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sepsis shock children

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https://www.readbyqxmd.com/read/29783819/-value-of-urine-soluble-triggering-receptor-expressed-on-myeloid-cells-1-in-the-early-diagnosis-of-sepsis-associated-acute-kidney-injury
#1
Z K Yuan, F Fang, C J Liu, J Li, Y F Chen, F Xu
Objective: To assess the value of urine soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in early diagnosis and prognosis of sepsis associated acute kidney injury (AKI). Methods: This was a case-control study. A total of 62 patients with sepsis during November 2016 to June 2017 were collected, who were divided into non-AKI sepsis ( n= 49) and AKI sepsis ( n= 13) groups according to the serum creatinine (SCr) or urine output, sepsis with shock ( n= 22) and sepsis without shock ( n= 40) groups according to the presence of shock, survival ( n= 47) and death ( n= 15) groups according to the mortality...
May 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29782390/suspecting-hyperferritinemic-sepsis-in-iron-deficient-population-do-we-need-a-lower-plasma-ferritin-threshold
#2
Swarup Ghosh, Arun K Baranwal, Prateek Bhatia, Karthi Nallasamy
OBJECTIVES: Hyperferritinemia is being suggested to identify patients with sepsis-induced macrophage activation syndrome for early intervention. However, data among iron-deficient children are scarce. This study was planned to explore the biological behavior of plasma ferritin in children from communities with a high frequency of iron deficiency with septic shock and its association with the outcome. DESIGN: Prospective observational study. SETTING: Tertiary care teaching hospital in a low-middle income economy of South Asia...
May 18, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29732457/a-computable-definition-of-sepsis-facilitates-screening-and-performance-improvement-tracking
#3
Lauren J Alessi, Holly R Warmus, Erin K Schaffner, Sajel Kantawala, Joseph Carcillo, Johanna Rosen, Christopher M Horvat
Background: Sepsis kills almost 5,000 children annually, accounting for 16% of pediatric health care spending in the United States. Objectives: We sought to identify sepsis within the Electronic Health Record (EHR) of a quaternary children's hospital to characterize disease incidence, improve recognition and response, and track performance metrics. Methods: Methods are organized in a plan-do-study-act cycle. During the "plan" phase, electronic definitions of sepsis (blood culture and antibiotic within 24 hours) and septic shock (sepsis plus vasoactive medication) were created to establish benchmark data and track progress with statistical process control...
March 2018: Pediatric Quality & Safety
https://www.readbyqxmd.com/read/29716506/parechovirus-an-important-emerging-infection-in-young-infants
#4
Philip N Britton, Cheryl A Jones, Kristine Macartney, Allen C Cheng
Epidemics of human parechovirus (HPeV) causing disease in young children have occurred every 2 years in Australia since 2013. HPeV genotype 3 caused the epidemic from late 2017 to early 2018. Most HPeV infections cause no or mild symptoms including gastroenteritis or influenza-like illness. Characteristically, young infants present with fever, irritability and on occasions a diffuse rash ("red, hot and angry" babies). Severe disease can manifest as meningoencephalitis, seizures or sepsis-like presentations (including septic shock), or less common presentations including signs of surgical abdomen...
May 7, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29699503/comparison-of-the-incidence-clinical-features-and-outcomes-of-invasive-candidiasis-in-children-and-neonates
#5
Jen-Fu Hsu, Mei-Yin Lai, Chiang-Wen Lee, Shih-Ming Chu, I-Hsyuan Wu, Hsuan-Rong Huang, I-Ta Lee, Ming-Chou Chiang, Ren-Huei Fu, Ming-Horng Tsai
BACKGROUND: Invasive candidiasis differs greatly between children and neonates. We aimed to investigate the different therapeutic approaches and their effects on treatment outcomes of these two groups. METHODS: Episodes of neonatal invasive candidiasis were compared with non-neonatal pediatric episodes during a 12-year cohort study. Clinical isolates were documented by matrix-assisted laser desorption/ionization-time of flight mass spectrometry and DNA sequencing, and antifungal susceptibility testing was performed...
April 24, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29678565/simplification-of-first-line-antibacterial-regimen-for-complicated-appendicitis-in-children-was-associated-with-better-adherence-to-guidelines-and-reduced-use-of-antibiotics
#6
Marion Taleb, Nicolas Nardi, Alexis Arnaud, Nathalie Costet, Pierre-Yves Donnio, Charlotte Engrand, Edouard Habonimana, Eric Wodey, Pierre Tattevin
Acute appendicitis in children requires early surgery, and a short course of antibiotics active on Enterobacteriaceae and anaerobes. Although aminoglycoside-containing 3-drug regimen have been used successfully for decades, simpler regimens with similar efficacy are increasingly used. We aimed to evaluate the impact of a switch from the combination of cefotaxime, metronidazole, and gentamicin (regimen 1), to piperacillin-tazobactam (regimen 2), as first-line regimen for complicated acute appendicitis in children...
April 17, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#7
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29675402/poor-compliance-with-sepsis-guidelines-in-a-tertiary-care-children-s-hospital-emergency-room
#8
Benjamin Louis Moresco, Clinton Woosley, Morris Sauter, Utpal Bhalala
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29601458/epidemiology-and-clinical-relevance-of-toxic-shock-syndrome-in-us-children
#9
James T Gaensbauer, Meghan Birkholz, Michael A Smit, Roger Garcia, James K Todd
INTRODUCTION: It is important for clinicians to recognize the contribution of toxic shock syndrome (TSS) to the overall burden of pediatric septic shock because the clinical features, optimal therapy and prognosis differ from non-TSS septic shock. METHODS: We analyzed cases of pediatric septic shock reported to the Pediatric Health Information Systems (PHIS) database between 2009 and 2013 to define the clinical and demographic characteristics of pediatric TSS in the US...
March 27, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29566368/the-trend-of-%C3%AE-3-adrenergic-receptor-in-the-development-of-septic-myocardial-depression-a-lipopolysaccharide-induced-rat-septic-shock-model
#10
Ni Yang, Xiao-Lu Shi, Bing-Lun Zhang, Jian Rong, Tie-Ning Zhang, Wei Xu, Chun-Feng Liu
Septic shock with low cardiac output is very common in children. However, the mechanism underlying myocardial depression is unclear. The role of β3-AR in the development of myocardial depression in sepsis is unknown. In the present study, we generated an adolescent rat model of hypodynamic septic shock induced by lipopolysaccharide (LPS). Neonatal cardiomyocytes were also treated with LPS to mimic myocardial depression in sepsis, which was confirmed via an in vivo left ventricular hemodynamic study, and measurements of contractility and the Ca2+ transient in isolated adolescent and neonatal cardiomyocytes...
March 22, 2018: Cardiology
https://www.readbyqxmd.com/read/29552957/global-longitudinal-strain-using-speckle-tracking-echocardiography-as-a-mortality-predictor-in-sepsis-a-systematic-review
#11
Saraschandra Vallabhajosyula, Hamza A Rayes, Ankit Sakhuja, Mohammad Hassan Murad, Jeffrey B Geske, Jacob C Jentzer
The data on speckle-tracking echocardiography (STE) in patients with sepsis are limited. This systematic review from 1975 to 2016 included studies in adults and children evaluating cardiovascular dysfunction in sepsis, severe sepsis, and septic shock utilizing STE for systolic global longitudinal strain (GLS). The primary outcome was short- or long-term mortality. Given the significant methodological and statistical differences between published studies, combining the data using meta-analysis methods was not appropriate...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29543684/effect-of-a-sepsis-educational-intervention-on-hospital-stay
#12
Jaime Fernández-Sarmiento, Joseph A Carcillo, Claudia M Salinas, Edgar F Galvis, Paula A López, Andrés Jagua-Gualdrón
OBJECTIVES: To evaluate adherence to the sepsis bundle before and after an educational strategy and its impact on hospital stay. DESIGN: A prospective, analytic, before-and-after study of children with severe sepsis and septic shock who presented to the emergency department. SETTING: Carried out from January to December 2014 in the emergency department of a quaternary care hospital. PATIENTS: Of a total of 19,836 children who presented to the emergency department, 4,383 had an infectious pathology, with 203 of these showing severe sepsis and septic shock (124 pre intervention, and 79 post intervention)...
March 14, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29536210/occurrence-of-marked-sepsis-induced-immunosuppression-in-pediatric-septic-shock-a-pilot-study
#13
Solenn Remy, Karine Kolev-Descamps, Morgane Gossez, Fabienne Venet, Julie Demaret, Etienne Javouhey, Guillaume Monneret
BACKGROUND: While the process of sepsis-induced immunosuppression is now well described in adults, very little information is available on immune functions in pediatric sepsis. The current study investigated this in children with septic shock by performing immunomonitoring, including both innate (monocyte human leukocyte antigen-DR, mHLA-DR, expression) and adaptive immunity (lymphocyte subsets count), as well as cytokine concentrations (IL-6, IL-8, IL-10, IL-1Ra, TNF-α, IFN-γ). Subsequent objectives were to assess the associations between inflammatory response, potential immunosuppression and secondary acquired infection occurrence...
March 13, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29470918/early-immune-function-and-duration-of-organ-dysfunction-in-critically-ill-septic-children
#14
Jennifer A Muszynski, Ryan Nofziger, Melissa Moore-Clingenpeel, Kristin Greathouse, Larissa Anglim, Lisa Steele, Josey Hensley, Lisa Hanson-Huber, Jyotsna Nateri, Octavio Ramilo, Mark W Hall
RATIONALE: Late immune suppression is associated with nosocomial infection and mortality in septic adults and children. Relationships between early immune suppression and outcomes in septic children remain unclear. OBJECTIVE: Prospective observational study to test the hypothesis that early innate and adaptive immune suppression are associated with longer duration of organ dysfunction in children with severe sepsis/septic shock. Methods, Measurements and Main Results: Children aged < 18 years meeting consensus criteria for severe sepsis or septic shock were sampled within 48 hours of sepsis onset...
February 22, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29469010/effect-of-blood-thiamine-concentrations-on-mortality-influence-of-nutritional-status
#15
Heitor Pons Leite, Lúcio Flávio Peixoto de Lima, José Augusto de A C Taddei, Ângela Tavares Paes
OBJECTIVE: To test the hypothesis that low blood thiamine concentrations in malnourished critically ill children are associated with higher risk of 30-d mortality. METHODS: Prospective cohort study in 202 consecutively admitted children who had whole blood thiamine concentrations assessed on admission and on days 5 and 10 of intensive care unit (ICU) stay. The primary outcome variable was 30-d mortality. Mean blood thiamine concentrations within the first 10 d of ICU stay, age, sex, malnutrition, C-reactive protein concentration, Pediatric Index of Mortality 2 score, and severe sepsis/septic shock were the main potential exposure variables for outcome...
April 2018: Nutrition
https://www.readbyqxmd.com/read/29424065/trend-and-outcome-of-sepsis-in-children-a-nationwide-cohort-study
#16
Chia-Hung Yo, Tzu-Chun Hsu, Meng-Tse Gabriel Lee, Lorenzo Porta, Po-Yang Tsou, Yu-Hsun Wang, Wan-Chien Lee, Szu-Ta Chen, Chien-Chang Lee
AIM: The aim of this study was to investigate the trend of incidence and outcome of paediatric sepsis in a population-based database. METHODS: Children with sepsis were identified from the 23 million nationwide health insurance claims database of Taiwan. Sepsis was defined by the presence of single ICD-9 code for severe sepsis or septic shock or a combination of ICD-9 codes for infection and organ dysfunction. We analysed the trend of incidence, mortality and source of infection in three age groups: infant (28 days to 1 year), child (1-9 years) and adolescent (10-18 years)...
February 9, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29390386/hemophagocytic-lymphohistiocytosis-in-an-adult-kidney-transplant-recipient-successfully-treated-by-plasmapheresis-a-case-report-and-review-of-the-literature
#17
REVIEW
Christian Nusshag, Christian Morath, Martin Zeier, Markus A Weigand, Uta Merle, Thorsten Brenner
RATIONALE: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease entity primarily described in children, but not less relevant in adults. It is characterized by a misdirected activation of the immune system, resulting in an uncontrolled cytokine release from macrophages and cytotoxic T-cells (CTLs). Primary HLH relies on a genetic predisposition, whereas secondary HLH develops in the context of infections, malignancies or autoimmune diseases. However, the awareness and therapeutic knowledge for HLH in adulthood is limited...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29371283/clinical-features-antimicrobial-susceptibility-patterns-and-genomics-of-bacteria-causing-neonatal-sepsis-in-a-children-s-hospital-in-vietnam-protocol-for-a-prospective-observational-study
#18
Nguyen Duc Toan, Thomas C Darton, Christine J Boinett, James I Campbell, Abhilasha Karkey, Evelyne Kestelyn, Le Quoc Thinh, Nguyen Kien Mau, Pham Thi Thanh Tam, Le Nguyen Thanh Nhan, Ngo Ngoc Quang Minh, Cam Ngoc Phuong, Nguyen Thanh Hung, Ngo Minh Xuan, Tang Chi Thuong, Stephen Baker
INTRODUCTION: The clinical syndrome of neonatal sepsis, comprising signs of infection, septic shock and organ dysfunction in infants ≤4 weeks of age, is a frequent sequel to bloodstream infection and mandates urgent antimicrobial therapy. Bacterial characterisation and antimicrobial susceptibility testing is vital for ensuring appropriate therapy, as high rates of antimicrobial resistance (AMR), especially in low-income and middle-income countries, may adversely affect outcome. Ho Chi Minh City (HCMC) in Vietnam is a rapidly expanding city in Southeast Asia with a current population of almost 8 million...
January 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29347924/causes-of-death-in-hospitalized-children-younger-than-12-years-of-age-in-a-chinese-hospital-a-10-year-study
#19
Yueniu Zhu, Xiaodong Zhu, Mengyan Deng, Hongxia Wei, Mingjun Zhang
BACKGROUND: In China, the majority (77%) of urban children die in hospitals. Hospital-based review could provide insight leading to improvements in clinical practice and increase the survival of critically ill children. The aim of the present study is to identify the trends of immediate causes and chronic underlying diseases associated with deaths of children at one of the largest teaching hospitals in China over a period of 10 years (2006-2015). METHODS: A retrospective analysis of data of all children aged 1 month to 11 years who died at Xinhua Hospital between 2006 and 2015...
January 18, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29338093/longitudinal-profiles-of-metabolism-and-bioenergetics-associated-with-innate-immune-hormonal-inflammatory-responses-and-amino-acid-kinetics-in-severe-sepsis-and-systemic-inflammatory-response-syndrome-in-children
#20
Anna Maria Spanaki, Theonymfi Tavladaki, Helen Dimitriou, Andrey V Kozlov, J Catharina Duvigneau, Eftychia Meleti, Adelheid Weidinger, Evangelos Papakonstantinou, George Briassoulis
BACKGROUND: Experimental data indicate that sepsis influences the mitochondrial function and metabolism. We aim to investigate longitudinal bioenergetic, metabolic, hormonal, amino-acid, and innate immunity changes in children with sepsis. METHODS: Sixty-eight children (sepsis, 18; systemic inflammatory response syndrome [SIRS], 23; healthy controls, 27) were enrolled. Plasma amino acids were determined by high-performance liquid chromatography (HPLC); flow-cytometry expressed as mean fluorescence intensity (MFI) of heat shock protein (HSP) levels from monocytes (m) and neutrophils (n); resistin, adiponectin, and extracellular (e) HSPs evaluated by ELISA; ATP levels in white blood cells by luciferase luminescent assay; lipid peroxidation products (TBARS) by colorimetric test; nitrite and nitrate levels by chemiluminescent assay; biliverdin reductase (BVR) activity by enzymatic assay; and energy-expenditure (EE) by E-COVX...
January 16, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
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