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Sepsis protocol

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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
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
https://www.readbyqxmd.com/read/27911391/a-murine-model-of-group-b-streptococcus-vaginal-colonization
#2
Kathryn A Patras, Kelly S Doran
Streptococcus agalactiae (group B Streptococcus, GBS), is a Gram-positive, asymptomatic colonizer of the human gastrointestinal tract and vaginal tract of 10 - 30% of adults. In immune-compromised individuals, including neonates, pregnant women, and the elderly, GBS may switch to an invasive pathogen causing sepsis, arthritis, pneumonia, and meningitis. Because GBS is a leading bacterial pathogen of neonates, current prophylaxis is comprised of late gestation screening for GBS vaginal colonization and subsequent peripartum antibiotic treatment of GBS-positive mothers...
November 16, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27908332/prehospital-sepsis-care
#3
REVIEW
Jerrilyn Jones, Benjamin J Lawner
Prehospital care providers are tasked with the delivery of time-sensitive care, and emergency medical services (EMS) systems must match patients to appropriate clinical resources. Modern systems are uniquely positioned to recognize and treat patients with sepsis. Interventions such as administration of intravenous fluid and transporting patients to the appropriate level of definitive care are linked to improved patient outcomes. As EMS systems refine their protocols for the recognition and stabilization of patients with suspected or presumed sepsis, EMS providers need to be educated about the spectrum of sepsis-related presentations and treatment strategies need to be standardized...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27884349/endotoxemia-accelerates-diaphragm-dysfunction-in-ventilated-rabbits
#4
Yi Yang, Tao Yu, Chun Pan, Federico Longhini, Ling Liu, Yingzi Huang, Fengmei Guo, Haibo Qiu
BACKGROUND: Ventilators may induce diaphragm dysfunction, and most of the septic population who are admitted to the intensive care unit require mechanical ventilation. However, there is no evidence that sepsis accelerates the onset of ventilator-induced diaphragm dysfunction or affects the microcirculation. Our study investigated whether lipopolysaccharide (LPS)-induced endotoxemia accelerated diaphragm dysfunction in ventilated rabbits by evaluating microcirculation, lipid accumulation, and diaphragm contractility...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27876325/does-early-goal-directed-therapy-decrease-mortality-compared-with-standard-care-in-patients-with-septic-shock
#5
Michael E Winters, Robert Sherwin, Gary M Vilke, Gabriel Wardi
BACKGROUND: Current international guidelines for the treatment of patients with severe sepsis and septic shock recommend that patients receive targeted care to various physiologic endpoints, thereby optimizing tissue perfusion and oxygenation. These recommendations are primarily derived from a protocol published >15 years ago, which was viewed by many as complex and was therefore not widely adopted. Instead, many emergency physicians focused on the administration of early antibiotics, source control, aggressive fluid resuscitation, vasoactive medications as needed to maintain mean arterial blood pressure, and careful monitoring of these patients...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876013/reduced-neonatal-mortality-in-a-regional-hospital-in-mozambique-linked-to-a-quality-improvement-intervention
#6
Maria Elena Cavicchiolo, Paolo Lanzoni, Mazungo Olivier Wingi, Damiano Pizzol, Marco Daverio, Liviana Da Dalt, Giovanni Putoto, Daniele Trevisanuto
BACKGROUND: Neonatal mortality remains a serious health issue especially in low resource countries, where 99% of neonatal deaths occur. Doctors with Africa CUAMM is an Italian non-governmental organization in the field of healthcare that has been working in Africa since 1955. In Mozambique, at the Central Beira Hospital (CBH), it has a project with the aim of supporting the neonatal intensive care unit (NICU) and the Obstetrical Department of the CBH through a multi-level intervention...
November 22, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27872122/polymyxin-b-immobilised-haemoperfusion-and-mortality-in-critically-ill-patients-with-sepsis-septic-shock-a-protocol-for-a-systematic-review-and-meta-analysis
#7
Tomoko Fujii, Riki Ganeko, Yuki Kataoka, Robin Featherstone, Sean M Bagshaw, Toshi A Furukawa
INTRODUCTION: Polymyxin-B immobilised haemoperfusion (PMX-HP) is a promising adjuvant strategy for the treatment of sepsis and septic shock. PMX-HP therapy works by clearing circulating endotoxin through binding to polymyxin-immobilised fibres during haemoperfusion. Small clinical trials have shown that PMX-HP therapy is associated with improved haemodynamic profile, oxygenation and survival. However, clear inferences have been largely inconclusive due to limitations in study design (eg, small, unblinded) and generalisability...
November 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27851061/1425-sepsis-management-the-effect-of-protocol-initiation-on-patient-outcome
#8
Ruth Spector, Steven Blau
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27851006/1370-volume-administration-and-outcomes-in-obese-patients-with-sepsis-in-the-era-of-protocolized-care
#9
Brice Taylor, Edwin Gunn, Megan Templin, Colleen Karvestski, Stephanie Taylor
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27842958/mortality-related-factors-in-gastroschisis-a-jamaican-perspective
#10
Sarah G Marshall Niles, Kathryn Mitchell-Fearon, Mitchell I Gill, Claudine J DeSouza, Ian C Fearon, Colin A Abel, Brian A James, Noel J McLennon
OBJECTIVE: To determine the mortality rate of patients treated with gastroschisis at a Jamaican pediatric hospital, and to identify factors that contribute significantly to mortality. METHODS: Eighty-five patients were treated with gastroschisis between November 1, 2006 and November 30, 2015. Of these, 80 records were recovered and reviewed retrospectively. Records were analyzed for maternal and patient characteristics, and details of the clinical course. Death during admission was the primary outcome measure...
October 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27836005/the-causes-of-maternal-mortality-in-adolescents-in-low-and-middle-income-countries-a-systematic-review-of-the-literature
#11
Sarah Neal, Shanti Mahendra, Krishna Bose, Alma Virginia Camacho, Matthews Mathai, Andrea Nove, Felipe Santana, Zoë Matthews
BACKGROUND: While the main causes of maternal mortality in low and middle income countries are well understood, less is known about whether patterns for causes of maternal deaths among adolescents are the same as for older women. This study systematically reviews the literature on cause of maternal death in adolescence. Where possible we compare the main causes for adolescents with those for older women to ascertain differences and similarity in mortality patterns. METHODS: An initial search for papers and grey literature in English, Spanish and Portuguese was carried out using a number of electronic databases based on a pre-determined search strategy...
November 11, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27826650/protocol-based-management-of-154-cases-of-pediatric-liver-abscess
#12
Subhasis Roy Choudhury, Niyaz Ahmed Khan, Rahul Saxena, Partap Singh Yadav, Jigar N Patel, Rajiv Chadha
AIM: Although liver abscess (LA) is prevalent worldwide, especially in developing countries, there is a paucity of data regarding the protocol for management of LA in children. The aim of this study was to analyze the outcome of a protocol-based management of pediatric LA from a single institution. MATERIALS AND METHODS: This prospective observational study was conducted in a tertiary-care children's hospital and included all patients with LA managed over a 5-year period...
November 8, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27825282/relationship-between-maternal-c-reactive-protein-level-and-neonatal-outcome-in-patients-with-preterm-premature-rupture-of-membranes-treated-with-ampicillin-and-azithromycin
#13
Mehmet Serdar Kutuk, Osman Bastug, Ahmet Ozdemir, Mehmet Adnan Ozturk, Mahmut Tuncay Ozgun, Mustafa Basbug, Tamer Gunes, Selim Kurtoglu
This historical cohort study aimed to assess the relationship between antenatal maternal C-reactive protein (CRP) level and neonatal outcome preterm premature rupture of membranes (PPROM). We reviewed the records of 70 singleton pregnancies with PPROM between 24 and 34 weeks. Maternal CRP levels of neonates with respiratory distress syndrome, neonatal sepsis, grade 3-4 intraventricular haemorrhage and stage 2-3 necrotizing enterocolitis, perinatal mortality were compared with those without these complications...
August 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27811968/very-short-mitochondrial-dna-fragments-and-heteroplasmy-in-human-plasma
#14
Ruoyu Zhang, Kiichi Nakahira, Xiaoxian Guo, Augustine M K Choi, Zhenglong Gu
Cell free DNA (cfDNA) has received increasing attention and has been studied in a broad range of clinical conditions. However, few studies have focused on mitochondrial DNA (mtDNA) in the cell free form. We optimized DNA isolation and sequencing library preparation protocols to better retain short DNA fragments from plasma, and applied these optimized methods to plasma samples from patients with sepsis. Our methods can retain substantially shorter DNA, resulting in an average of 11.5 fold increase in short DNA fragments yield (DNA <100bp)...
November 4, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27809728/does-lyme-disease-exist-in-australia
#15
Peter J Collignon, Gary D Lum, Jennifer Mb Robson
There is no convincing evidence that classic Lyme disease occurs in Australia, nor is there evidence that the causative agent, Borrelia burgdorferi, is found in Australian animals or ticks. Lyme disease, however, can be acquired overseas but diagnosed in Australia; most people presenting with laboratory-confirmed Lyme disease in Australia were infected in Europe. Despite the lack of evidence that Lyme disease can be acquired in Australia, growing numbers of patients, their supporters, and some politicians demand diagnoses and treatment according to the protocols of the "chronic Lyme disease" school of thought...
November 7, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27793122/acute-pancreatitis-associated-with-everolimus-after-kidney-transplantation-a-case-report
#16
Francesco Fontana, Gianni Cappelli
BACKGROUND: Acute pancreatitis (AP) following KT is a rare and often fatal complication of the early post-transplant period. Common causative factors for AP are rare after KT; anti-rejection drugs as CyA, prednisone and MMF have been implicated, although evidence is not strong and we found no reports on possible causative role for mTOR inhibitors. CASE PRESENTATION: A 55-year-old Caucasian man with end-stage renal disease due to idiopathic membrano-prolipherative glomerulonephritis underwent single kidney transplantation (KT) from cadaveric donor...
October 28, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27788809/hepatic-venous-and-inferior-vena-cava-morphology-no-longer-a-barrier-to-living-donor-liver-transplantation-for-budd-chiari-syndrome-surgical-techniques-and-outcomes
#17
H Pahari, R J Chaudhary, S Thiagarajan, V Raut, R Babu, P Bhangui, S Goja, A Rastogi, V Vohra, A S Soin
BACKGROUND: Living donor liver transplantation (LDLT) for Budd-Chiari syndrome (BCS) has been reported with <10 inferior vena cava (IVC) replacements with vascular/synthetic graft. The goal of this study was to review outcomes of LDLT for BCS at our center, with an emphasis on surgical techniques and postoperative anticoagulation therapy. METHODS: Between October 2011 and December 2015, a total of 1027 LDLTs were performed. Nine of these patients had BCS. We analyzed their etiologies, operative details, postoperative complications, and outcomes...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27779982/impact-of-massive-transfusion-and-aging-blood-in-acute-trauma
#18
Tanya Anand, Rajesh Ramnanan, Ruby Skinner, Maureen Martin
Blood transfusions cause altered immunity and the duration of storage is contributory. In the era of massive transfusion protocols (MTPs) this impact is unclear, particularly as it relates to balanced transfusions. Trauma patients requiring our MTP after admission to our Level II trauma center were studied. The average age of blood transfused was calculated; old blood was a storage time of ≥14 days versus new blood <14 days. Blood to plasma ratios of 1:1 were compared with ratios >1:1. Infections, organ dysfunction multiorgan injury (MOI), and death were compared based on ratios and blood storage times...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27771026/impact-of-the-implementation-of-a-sepsis-code-hospital-protocol-in-antibiotic-prescription-and-clinical-outcomes-in-an-intensive-care-unit
#19
L García-López, S Grau-Cerrato, A de Frutos-Soto, F Bobillo-Delamo, R Cítores-Gónzalez, F Diez-Gutierrez, M F Muñoz-Moreno, T Sánchez-Sánchez, F Gandía-Martínez, D Andaluz-Ojeda
INTRODUCTION: A study is made of the impact of a Sepsis Code Hospital Protocol upon antibiotic use, hospital stay and mortality. DESIGN: A quasi-experimental, retrospective observational study was carried out. SETTING: A polyvalent ICU with 11 beds belonging to a tertiary hospital. PATIENTS: Patients admitted to the ICU with severe sepsis or septic shock. INTERVENTIONS: A post-intervention group (POST-SC) (September 2012-August 2013) was compared with a historical control group (PRE-SC) (January-December 2010)...
October 19, 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/27751752/-cord-blood-procalcitonin-in-the-assessment-of-early-onset-neonatal-sepsis
#20
Olivia Oria de Rueda Salguero, José Beceiro Mosquera, Marta Barrionuevo González, María Jesús Ripalda Crespo, Cristina Olivas López de Soria
INTRODUCTION: Early diagnosis of early-onset neonatal sepsis (EONS) is essential to reduce morbidity and mortality. Procalcitonin (PCT) in cord blood could provide a diagnosis of infected patients from birth. OBJECTIVE: To study the usefulness and safety of a procedure for the evaluation of newborns at risk of EONS, based on the determination of PCT in cord blood. PATIENTS AND METHODS: Neonates with infectious risk factors, born in our hospital from October 2013 to January 2015 were included...
October 14, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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