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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/28225634/journal-club-ultrasound-guided-breast-interventions-low-incidence-of-infectious-complications-with-use-of-an-uncovered-probe
#2
Chris Reisenauer, Robert T Fazzio, Gina Hesley
OBJECTIVE: The purpose of this study was to determine the incidence of infectious complications after ultrasound-guided breast interventions performed with an intermediate-level disinfection protocol without an ultrasound probe cover. MATERIALS AND METHODS: Two independent institutional databases were searched to identify breast infections in patients who underwent ultrasound-guided interventions between January 2005 and July 2013. The departments of radiology and infectious diseases independently maintained these databases...
February 22, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28224092/language-and-cognitive-outcome-for-high-risk-neonates-at-the-age-of-2-3-years-experience-from-an-arab-country
#3
Tamer Abou-Elsaad, Hesham Abdel-Hady, Hemmat Baz, Doaa ElShabrawi
AIM: To investigate the effect of different neonatal risk factors on different language parameters as well as cognitive abilities among Arabic speaking Egyptian children at the age of two to three years of life and to find out which risk factor(s) had the greatest impact on language and cognitive abilities. METHODS: This retrospective cohort study was conducted on 103 children with age range of 2-3 years (median age 31 mo). They were 62 males and 41 females who were exposed to different high-risk factors in the perinatal period, with exclusion of metabolic disorders, sepsis/meningitis, congenital anomalies and chromosomal aberrations...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28202033/use-of-stepwise-lactate-kinetics-oriented-hemodynamic-therapy-could-improve-the-clinical-outcomes-of-patients-with-sepsis-associated-hyperlactatemia
#4
Xiang Zhou, Dawei Liu, Longxiang Su, Bo Yao, Yun Long, Xiaoting Wang, Wenzhao Chai, Na Cui, Hao Wang, Xi Rui
BACKGROUND: Setting lactate kinetics at >30% might improve the clinical outcomes of patients with sepsis-associated hyperlactatemia. The aim of this study was to explore the outcome benefits of stepwise lactate kinetics vs central venous oxygen saturation (ScvO2)-oriented hemodynamic therapy at 6 h as the protocol goal during early resuscitation. METHODS: The relevant parameters and adverse events after different targets in 360 randomly assigned patients with sepsis-associated hyperlactatemia were recorded and compared...
February 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28190560/filtering-authentic-sepsis-arising-in-the-icu-using-administrative-codes-coupled-to-a-sirs-screening-protocol
#5
Christopher L Sudduth, Elizabeth C Overton, Peter F Lyu, Ramzy H Rimawi, Timothy G Buchman
PURPOSE: Using administrative codes and minimal physiologic and laboratory data, we sought a high-specificity identification strategy for patients whose sepsis initially appeared during their ICU stay. MATERIALS AND METHODS: We studied all patients discharged from an academic hospital between September 1, 2013 and October 31, 2014. Administrative codes and minimal physiologic and laboratory criteria were used to identify patients at high risk of developing the onset of sepsis in the ICU...
February 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28165586/efficacy-of-postoperative-polymyxin-b-hemoperfusion-in-secondary-peritonitis-patients-with-septic-shock-a-propensity-matched-analysis
#6
Kuo-Ching Yuan, Shang-Yu Wang, Ming-Chin Yu, Yu-Pao Hsu, Heng-Chih Pan, Yung-Chang Chen
INTRODUCTION: Severe sepsis and septic shock is still a challenge. Polymyxin B hemoperfusion (PMX) is a device designed to remove circulating endotoxin by adsorption, which is reported to improve treatment outcomes. This study aimed to further verify the efficacy of PMX on postoperative, peritonitis, septic shock patients. METHODS: This study prospectively analyzed 20 of 155 patients who presented with postoperative septic shock and were treated with PMX in a single institute during the period March 2013 to September 2014 (Clinical Trial Protocol number: ChiCTR-ONC-16008160)...
February 4, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28159975/use-of-a-supplemental-oxygen-protocol-to-suppress-progression-of-retinopathy-of-prematurity
#7
Tarah T Colaizy, Susannah Longmuir, Kevin Gertsch, Michael David Abràmoff, Jonathan M Klein
Purpose: To compare progression of retinopathy of prematurity (ROP) before and after institution of an oxygen therapy protocol to inhibit active proliferation and progression of ROP in premature infants. Methods: A retrospective cohort study was performed of premature infants undergoing ROP screening before (cohort A) and after (cohort B) implementation of an oxygen therapy protocol to inhibit further progression for those with stage 2 ROP or worse. Statistical analysis with χ2, Fisher's exact test, or Wilcoxon rank sum test was performed; and logistic regression models were created to determine the odds ratio of cohort B developing ROP progression beyond stage 2, compared to cohort A, adjusting for other risk factors for ROP...
February 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28159011/fluids-and-sepsis-changing-the-paradigm-of-fluid-therapy-a-case-report
#8
Hori Hariyanto, Corry Quando Yahya, Monika Widiastuti, Primartanto Wibowo, Oloan Eduard Tampubolon
BACKGROUND: Over the past 16 years, sepsis management has been guided by large-volume fluid administration to achieve certain hemodynamic optimization as advocated in the Rivers protocol. However, the safety of such practice has been questioned because large-volume fluid administration is associated with fluid overload and carries the worst outcome in patients with sepsis. Researchers in multiple studies have declared that using less fluid leads to increased survival, but they did not describe how to administer fluids in a timely and appropriate manner...
February 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28152540/vancomycin-during-the-last-hour-of-the-hemodialysis-session-a-pharmacokinetic-analysis
#9
Lila Ghouti-Terki, Elodie Chasseuil, Nolwenn Rabot, Gilles Paintaud, Maud François, Béatrice Birmelé, François Darrouzain, Matthias Büchler, Jean-Michel Halimi, David Ternant
BACKGROUND: Vancomycin is usually administered after the dialysis sessions to patients undergoing hemodialysis. Administration of vancomycin during (as opposed to after) sessions would save time, and would be more acceptable to patients and staff, but may lead to vancomycin underexposure. The aim of this study was to propose a new dosing regimen of vancomycin taking into account the dialysis-related losses of vancomycin when administered during dialysis. METHODS: In this monocentric prospective study, vancomycin was infused to dialyzed patients during the last hour of the dialysis session at increased doses...
February 3, 2017: Nephron
https://www.readbyqxmd.com/read/28141913/systemic-corticosteroid-regimens-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#10
REVIEW
Wes Onland, Anne Pmc De Jaegere, Martin Offringa, Anton van Kaam
BACKGROUND: Cochrane systematic reviews show that systemic postnatal corticosteroids reduce the risk of bronchopulmonary dysplasia (BPD) in preterm infants. However, corticosteroids have also been associated with an increased risk of neurodevelopmental impairment. It is unknown whether these beneficial and adverse effects are modulated by differences in corticosteroid treatment regimens. OBJECTIVES: To assess the effects of different corticosteroid treatment regimens on mortality, pulmonary morbidity, and neurodevelopmental outcome in very low birth weight (VLBW) infants...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28137306/case-report-when-two-and-%C3%A2-men-go-camping%C3%A2
#11
Matthias von Rotz, Alexa Dierig, Ulrich Heininger, Carl Chrobak, Veronika Baettig, Adrian Egli
BACKGROUND: In patients, rapid identification of bacterial species may help to guide treatment at early stages. New protocols for the identification directly from positive blood culture flasks significantly helped in the presented case report. CASE PRESENTATION: Two patients (a father and son) presented with diarrhea, malaise, and fever of 3 to 4 days duration. Blood cultures from both patients cultured short Gram-positive rods. MALDI-TOF based rapid identification protocol direct from positive blood culture identified Listeria monocytogenes as the cause of sepsis and could be confirmed with conventional methods...
January 30, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28128911/emergency-percutaneous-nephrostomy-versus-emergency-percutaneous-nephrolithotomy-in-patients-with-sepsis-associated-with-large-uretero-pelvic-junction-stone-impaction-a-randomized-controlled-trial
#12
Chi-Sen Hsu, Chung-Jing Wang, Chien-Hsing Chang, Po-Chao Tsai, Hung-Wen Chen, Yi-Chun Su
INTRODUCTION: A randomized trial was conducted prospectively to evaluate the efficacy, related complications, and convalescence of emergency percutaneous nephrolithotomy compared to percutaneous nephrostomy for decompression of the collecting system in cases of sepsis associated with large uretero-pelvic junction stone impaction. MATERIALS AND METHODS: The inclusion criteria included a WBC count of 10.000/mm3 or more and/or a temperature of 38°C or higher. Besides, all enrolled patients should maintain stable hemodynamic status and proper organ perfusions...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28122493/association-between-the-159c-t-polymorphism-in-the-promoter-region-of-the-cd14-gene-and-sepsis-a-meta-analysis
#13
Qin Wu, Xiaomeng Xu, Jianan Ren, Song Liu, Xuelian Liao, Xiuwen Wu, Dong Hu, Gefei Wang, Guosheng Gu, Yan Kang, Jieshou Li
BACKGROUND: The association between CD14-159C/T polymorphism and sepsis has been assessed but results of current studies appeared conflicting and inconstant. This analysis was aimed to determine whether the CD14-159C/T polymorphism confers susceptibility to sepsis or is associated with increased risk of death from sepsis. METHOD: The authors conducted a comprehensive search of PubMed, EMBASE, ISI Web of Science, Cochrane library, ScienceDirect, Wiley Online Library and CNKI databases according to a prespecified protocol...
January 25, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28115333/clinical-efficacy-of-%C3%AE-lactam-%C3%AE-lactamase-inhibitor-combinations-for-the-treatment-of-bloodstream-infection-due-to-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-haematological-patients-with-neutropaenia-a-study-protocol-for-a-retrospective-observational
#14
C Gudiol, C Royo-Cebrecos, C Tebe, E Abdala, M Akova, R Álvarez, G Maestro-de la Calle, A Cano, C Cervera, W T Clemente, P Martín-Dávila, A Freifeld, L Gómez, T Gottlieb, M Gurguí, F Herrera, A Manzur, G Maschmeyer, Y Meije, M Montejo, M Peghin, J Rodríguez-Baño, I Ruiz-Camps, T C Sukiennik, J Carratalà
INTRODUCTION: Bloodstream infection (BSI) due to extended-spectrum β-lactamase-producing Gram-negative bacilli (ESBL-GNB) is increasing at an alarming pace worldwide. Although β-lactam/β-lactamase inhibitor (BLBLI) combinations have been suggested as an alternative to carbapenems for the treatment of BSI due to these resistant organisms in the general population, their usefulness for the treatment of BSI due to ESBL-GNB in haematological patients with neutropaenia is yet to be elucidated...
January 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28114415/managing-neonatal-and-early-childhood-syndromic-sepsis-in-sub-district-hospitals-in-resource-poor-settings-improvement-in-quality-of-care-through-introduction-of-a-package-of-interventions-in-rural-bangladesh
#15
Ahmed Ehsanur Rahman, Afrin Iqbal, D M Emdadul Hoque, Md Moinuddin, Sojib Bin Zaman, Qazi Sadeq-Ur Rahman, Tahmina Begum, Atique Iqbal Chowdhury, Rafiqul Haider, Shams El Arifeen, Niranjan Kissoon, Charles P Larson
INTRODUCTION: Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments...
2017: PloS One
https://www.readbyqxmd.com/read/28110287/aspirin-to-inhibit-sepsis-antisepsis-randomised-controlled-trial-protocol
#16
Damon P Eisen, Elizabeth M Moore, Karin Leder, Jessica Lockery, Emma S McBryde, John J McNeil, David Pilcher, Rory Wolfe, Robyn L Woods
INTRODUCTION: Sepsis is a leading global cause of morbidity and mortality, and is more common at the extremes of age. Moreover, the cost of in-hospital care for elderly patients with sepsis is significant. There are indications from experimental and observational studies that aspirin may reduce inflammation associated with infection. This paper describes the rationale and design of the AspiriN To Inhibit SEPSIS (ANTISEPSIS) trial, a substudy of ASPirin in Reducing Events in the Elderly (ASPREE)...
January 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28109962/endothelial-permeability-and-hemostasis-in-septic-shock-results-from-the-process-trial
#17
Peter Hou, Michael Filbin, Henry Wang, Long Ngo, David T Huang, William C Aird, Donald M Yealy, Derek C Angus, John A Kellum, Nathan I Shapiro
BACKGROUND: We studied patients from the Protocolized Care in Early Septic Shock (ProCESS) trial to determine: the effects of alternative resuscitation strategies on circulating markers of endothelial cell permeability and hemostasis, and; the association between biomarkers and mortality. METHODS: Prospective study of biomarkers of endothelial cell permeability (vegf, sflt-1, ang-2) and hemostasis (vwf, thrombomodulin, tpa) in 605 of the 1341 ProCESS participants in a derivation cohort and 305 in validation...
January 18, 2017: Chest
https://www.readbyqxmd.com/read/28098592/protocolized-early-sepsis-care-is-not-only-helpful-for-patients-it-prevents-medical-errors
#18
Angel Coz Yataco, Anja Kathrin Jaehne, Emanuel Phillip Rivers
No abstract text is available yet for this article.
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28096576/role-of-edaravone-in-managemant-of-septic-peritonitis
#19
Ghada Fouad Elbaradey, Nagat Sayed Elshmaa, Hossam Hodeib
BACKGROUND AND AIMS: Sepsis is a complex rapidly progressive infectious disease that remain a major cause of morbidity and mortality in surgical patients and trauma victims. Edaravone a novel free radical scavenger was approved in 2001 in Japan for treatment of acute cerebral and myocardial infarction. Hence, in this work we attempt to evaluate its role in cases of septic peritonitis (SP). MATERIAL AND METHODS: This is a prospective randomized observer-blinded study carried out in surgical Intensive Care Unit (ICU) after approval by Hospital Ethical Committee...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28094478/fluid-management-in-cardiac-surgery-patients-pitfalls-challenges-and-solutions
#20
Elena Bignami, Marcello Guarnieri, Marco Gemma
Fluid administration is a powerful tool for hemodynamic stabilization as it increases preload and improves cardiac function in fluid-responsive patients. However, there are various types of fluid to choose from. The use of colloids and crystalloids in non-cardiac Intensive Care Units (ICU) has been reported, showing controversial results. Many trials on sepsis in a non-cardiac ICU setting show that colloids, in particular hydroxyethyl starches and gelatins, might have a detrimental effect on kidney function, and on major outcomes such as mortality...
January 17, 2017: Minerva Anestesiologica
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