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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/28432884/use-of-presepsin-and-procalcitonin-for-prediction-of-septifast-results-in-critically-ill-patients
#2
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
https://www.readbyqxmd.com/read/28425610/bacterial-screening-of-platelet-components-by-national-health-service-blood-and-transplant-an-effective-risk-reduction-measure
#3
Carl McDonald, Jennifer Allen, Susan Brailsford, Anjana Roy, Joanne Ball, Richard Moule, Mariza Vasconcelos, Rachael Morrison, Tyrone Pitt
BACKGROUND: Bacterial contamination of blood components remains a major cause of sepsis in transfusion medicine. Between 2006 and 2010 in the 5 years before the introduction of bacterial screening of platelet (PLT) components by National Health Service Blood and Transplant (NHSBT), seven cases of PLT component-associated transmission of bacterial infection were recorded for 10 patients, three of which were fatal. STUDY DESIGN AND METHODS: Sampling of individual PLT components was undertaken at 36 to 48 hours after donation and tested in the BacT/ALERT system with 8 mL inoculated into each of aerobic and anaerobic culture bottles...
May 2017: Transfusion
https://www.readbyqxmd.com/read/28419753/systematic-review-of-gender-differences-in-sepsis-management-and-outcomes
#4
Kim Reina Failla, Cynthia D Connelly
PURPOSE: Contributors to disparities in sepsis management have been attributed to genetic susceptibility, differences in clinical presentation, and healthcare delivery. The influence of gender on survival or mortality of patients with sepsis-related diagnoses is unclear. The purpose of the current study was to systematically review published research to identify factors and outcomes associated with sepsis management and outcomes based on gender differences. METHODS: Covering a period from 2006 to 2016, a literature search was conducted on four electronic data bases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCO, MedlinePlus, and PubMed...
April 18, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28416934/sepsis-and-septic-shock-current-treatment-strategies-and-new-approaches
#5
REVIEW
Gizem Polat, Rustem Anil Ugan, Elif Cadirci, Zekai Halici
Sepsis is a complex condition characterized by the simultaneous activation of inflammation and coagulation in response to microbial insult. These events manifest as systemic inflammatory response syndrome or sepsis symptoms through the release of proinflammatory cytokines, procoagulants, and adhesion molecules from immune cells and/or damaged endothelium. Today, sepsis is a severe multisystem disease with difficult treatments for its manifestations and high mortality rates. In the last two decades in particular, many studies have been conducted on sepsis that cause shock, multiorgan dysfunction, and organ failure by especially leading to hemodynamic changes...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28414686/severe-sepsis-and-septic-shock-cases-meeting-guidelines-among-patients-in-a-university-hospital-setting
#6
J A Charrier, C L Steen, E Borrero
BACKGROUND: A diagnosis of severe sepsis or septic shock has been shown to significantly increase mortality rate independent of other factors. Research has revealed all cause hospital case fatality rates have declined yet the percentage of severe sepsis cases continues to increase and age-adjusted mortality rates from severe sepsis and septic shock has significantly increased during the same time period. Patients with severe sepsis demonstrate ongoing mortality rate increases for up to 2 years following hospitalization when compared to aged matched controls of nonseptic patients...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28409756/standardized-slow-enteral-feeding-protocol-reduces-necrotizing-enterocolitis-in-micropremies
#7
S Viswanathan, R Merheb, Xintong Wen, M Collin, S Groh-Wargo
BACKGROUND: Compared to early enteral feeds, delayed introduction and slow enteral feeding advancement to reduce necrotizing enterocolitis (NEC) is not well studied in micropremies (<750g birth weight). METHODS: Pre-post case control study. Micropremies who followed a standardized slow enteral feeding (SSEF) protocol (September 2009 to March 2015) were compared with a similar group of historical controls (PreSSEF, January 2003 to July 2009). Enteral feeding withheld for first 10-14 days and advanced at <10 ml/kg/day in the SSEF group...
April 8, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28409028/impact-of-delayed-admission-to-the-intensive-care-unit-from-the-emergency-department-upon-sepsis-outcomes-and-sepsis-protocol-compliance
#8
Michael Agustin, Lori Lyn Price, Augustine Andoh-Duku, Peter LaCamera
Rationale. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. Methods. We performed a retrospective observational study of septic patients admitted to the ICU from the ED between January 2012 and December 2015 in a single tertiary care teaching hospital. 287 patients with severe sepsis and septic shock were included. Study population was divided into patients with EDLOS < 6 hrs (early admission) versus ≥6 hours (delayed admission)...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28401738/clinical-comparison-of-the-efficacy-of-three-different-bowel-preparation-methods-on-the-infectious-complications-following-transrectal-ultrasonography-guided-prostate-biopsy-in-nursing-practice
#9
Xin-Hong Zhang, Yong Jia, Wei-Hua Guo, Yu-Rong Ma, Jing Yang, Yu Zhang, Si-Chuan Hou, Chang-Cun Zhang
AIMS AND OBJECTIVES: To assess the effects of three different bowel preparation methods on the incidence of infectious complications in patients who underwent transrectal ultrasonography (TRUS) guided prostate biopsy. BACKGROUND: The standard bowel preparation protocol for prostate biopsy has not been established. DESIGN: A retrospective study in a single center. METHODS: From January 2013 to December 2015, the clinical records of 1130 patients who underwent prostate biopsy were respectively reviewed...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28399843/effectiveness-of-needle-and-syringe-programmes-in-people-who-inject-drugs-an-overview-of-systematic-reviews
#10
Ricardo M Fernandes, Maria Cary, Gonçalo Duarte, Gonçalo Jesus, Joana Alarcão, Carla Torre, Suzete Costa, João Costa, António Vaz Carneiro
BACKGROUND: Needle and syringe programmes (NSP) are a critical component of harm reduction interventions among people who inject drugs (PWID). Our primary objective was to summarize the evidence on the effectiveness of NSP for PWID in reducing blood-borne infection transmission and injecting risk behaviours (IRB). METHODS: We conducted an overview of systematic reviews that included PWID (excluding prisons and consumption rooms), addressed community-based NSP, and provided estimates of the effect regarding incidence/prevalence of Human Immunodeficiency Virus (HIV), Hepatitis C virus (HCV), Hepatitis B virus (HBV) and bacteremia/sepsis, and/or measures of IRB...
April 11, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28395880/treatment-of-metastatic-uveal-melanoma-with-adoptive-transfer-of-tumour-infiltrating-lymphocytes-a-single-centre-two-stage-single-arm-phase-2-study
#11
Smita S Chandran, Robert P T Somerville, James C Yang, Richard M Sherry, Christopher A Klebanoff, Stephanie L Goff, John R Wunderlich, David N Danforth, Daniel Zlott, Biman C Paria, Arvind C Sabesan, Abhishek K Srivastava, Liqiang Xi, Trinh H Pham, Mark Raffeld, Donald E White, Mary Ann Toomey, Steven A Rosenberg, Udai S Kammula
BACKGROUND: Uveal melanoma is a rare tumour with no established treatments once metastases develop. Although a variety of immune-based therapies have shown efficacy in metastatic cutaneous melanoma, their use in ocular variants has been disappointing. Recently, adoptive T-cell therapy has shown salvage responses in multiple refractory solid tumours. Thus, we sought to determine if adoptive transfer of autologous tumour-infiltrating lymphocytes (TILs) could mediate regression of metastatic uveal melanoma...
April 7, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28395668/delayed-rhabdomyolysis-with-paclitaxel-ifosfamide-carboplatin-and-etoposide-regimen-a-case-report
#12
Alexandra Sokolova, Onyee Chan, Waqas Ullah, Auon Abbas Hamdani, Faiz Anwer
BACKGROUND: High-dose chemotherapy with autologous stem cell rescue is commonly used for the treatment of relapsed germ cell tumors. We report the first case of delayed rhabdomyolysis with paclitaxel, ifosfamide, carboplatin, and etoposide regimen. CASE PRESENTATION: We report a case of a 21-year-old African-American man diagnosed with relapsed non-seminomatous germ cell tumor who received high-dose chemotherapy with carboplatin and etoposide following TIGER trial arm B off-protocol...
April 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28385575/intersecting-worlds-of-transfusion-and-transplantation-medicine-an-international-symposium-organized-by-the-canadian-blood-services-centre-for-innovation
#13
REVIEW
Kendra M Hodgkinson, Jeffrey Kiernan, Andrew W Shih, Ziad Solh, William P Sheffield, Nicolas Pineault
The principal theme of the symposium was centered on how the world of regenerative medicine intersects with that of transfusion medicine, with a particular focus on hematopoietic stem cells (HSCs) and stem cell therapies. The symposium highlighted several exciting developments and identified areas where additional research is needed. A revised map of human hematopoietic hierarchy was presented based on the functional and phenotypic analysis of thousands of single stem and progenitor cells from adult bone marrow and fetal liver...
March 22, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28369652/early-versus-late-enteral-feeding-in-preterm-intrauterine-growth-restricted-neonates-with-antenatal-doppler-abnormalities-an-open-label-randomized-trial
#14
Vishal Vishnu Tewari, Sachin Kumar Dubey, Reema Kumar, Shakti Vardhan, C M Sreedhar, Girish Gupta
Background of the study: Enteral feeding in preterm neonates with intrauterine growth restriction (IUGR) and absent or reversed end diastolic flow (AREDF) on umbilical artery (UA) Doppler is delayed owing to an increased risk of necrotizing enterocolitis (NEC). Delaying enteral feeding with longer duration of parenteral nutrition (PN) carries an increased risk of sepsis. Objectives: To study early versus late feeding in preterm IUGR neonates for time required to attain sufficient feed volume to discontinue PN and increased risk of NEC or feed intolerance (FI)...
March 24, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28364306/-antipyretics-in-intensive-care-patients
#15
A Simon, A Leffler
BACKGROUND: Antipyretics are among the most widely prescribed drugs in German hospitals. Despite this widespread use, their role for treatment of critically ill patients still remains unclear. In particular, the questionable positive effects of reducing fever are discussed. OBJECTIVES: In this review we aimed to summarize and discuss current study results covering the use of antipyretics in critically ill patients. Suspected effects with regard to fever reduction and lethality should be considered...
March 31, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28363592/a-survey-of-critical-care-nurses-practices-and-perceptions-surrounding-early-intravenous-antibiotic-initiation-during-septic-shock
#16
Russel J Roberts, Abdullah M Alhammad, Lindsay Crossley, Eric Anketell, LeeAnn Wood, Greg Schumaker, Erik Garpestad, John W Devlin
BACKGROUND: Delays in antibiotic administration after severe sepsis recognition increases mortality. While physician and pharmacy-related barriers to early antibiotic initiation have been well evaluated, those factors that affect the speed by which critical care nurses working in either the emergency department or the intensive care unit setting initiate antibiotic therapy remains poorly characterized. AIM: To evaluate the knowledge, practices and perceptions of critical care nurses regarding antibiotic initiation in patients with newly recognised septic shock...
March 28, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28360256/predicting-late-onset-sepsis-by-routine-neonatal-screening-for-colonisation-by-gram-negative-bacteria-in-neonates-at-intensive-care-units-a-protocol-for-a-systematic-review
#17
Thomas Harder, Juliane Seidel, Tim Eckmanns, Bettina Weiss, Sebastian Haller
INTRODUCTION: Hospitals conduct extensive screening procedures to assess colonisation of the body surface of neonates by gram-negative bacteria to avoid complications like late-onset sepsis. However, the benefits of these procedures are controversially discussed. Until now, no systematic review has investigated the value of routine screening for colonisation by gram-negative bacteria in neonates for late-onset sepsis prediction. METHODS AND ANALYSIS: We will conduct a systematic review, considering studies of any design that include infants up to an age of 12 months...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28352198/antimicrobial-susceptibility-profile-treatment-outcome-and-serotype-distribution-of-clinical-isolates-of-salmonella-enterica-subspecies-enterica-a-2-year-study-from-kerala-south-india
#18
Deepa Harichandran, Kavitha Radhakrishnan Dinesh
BACKGROUND/PURPOSE: Typhoid and paratyphoid fever continue to be important causes of illness and death in parts of Asia, being associated with poor sanitation and consumption of unsafe food and water. Antimicrobial resistance has emerged to traditional first-line drugs, namely, the fluoroquinolones, as well as to third-generation cephalosporins, posing challenges to treatment. Azithromycin has proven to be an effective alternative for treatment of uncomplicated typhoid fever. The purpose of this study was to determine the antimicrobial susceptibility, clinical outcome and serotype distribution pattern of clinical isolates belonging to Salmonella enterica subspecies enterica...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28329088/short-course-adjunctive-gentamicin-as-empirical-therapy-in-patients-with-severe-sepsis-and-septic-shock-a-prospective-observational-cohort-study
#19
David S Y Ong, Jos F Frencken, Peter M C Klein Klouwenberg, Nicole Juffermans, Tom van der Poll, Marc Bonten, Olaf Cremer
Background.: Meta-analyses failed to demonstrate clinical benefits of beta lactam plus aminoglycoside combination therapy, compared to beta lactam monotherapy, in patients with sepsis. However, few data exist on the effects of short-course adjunctive aminoglycoside therapy in sepsis patients with organ failure or shock. Methods.: We prospectively enrolled consecutive patients with severe sepsis or septic shock in two intensive care units in the Netherlands from 2011 to 2015...
February 28, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28328650/exosomes-in-critical-illness
#20
Nora Terrasini, Vincenzo Lionetti
OBJECTIVE: Exosomes are small, cell-released vesicles (40-100 nm in size) with the potential to transfer proteins, lipids, small RNAs, messenger RNAs, or DNA between cells via interstitial fluids. Due to their role in tissue homeostasis, exosomes have emerged as a new type of therapeutic and diagnostic (theranostic) tool in the noninvasive assessment of organ response to injury or treatment and in the development of reliable organ-protective intensive therapy. Our review provides current insights into the role of exosomes in the personalized management of injury and repair responses in critical illness...
March 21, 2017: Critical Care Medicine
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