoch, M Bernhard, F Uhle, M Gründling, T Brenner, M A Weigand
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) have been available since the beginning of 2016. SEPSIS-3 completely replaces the old SIRS criteria in the definition of sepsis and defines sepsis from now on as "life-threatening organ dysfunction caused by a dysregulated host response to infection". However, it seems questionable whether in clinical practice the new definition is really superior to the old one. The most important question is the following: Is it helpful to have a definition that first recognizes a patient once organ dysfunction has occurred and the patient already needs intensive care?...
May 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28495639/safety-and-tolerability-of-the-first-in-class-agent-cpi-613-in-combination-with-modified-folfirinox-in-patients-with-metastatic-pancreatic-cancer-a-single-centre-open-label-dose-escalation-phase-1-trial
#19
Angela Alistar, Bonny B Morris, Rodwige Desnoyer, Heidi D Klepin, Keyanoosh Hosseinzadeh, Clancy Clark, Amy Cameron, John Leyendecker, Ralph D'Agostino, Umit Topaloglu, Lakmal W Boteju, Asela R Boteju, Rob Shorr, Zuzana Zachar, Paul M Bingham, Tamjeed Ahmed, Sandrine Crane, Riddhishkumar Shah, John J Migliano, Timothy S Pardee, Lance Miller, Gregory Hawkins, Guangxu Jin, Wei Zhang, Boris Pasche
BACKGROUND: Pancreatic cancer statistics are dismal, with a 5-year survival of less than 10%, and more than 50% of patients presenting with metastatic disease. Metabolic reprogramming is an emerging hallmark of pancreatic adenocarcinoma. CPI-613 is a novel anticancer agent that selectively targets the altered form of mitochondrial energy metabolism in tumour cells, causing changes in mitochondrial enzyme activities and redox status that lead to apoptosis, necrosis, and autophagy of tumour cells...
June 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28488038/-the-2016-surviving-sepsis-campaign-sepsis-guideline
#20
REVIEW
S Petros, S John
Sepsis is still associated with very high morbidity and mortality. Continuous improvements in the early recognition and management of this syndrome are thus necessary. The 2016 Surviving Sepsis Campaign sepsis guideline presents current evidence and consequences in the management of sepsis. This new guideline came at the beginning of the paradigm shift in sepsis definition, whereby the influence of the current sepsis definition on the management of sepsis is yet to be seen. Despite tremendous research efforts, several recommendations in the new sepsis guideline have a weak to moderate evidence grade...
June 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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