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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/28534028/mechanisms-affecting-the-gut-of-preterm-infants-in-enteral-feeding-trials
#2
Nicholas D Embleton, Janet E Berrington, Jon Dorling, Andrew K Ewer, Edmund Juszczak, John A Kirby, Christopher A Lamb, Clare V Lanyon, William McGuire, Christopher S Probert, Stephen P Rushton, Mark D Shirley, Christopher J Stewart, Stephen P Cummings
Large randomized controlled trials (RCTs) in preterm infants offer unique opportunities for mechanistic evaluation of the risk factors leading to serious diseases, as well as the actions of interventions designed to prevent them. Necrotizing enterocolitis (NEC) a serious inflammatory gut condition and late-onset sepsis (LOS) are common feeding and nutrition-related problems that may cause death or serious long-term morbidity and are key outcomes in two current UK National Institutes for Health Research (NIHR) trials...
2017: Frontiers in Nutrition
https://www.readbyqxmd.com/read/28528569/time-to-treatment-and-mortality-during-mandated-emergency-care-for-sepsis
#3
Christopher W Seymour, Foster Gesten, Hallie C Prescott, Marcus E Friedrich, Theodore J Iwashyna, Gary S Phillips, Stanley Lemeshow, Tiffany Osborn, Kathleen M Terry, Mitchell M Levy
Background In 2013, New York began requiring hospitals to follow protocols for the early identification and treatment of sepsis. However, there is controversy about whether more rapid treatment of sepsis improves outcomes in patients. Methods We studied data from patients with sepsis and septic shock that were reported to the New York State Department of Health from April 1, 2014, to June 30, 2016. Patients had a sepsis protocol initiated within 6 hours after arrival in the emergency department and had all items in a 3-hour bundle of care for patients with sepsis (i...
May 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28527564/prospective-comparison-of-perioperative-antibiotic-management-protocols-in-oncological-head-and-neck-surgery
#4
Alexander K Bartella, Mohammad Kamal, Jan Teichmann, Anita Kloss-Brandstätter, Timm Steiner, Frank Hölzle, Bernd Lethaus
OBJECTIVES: The adequate perioperative antibiotic prophylaxis in head and neck cancer surgery is an important and easy applicable tool to decrease nosocomial morbidity and mortality by reducing the rate of infections. In the study a strictly perioperative antibiosis is compared with an extended postoperative prophylactic antibiosis. We aim to clarify the value of postoperative prophylactic antibiosis for the recovery and clinical course of patients. MATERIAL AND METHODS: In this prospective study 75 consecutive patients, who underwent major oncological head and neck surgery were included and divided in three groups, each containing 25 patients...
April 20, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28526536/trastuzumab-emtansine-versus-capecitabine-plus-lapatinib-in-patients-with-previously-treated-her2-positive-advanced-breast-cancer-emilia-a-descriptive-analysis-of-final-overall-survival-results-from-a-randomised-open-label-phase-3-trial
#5
Véronique Diéras, David Miles, Sunil Verma, Mark Pegram, Manfred Welslau, José Baselga, Ian E Krop, Kim Blackwell, Silke Hoersch, Jin Xu, Marjorie Green, Luca Gianni
BACKGROUND: The antibody-drug conjugate trastuzumab emtansine is indicated for the treatment of patients with HER2-positive metastatic breast cancer previously treated with trastuzumab and a taxane. Approval of this drug was based on progression-free survival and interim overall survival data from the phase 3 EMILIA study. In this report, we present a descriptive analysis of the final overall survival data from that trial. METHODS: EMILIA was a randomised, international, open-label, phase 3 study of men and women aged 18 years or older with HER2-positive unresectable, locally advanced or metastatic breast cancer previously treated with trastuzumab and a taxane...
May 16, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28522110/high-dose-gemcitabine-busulfan-and-melphalan-for-autologous-stem-cell-transplant-in-patients-with-relapsed-or-refractory-myeloma-a-phase-2-trial-and-matched-pair-comparison-with-melphalan
#6
Yago Nieto, Benigno C Valdez, Sai R Pingali, Roland Bassett, Ruby Delgado, John Nguyen, Nina Shah, Uday Popat, Roy B Jones, Borje S Andersson, Alison Gulbis, Sairah Ahmed, Qaiser Bashir, Simrit Parmar, Krina Patel, Alan Myers, Gabriela Rondon, Robert Z Orlowski, Richard Champlin, Muzaffar Qazilbash
BACKGROUND: High-dose melphalan is of little benefit as a regimen for patients with relapsed or refractory myeloma undergoing an autologous stem-cell transplant (ASCT). The poor performance of single-agent melphalan in this setting prompted us to study a new high-dose combination of infused gemcitabine, busulfan, and melphalan. METHODS: We did a phase 2 trial at the University of Texas MD Anderson Cancer Center (Houston, TX, USA). We enrolled patients with primary refractory or relapsed myeloma who had received treatment with bortezomib, an immunomodulatory drug, or both, or who were receiving a salvage ASCT...
May 15, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28518095/use-of-a-central-venous-line-for-fluids-drugs-and-nutrient-administration-in-a-mouse-model-of-critical-illness
#7
Sarah Derde, Steven Thiessen, Chloë Goossens, Thomas Dufour, Greet Van den Berghe, Lies Langouche
This protocol describes a centrally catheterized mouse model of prolonged critical illness. We combine the cecal ligation and puncture method to induce sepsis with the use of a central venous line for fluids, drugs and nutrient administration to mimic the human clinical setting. Critically ill patients require intensive medical support in order to survive. While the majority of patients will recover within a few days, about a quarter of the patients need prolonged intensive care and are at high risk of dying from non-resolving multiple organ failure...
May 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28506711/screening-for-sepsis-in-general-hospitalised-patients-a-systematic-review
#8
REVIEW
Laura Alberto, Andrea P Marshall, Rachel Walker, Leanne M Aitken
INTRODUCTION: Sepsis is a common condition observed outside critical care areas. The purpose of this review was to examine the application of sepsis screening tools for early recognition of sepsis in general hospitalised patients to: (i) identify the accuracy of these tools; (ii) determine the outcomes associated with their implementation and; (iii) describe the implementation process. METHOD: A systematic review method was used. PubMed, CINAHL, COCHRANE, SCOPUS, Web of Science and EMBASE databases were systematically searched for primary articles, published from January 1990 to June 2016, that investigated screening tools or alert mechanisms for early identification of sepsis in adult general hospitalized patients...
May 12, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28503891/the-use-of-intravesical-gentamicin-to-treat-recurrent-urinary-tract-infections-in-lower-urinary-tract-dysfunction
#9
Paul Abrams, Hashim Hashim, Charles Tomson, Alasdair Macgowan, Rachel Skews, Katherine Warren
AIMS: To assess the use of intravesical gentamicin to treat intractable recurrent urinary tract infections in lower urinary tract dysfunction. METHODS: A two-center retrospective cohort study of 27 patients treated with intravesical gentamicin was performed over a 2-year period. A treatment protocol was developed, reviewed, and accepted by the clinical effectiveness committee of both hospitals. Patients were taught to instill the gentamicin into the bladder on a nightly basis...
May 15, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28501032/-perinatal-outcome-in-relation-to-chorionicity-in-twin-pregnancy
#10
Marta Machado, Elsa Lima Teixeira, Lígia Maria Ferreira, Filipa Rodrigues, Raquel Henriques, Eulália Afonso
INTRODUCTION: The incidence of multiple gestations is increasing worldwide and many studies have shown higher perinatal morbidity and mortality rates in monochorionic twins compared to dichorionic. The aim of this study was to assess the twin population born at a tertiary center and to evaluate the impact of chorionicity on perinatal outcomes of twin pregnancies. MATERIAL AND METHODS: Retrospective study of all twins born in a tertiary center from January 2004 to December 2013...
January 31, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28487456/deriving-literature-based-benchmarks-for-surgical-complications-in-high-income-countries-a-protocol-for-a-systematic-review-and-meta-analysis
#11
Mary E Brindle, Derek J Roberts, Oluwatomilayo Daodu, Alex Bernard Haynes, Christy Cauley, Elijah Dixon, Claude La Flamme, Paul Bain, William Berry
INTRODUCTION: To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs)...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28479312/a-modified-esbl-nordmann-dortet-poirel-based-protocol-to-optimize-early-sepsis-management
#12
Jorge Arca-Suárez, Fátima Galán-Sánchez, César Del Prado Montoro, Manuel A Rodríguez-Iglesias
We evaluated a modification of a colorimetric test recently described by Dortet et al. (2015) for the rapid detection of ESBL-producing Enterobacteriaceae directly from positive blood cultures that requires less manipulation, materials and hands-on time. The simplified protocol showed a sensitivity and specificity of 100% and 95.7% respectively.
May 4, 2017: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/28458938/septic-arthritis-of-the-temporomandibular-joint-secondary-to-acute-otitis-media-in-an-adult-a-rare-case-with-achromobacter-xylosoxidans
#13
Ryan Chin Taw Cheong, Laura Harding
Septic arthritis of the temporomandibular joint (SATMJ) is a rare complication of acute otitis media (AOM) with only four reported cases in the English and Japanese literature. Based on the unusual nature of this clinical condition, we discuss the first documented case due to Achromobacter xylosoxidans and the utility of myringotomy with long-term intravenous antibiotics via a peripherally inserted central catheter (PICC). We describe the case of a 76-year-old male patient that was brought in by ambulance to the accident and emergency (A&E) department due to severe right-sided otalgia with increased hearing impairment...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28457372/lung-transplantation-from-donors-after-previous-cardiac-surgery-ideal-graft-in-marginal-donor
#14
A Palleschi, P Mendogni, D Tosi, M Montoli, R Carrinola, A V Mariolo, F Briganti, M Nosotti
Lung transplantation is a limited by donor pool shortage. Despite the efforts to extend the graft acceptability with recurrent donor criteria reformulations, previous cardiothoracic surgery is still considered a contraindication. A donor who underwent cardiac surgery could potentially provide an ideal lung but high intraoperative risks and intrinsic technical challenges are expected during the graft harvesting. The purpose of this study is to present our dedicated protocol and four clinical cases of successful lung procurements from donors who had a previous major cardiac surgery...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28452877/incompatible-type-a-plasma-transfusion-in-patients-requiring-massive-transfusion-protocol-outcomes-of-an-east-multicenter-study
#15
W Tait Stevens, Bryan C Morse, Andrew Bernard, Dan Davenport, Valerie G Sams, Michael Goodman, Russell Dumire, Matt Carrick, Patrick McCarthy, James R Stubbs, Timothy Pritts, Christopher J Dente, Xian Luo-Owen, Jason Gregory, David Turay, Dina Gomaa, Juan C Quispe, Caitlin A Fitzgerald, Nadeem Haddad, Asad Choudhry, Jose Quesada, Martin D Zielinski
With a relative shortage of type AB plasma, many centers have converted to type A plasma for resuscitation of patients whose blood type is unknown. The goal of this study is to determine outcomes for trauma patients who received incompatible plasma transfusions as part of a massive transfusion protocol (MTP). METHODS: As part of an EAST multi-institutional trial, registry and blood bank data were collected from 8 trauma centers for trauma patients (age ≥ 15 years) receiving emergency release plasma transfusions as part of MTPs from January 2012 - August 2016...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28446775/delivering-prolonged-intensive-care-to-a-non-human-primate-a-high-fidelity-animal-model-of-critical-illness
#16
P Guillaume Poliquin, Mia Biondi, Charlene Ranadheera, Mable Hagan, Alexander Bello, Trina Racine, Mark Allan, Duane Funk, Gregory Hansen, B J Hancock, Murray Kesselman, Todd Mortimer, Anand Kumar, Shane Jones, Anders Leung, Allen Grolla, Kaylie N Tran, Kevin Tierney, Xiangguo Qiu, Darwyn Kobasa, James E Strong
Critical care needs have been rising in recent decades as populations age and comorbidities increase. Sepsis-related admissions to critical care contribute up to 50% of volume and septic shock carries a 35-54% fatality rate. Improvements in sepsis-related care and mortality would have a significant impact of a resource-intensive area of health care delivery. Unfortunately, research has been hampered by the lack of an animal model that replicates the complex care provided to humans in an intensive care unit (ICU)...
April 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28446484/cystic-artery-pseudoaneurysm-following-acute-necrotising-pancreatitis
#17
Manoj Thillai, Pulkit Sethi, Ramachandran Narayana Menon, Nazar Puthukudiyil Kader
Cystic artery pseudoaneurysm is a rare pathology. Of the 20 cases reported so far, chronic cholecystitis and iatrogenic biliary injury form the majority of causes. Currently, there is no published report of such pseudoaneurysms caused secondary to pancreatitis, hence the management in such a scenario is unclear. We hereby present the first such report of cystic artery pseudoaneurysm occurring as a sequel of acute necrotising pancreatitis. A 33-year-old man who recovered from a recent attack of acute pancreatitis was readmitted for melena and fever...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28443360/overview-of-procalcitonin-assays-and-procalcitonin-guided-protocols-for-the-management-of-patients-with-infections-and-sepsis
#18
Philipp Schuetz, Celine Bretscher, Luca Bernasconi, Beat Mueller
Procalcitonin is a surrogate infection blood marker whose levels help estimate the likelihood of bacterial infections and correlate with their resolution. Recent trials have revealed the benefits of inclusion of procalcitonin in antibiotic stewardship protocols for initiation and discontinuation of antimicrobial therapy. Areas covered: Procalcitonin-guided antibiotic stewardship protocols have shown appreciable reductions in antibiotic use and duration of therapy in respiratory infections, sepsis, and other infections, with positive effects on clinical outcomes...
May 3, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28438186/mortality-and-infectious-complications-of-therapeutic-endovascular-interventional-radiology-a-systematic-and-meta-analysis-protocol
#19
Kaoutar Mellouk Aid, Hervé Tchala Vignon Zomahoun, Abdelmajid Soulaymani, Karin Lebascle, Stephane Silvera, Pascal Astagneau, Benoit Misset
BACKGROUND: Endovascular interventional radiology (EIR) is an increasingly popular, mini invasive treatment option for patient with symptomatic vascular disease. The EIR practiced by qualified hands is an effective, well-tolerated procedure that offers relief of patient's symptoms with a low risk of complications. During acute post procedural period, immediate complications may relate to vascular access, restenosis, thromboembolic events, uterine ischemia, infection, necrosis, sepsis, ICU stay, surgical recovery, pain management, treatment failure, and death...
April 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28432884/use-of-presepsin-and-procalcitonin-for-prediction-of-septifast-results-in-critically-ill-patients
#20
Dunja Mihajlovic, Snezana Brkic, Arsen Uvelin, Biljana Draskovic, Vladimir Vrsajkov
PURPOSE: There is a need for identification of marker that could lead physicians to take the right step towards laboratory techniques for documentation of infection. The aim of this study was to investigate whether presepsin and procalcitonin (PCT) levels in patients with suspected sepsis could predict blood culture (BC) and SeptiFast (SF) results. MATERIAL AND METHODS: 100 patients were included in our study. PCT, C-reactive protein (CRP), and presepsin levels were determined...
April 8, 2017: Journal of Critical Care
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