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David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
Shaden Jobran, Randa Kattan, Jamal Shamaa, Hiyam Marzouqa, Musa Hindiyeh
BACKGROUND: Human adenoviruses have an important role in paediatric respiratory tract infections. They are estimated to cause 2-5% of the overall respiratory tract infections and 4-10% of all pneumonias. The aim of this study was to evaluate the clinical presentation and effect of adenoviral infection on the management of infected infants. METHODS: Data were collected from the medical records of patients infected with adenovirus and admitted to Caritas Baby Hospital...
February 21, 2018: Lancet
Adrien Koeltz, Stephane Lastere, Sylvain Jean-Baptiste
During the 2014-2015 chikungunya outbreak in French Polynesia, 64 patients with confirmed chikungunya virus infection were admitted into intensive care. Sixty-three were nonpregnant adults; 11 had an atypical form, 21 had severe sepsis or septic shock, and 18 died. These findings indicate that critical illness frequently complicates the course of chikungunya virus infection.
April 2018: Emerging Infectious Diseases
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
Takamitsu Masuda, Tomohisa Shoko, Yoshizumi Deguchi
Disseminated intravascular coagulation (DIC) often complicates sepsis, and its early treatment is crucial for improving patient outcomes. Coagulation markers may enable earlier diagnosis of DIC. The purpose of this study was to evaluate whether the risk of DIC onset can be predicted using coagulation markers. Patients who showed symptoms of systemic inflammatory response syndrome ≥2 and the quick Sequential Organ Failure Assessment score ≥2 points were investigated. All blood samples collected from the time of hospital admission to 7 days postadmission were investigated...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
Nikhil Satchidanand, Timothy J Servoss, Ranjit Singh, Angela M Bosinski, Penny Tirpak, Linda L Horton, Bruce J Naughton
BACKGROUND: Early, data-driven discussion surrounding palliative care can improve care delivery and patient experience. OBJECTIVE: To develop a 30-day mortality prediction tool for older patients in intensive care unit (ICU) with pneumonia that will initiate palliative care earlier in hospital course. DESIGN: Retrospective Electronic Health Record (EHR) review. SETTING: Four urban and suburban hospitals in a Western New York hospital system...
January 1, 2018: American Journal of Hospice & Palliative Care
Jayashree Veerasamy, Jayalakshmi Jayarajan
Pneumonia with bacteremia accounts for the majority (70%) of cases of invasive pneumococcal diseases. Laboratory characterization of pneumococci is routinely done by sensitivity to optochin. We identified an atypical presentation of optochin-resistant pneumococci in blood isolate of a patient with sepsis. Polymerase chain reaction for autolysin (lytA) and pneumolysin (ply) was positive in the bile soluble isolate. Gene sequencing revealed synonymous single nucleotide polymorphism type of functional mutation in lytA gene...
January 2018: International Journal of Applied and Basic Medical Research
Carlos Rodríguez-Lucas, M Rosario Rodicio, Isabel Costales, José Antonio Boga, Fernando Vazquez, Javier Fernández
Blood stream infections are serious conditions associated with high morbi-mortality. In this study, the new Sepsis Flow Chip (SFC) assay for identification of Gram-negative bacteria and their antimicrobial resistance genes was evaluated in positive blood cultures (BCs). SFC is a microarray with a broad panel comprising the most frequent causative agents of sepsis and antimicrobial resistance genes associated with them. A total of 100 prospective BCs, positive for Gram-negative bacilli, were assessed in the routine of the clinical microbiology laboratory and also applying the SFC assay...
February 14, 2018: Diagnostic Microbiology and Infectious Disease
Benjamin D Reed, Kurt R Schibler, Hitesh Deshmukh, Namasivayam Ambalavanan, Ardythe L Morrow
OBJECTIVES: We examined the impact of prenatal exposure to maternal antibiotics on risk of necrotizing enterocolitis (NEC), late onset sepsis (LOS), and death in infants born preterm. STUDY DESIGN: Secondary data analysis was conducted via an extant cohort of 580 infants born <32 weeks of gestation and enrolled in 3 level III neonatal intensive care units. Prenatal antibiotic exposure was defined as antibiotics received by the mother within 72 hours before delivery...
March 16, 2018: Journal of Pediatrics
Daniel D Bohl, Nathaniel T Ondeck, Brian Darrith, Charles P Hannon, Yale A Fillingham, Craig J Della Valle
BACKGROUND: Little is known regarding the impact of operative time on adverse events following arthroplasty. The present study tests for associations between a 15-minute increase in operative time and the occurrence of adverse events following primary total joint arthroplasty. METHODS: Patients undergoing primary total hip or knee arthroplasty during 2006-2013 were identified in the American College of Surgeons National Surgical Quality Improvement Program. Operative time (as a continuous variable) was tested for association with perioperative outcomes using multivariate regression...
February 17, 2018: Journal of Arthroplasty
Eashaa Kumar, Michael T McCurdy, Christian A Koch, Abdurrahman Hamadah, Tibor Fülöp, Kamel A Gharaibeh
Unexplained hypotension in the intensive care unit is commonly attributed to volume depletion, cardiorespiratory failure, sepsis, or relative adrenal insufficiency. In these acute conditions, thyroid hormone levels measured in blood, serum or plasma are often altered and solely attributed to critical illness. We report a series of 3 critically ill patients with prolonged respiratory failure, suppressed mental status and unexplained hypotension. Thyroid stimulating hormone levels ranged from normal to mildly elevated (2...
March 2018: American Journal of the Medical Sciences
Daisuke Kudo, Shigeki Kushimoto, Noriko Miyagawa, Tetsuya Sato, Masatsugu Hasegawa, Fumihito Ito, Sathoshi Yamanouchi, Hiroyuki Honda, Kohkichi Andoh, Hajime Furukawa, Yasuo Yamada, Yuta Tsujimoto, Manabu Okuyama
PURPOSE: Disseminated intravascular coagulations (DIC), acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI) are major organ dysfunctions that occur in patients with sepsis. This study aimed to elucidate the impact of these organ dysfunctions on mortality in patients with severe sepsis. MATERIAL AND METHODS: A prospective observational study was performed in 10 ICUs to obtain data from patients with severe sepsis. Multivariate analyses to examine in-hospital mortality were performed...
March 7, 2018: Journal of Critical Care
Mohamed A Dkhil, Rami B Kassab, Saleh Al-Quraishy, Mohamed M Abdel-Daim, Rafat Zrieq, Ahmed E Abdel Moneim
Ziziphus spina-christi (L.), a traditional Arabian medicinal herb, has been used by Egyptians (Bedouin and Nubian) to treat inflammatory symptoms and swellings, pain, and heat since long. We aimed to investigate whether Ziziphus spina-christi leaf extract (ZSCLE) exerted a myocardial and renal protective effect on mice in which sepsis had been induced with cecal ligation and puncture (CLP). Male C57BL/6 mice were divided randomly into six groups (n = 7): sham-operated group, sham-operated mice treated with ZSCLE (300 mg/kg), CLP-induced sepsis group, ZSCLE (100 mg/kg)-treated group, ZSCLE (200 mg/kg)-treated group, and ZSCLE (300 mg/kg)-treated group...
March 14, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Katerina Kaziani, Alice G Vassiliou, Anastasia Kotanidou, Chariclea Athanasiou, Ioanna Korovesi, Konstantinos Glynos, Stylianos E Orfanos
INTRODUCTION: Pulmonary capillary endothelium-bound (PCEB) angiotensin-converting enzyme (ACE) activity is a direct and quantifiable index of pulmonary endothelial function that decreases early in acute respiratory distress syndrome (ARDS) and correlates with its severity. Endothelial dysfunction is a major pathophysiology that underlies sepsis-related ARDS. Recombinant human activated protein C (rhAPC), now withdrawn from the market, has been used in the recent past as an endothelial-protective treatment in patients with septic organ dysfunction...
March 2018: Infectious Diseases and Therapy
Alice G Vassiliou, Anastasia Kotanidou, Zafeiria Mastora, Carlo Tascini, Gianluigi Cardinali, Stylianos E Orfanos
INTRODUCTION: A soluble (s) form of the endothelial protein C receptor (EPCR) circulates in plasma and inhibits activated protein C (APC) activities. The clinical impact of sEPCR and its involvement in the septic process is under investigation. This study determined the frequencies of EPCR haplotypes H1 and H3 to investigate possible associations with plasma admission levels of sEPCR in an intensive care unit (ICU) cohort of septic patients. METHODS: Three polymorphisms in the EPCR gene were genotyped in 239 Caucasian critically ill patients, and their plasma sEPCR levels were also measured at the time of admission to the ICU...
March 2018: Infectious Diseases and Therapy
Rachael F Grace, Paola Bianchi, Eduard J van Beers, Stefan W Eber, Bertil Glader, Hassan M Yaish, Jenny M Despotovic, Jennifer A Rothman, Mukta Sharma, Melissa M McNaull, Elisa Fermo, Kimberly Lezon-Geyda, D Holmes Morton, Ellis J Neufeld, Satheesh Chonat, Nina Kollmar, Christine M Knoll, Kevin Kuo, Janet L Kwiatkowski, Dagmar Pospíŝilová, Yves D Pastore, Alexis A Thompson, Peter E Newburger, Yaddanapudi Ravindranath, Winfred C Wang, Marcin W Wlodarski, Heng Wang, Susanne Holzhauer, Vicky R Breakey, Joachim Kunz, Sujit Sheth, Melissa J Rose, Heather A Bradeen, Nolan Neu, Dongjing Guo, Hasan Al-Sayegh, Wendy B London, Patrick G Gallagher, Alberto Zanella, Wilma Barcellini
An international, multicenter registry was established to collect retrospective and prospective clinical data on patients with pyruvate kinase (PK) deficiency, the most common glycolytic defect causing congenital non-spherocytic hemolytic anemia. Medical history and laboratory and radiologic data were retrospectively collected at enrollment in 254 patients with molecularly confirmed PK deficiency. Perinatal complications were common, including anemia requiring transfusions, hyperbilirubinemia, hydrops, and prematurity...
March 16, 2018: Blood
G van Niekerk, S Adams, H Rode
BACKGROUND: Since 2003 we have used the scalp as a donor site for split skin grafts (SSGs) in major burns when there was a shortage of conventional donor areas. However, we seen a high incidence of complications, contrary to international experience. OBJECTIVE: The aim of this study was to analyze the results and complications related to the scalp as a donor site and to determine whether there is an association between our specific patient population and the complications encountered...
March 13, 2018: Burns: Journal of the International Society for Burn Injuries
Anne K Jensen, Gui-Shuang Ying, Jiayan Huang, Graham E Quinn, Gil Binenbaum
BACKGROUND: An association between thrombocytopenia and retinopathy of prematurity (ROP) has been suggested but not been studied longitudinally. We sought to identify the time period in postnatal development during which thrombocytopenia and the subsequent development of severe ROP are associated. METHODS: This was a retrospective case-control study of 100 subjects who received laser photocoagulation for type 1 ROP between 2005 and 2009 and 100 controls with no ROP or only stage 1 ROP...
March 13, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Shannon M Fernando, Douglas P Barnaby, Christophe L Herry, E John Gallagher, Nathan I Shapiro, Andrew J E Seely
BACKGROUND: Early emergency department (ED) identification of septic patients at risk of deterioration is critical. Lactate is associated with 28-day mortality in admitted patients, but little evidence exists on its use in predicting short-term deterioration. OBJECTIVE: Our aim was to determine the role of initial serum lactate for prediction of short-term deterioration in stable ED patients with suspected sepsis. METHODS: We conducted a prospective cohort study of adult ED sepsis patients...
March 13, 2018: Journal of Emergency Medicine
Dimitrios K Matthaiou, Stijn Blot, Despoina Koulenti
No abstract text is available yet for this article.
March 13, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
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