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Septic shock review

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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/28092497/polymyxin-b-hemoperfusion-for-sepsis-and-septic-shock-a-systematic-review-and-meta-analysis
#2
Takero Terayama, Kazuma Yamakawa, Yutaka Umemura, Morio Aihara, Satoshi Fujimi
BACKGROUND: To evaluate the efficacy and safety of direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) therapy in patients with sepsis. DESIGN: A systematic review and meta-analysis of four major databases: Cochrane Central Register of Controlled Trials, MEDLINE, Scopus, and Science Citation Index Expanded. STUDY SELECTION: Randomized controlled trials comparing PMX-DHP with conventional therapy on the outcome of mortality in patients with severe sepsis/septic shock...
January 16, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#3
David Ntirushwa, Stephen Rulisa, Febronie Muhorakeye, Lisa Bazzett-Matabele, Theogene Rurangwa, Maria Small
Background Gastric rupture is a rare, life-threatening condition during pregnancy. Case study We present three cases of gastric perforation during pregnancy and the puerperium. The first patient presented with gastric perforation 4 days following an uncomplicated cesarean delivery for obstetric indications. She initially complained of epigastric pain; however, those symptoms resolved. She later demonstrated worsening abdominal distension, intra-abdominal free fluid, and signs of peritonitis. At laparotomy, an ascariasis-associated gastric rupture was diagnosed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28073314/safety-of-the-peripheral-administration-of-vasopressor-agents
#4
Tyler Lewis, Cristian Merchan, Diana Altshuler, John Papadopoulos
Vasopressors are an integral component of the management of septic shock and are traditionally given via a central venous catheter (CVC) due to the risk of tissue injury and necrosis if extravasated. However, the need for a CVC for the management of septic shock has been questioned, and the risk of extravasation and incidence of severe injury when vasopressors are given via a peripheral venous line (PVL) remains poorly defined. We performed a retrospective chart review of 202 patients who received vasopressors through a PVL...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28069912/idiosyncratic-drug-induced-neutropenia-agranulocytosis
#5
Emmanuel Andrès, Rachel Mourot-Cottet, Frédéric Maloisel, François Séverac, Olivier Keller, Thomas Vogel, Martine Tebacher, Jean-Christophe Weber, Georges Kaltenbach, Jacques-Eric Gottenberg, Bernard Goichot, Jean Sibilia, Anne-Sophie Korganow, Raoul Herbrecht
BACKGROUD: Few data is currently available on neutropenia and agranulocytosis related to drug intake. We report here data on 203 patients with established idiosyncratic drug-induced agranulocytosis, followed up in a referral centre within a university hospital. PATIENTS AND METHODS: Data from 203 patients with idiosyncratic drug-induced agranulocytosis were retrospectively reviewed. All cases were extracted from a cohort study on agranulocytosis in the Strasbourg University Hospital (Strasbourg, France) RESULTS: : The mean age was 61...
January 9, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28060817/high-levels-of-post-abortion-complication-in-a-setting-where-abortion-service-is-not-legalized
#6
Tadele Melese, Dereje Habte, Billy M Tsima, Keitshokile Dintle Mogobe, Kesegofetse Chabaesele, Goabaone Rankgoane, Tshiamo R Keakabetse, Mabole Masweu, Mosidi Mokotedi, Mpho Motana, Badani Moreri-Ntshabele
BACKGROUND: Maternal mortality due to abortion complications stands among the three leading causes of maternal death in Botswana where there is a restrictive abortion law. This study aimed at assessing the patterns and determinants of post-abortion complications. METHODS: A retrospective institution based cross-sectional study was conducted at four hospitals from January to August 2014. Data were extracted from patients' records with regards to their socio-demographic variables, abortion complications and length of hospital stay...
2017: PloS One
https://www.readbyqxmd.com/read/28057212/regulation-of-cellular-immune-responses-in-sepsis-by-histone-modifications
#7
W F Carson, S L Kunkel
Severe sepsis, septic shock, and related inflammatory syndromes are driven by the aberrant expression of proinflammatory mediators by immune cells. During the acute phase of sepsis, overexpression of chemokines and cytokines drives physiological stress leading to organ failure and mortality. Following recovery from sepsis, the immune system exhibits profound immunosuppression, evidenced by an inability to produce the same proinflammatory mediators that are required for normal responses to infectious microorganisms...
2017: Advances in Protein Chemistry and Structural Biology
https://www.readbyqxmd.com/read/28056039/prediction-models-and-their-external-validation-studies-for-mortality-of-patients-with-acute-kidney-injury-a-systematic-review
#8
Tetsu Ohnuma, Shigehiko Uchino
OBJECTIVES: To systematically review AKI outcome prediction models and their external validation studies, to describe the discrepancy of reported accuracy between the results of internal and external validations, and to identify variables frequently included in the prediction models. METHODS: We searched the MEDLINE and Web of Science electronic databases (until January 2016). Studies were eligible if they derived a model to predict mortality of AKI patients or externally validated at least one of the prediction models, and presented area under the receiver-operator characteristic curves (AUROC) to assess model discrimination...
2017: PloS One
https://www.readbyqxmd.com/read/28050898/impact-of-transfusion-on-patients-with-sepsis-admitted-in-intensive-care-unit-a-systematic-review-and-meta-analysis
#9
REVIEW
Claire Dupuis, Romain Sonneville, Christophe Adrie, Antoine Gros, Michael Darmon, Lila Bouadma, Jean-François Timsit
Red blood cell transfusion (RBCT) threshold in patients with sepsis remains a matter of controversy. A threshold of 7 g/dL for stabilized patients with sepsis is commonly proposed, although debated. The aim of the study was to compare the benefit and harm of restrictive versus liberal RBCT strategies in order to guide physicians on RBCT strategies in patients with severe sepsis or septic shock. Four outcomes were assessed: death, nosocomial infection (NI), acute lung injury (ALI) and acute kidney injury (AKI)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28050897/fluid-resuscitation-in-human-sepsis-time-to-rewrite-history
#10
REVIEW
Liam Byrne, Frank Van Haren
Fluid resuscitation continues to be recommended as the first-line resuscitative therapy for all patients with severe sepsis and septic shock. The current acceptance of the therapy is based in part on long history and familiarity with its use in the resuscitation of other forms of shock, as well as on an incomplete and incorrect understanding of the pathophysiology of sepsis. Recently, the safety of intravenous fluids in patients with sepsis has been called into question with both prospective and observational data suggesting improved outcomes with less fluid or no fluid...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28040425/safety-and-efficacy-of-folfirinox-in-elderly-patients-with-metastatic-or-locally-advanced-pancreatic-adenocarcinoma-a-retrospective-analysis
#11
C Baldini, A Escande, O Bouché, F El Hajbi, J Volet, V Bourgeois, T Renaut Vantroys, A Ploquin, C Desauw, M Hebbar
BACKGROUND: FOLFIRINOX is a polychemotherapy regimen currently used to treat inoperable pancreatic cancer in patients with a good performance status (PS). FOLFIRINOX lengthens overall survival time (OS), but no specific data are available in elderly patients. METHODS: All cases of inoperable pancreatic adenocarcinoma in patients over 70 years old treated with FOLFIRINOX were retrospectively reviewed between 2008 and 2015 in five institutions in France. The primary objective was to evaluate the safety and efficacy of FOLFIRINOX in the elderly...
December 24, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28013226/disseminated-intravascular-coagulation
#12
Benjamin M Boral, Dennis J Williams, Leonard I Boral
OBJECTIVES: To provide a review of the definition, pathophysiology, differential diagnosis, and treatment of disseminated intravascular coagulation (DIC). METHODS: A case scenario and a review of the literature related to the pertinent facts concerning DIC are provided. RESULTS: DIC is a systemic pathophysiologic process and not a single disease entity, resulting from an overwhelming activation of coagulation that consumes platelets and coagulation factors and causes microvascular fibrin thrombi, which can result in multiorgan dysfunction syndrome from tissue ischemia...
December 24, 2016: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28013094/reasons-for-death-in-patients-with-sepsis-and-septic-shock
#13
Ari Moskowitz, Yasser Omar, Maureen Chase, Sharukh Lokhandwala, Parth Patel, Lars W Andersen, Michael N Cocchi, Michael W Donnino
PURPOSE: Understanding the underlying cause of mortality in sepsis has broad implications for both clinical care and interventional trial design. However, reasons for death in sepsis remain poorly understood. We sought to characterize reasons for in-hospital mortality in a population of patients with sepsis or septic shock. MATERIALS AND METHODS: We performed a retrospective review of patients admitted to the intensive care unit with sepsis or septic shock who died during their index admission...
December 2, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28005910/melioidosis-in-malaysia-a-review-of-case-reports
#14
Paul Vijay Kingsley, Mark Leader, Nandika Suranjith Nagodawithana, Meghan Tipre, Nalini Sathiakumar
BACKGROUND: Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. OBJECTIVE: We sought to review case reports of melioidosis from Malaysia. METHODS: We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome...
December 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28001191/purple-urine-bag-syndrome-case-report-for-streptoccocus-agalactiae-and-literature-review
#15
Klaus Nunes Ficher, Amanda Azevedo Neves de Araújo, Sandra Gomes de Barros Houly, Paulo Ricardo Gessolo Lins, Moacyr Silva, Aecio Flavio Teixeira de Góis
We report a case of purple urine bag syndrome, associated to Streptococcus agalactiae urinary tract infection, progressing to septic shock and death. We present a review of the literature on the subject and take the opportunity to attend readers about increasing incidence with population aging and its potential bad outcome.
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27975124/-updated-definition-of-sepsis-implications-for-diagnostics-and-therapy-principles
#16
N Schlegel
Until a short time ago the criteria for sepsis were based on the assumption that sepsis is primarily caused by the inflammatory reaction of the body to an infection, which does not correspond to the current knowledge on the pathophysiology of sepsis. Accordingly, sepsis is now defined as a life-threatening organ dysfunction due to a falsely regulated response of the body to an infection. Septic shock occurs when a condition of persisting hypotension with the continuous need for vasopressor agents and serum lactate levels of >2 mmol/l despite administration of sufficient volume and fluid is present...
December 14, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27969574/disparities-in-hemodynamic-resuscitation-of-the-obese-critically-ill-septic-shock-patient
#17
Chere Adams, Calvin Tucker, Bryan Allen, Andrew McRae, Julia Balazh, Spencer Horst, Donald Johnson, Jason Ferreira
BACKGROUND: With a growing obesity epidemic, the approach to care of this patient remains controversial and in many circumstances different than the general population. Appropriate hemodynamic support, although still controversial, remains a cornerstone of septic shock therapy. Catecholamines are currently recommended by guidelines without a preferred dosing strategy. However, the use of weight-based (μg kg(-1) min(-1)) or nonweight-based (μg/min) vasopressor drip rates may impact patient care in these populations...
February 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27968811/a-review-of-central-venous-pressure-and-its-reliability-as-a-hemodynamic-monitoring-tool-in-veterinary-medicine
#18
REVIEW
Kristen M Hutchinson, Scott P Shaw
OBJECTIVE: To review the current literature regarding central venous pressure (CVP) in veterinary patients pertaining to placement (of central line), measurement, interpretation, use in veterinary medicine, limitations, and controversies in human medicine. ETIOLOGY: CVP use in human medicine is a widely debated topic, as numerous sources have shown poor correlation of CVP measurements to the volume status of a patient. Owing to the ease of placement and monitoring in veterinary medicine, CVP remains a widely used modality for evaluating the hemodynamic status of a patient...
September 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/27965070/fluoroquinolones-or-macrolides-in-combination-with-%C3%AE-lactams-in-adult-patients-hospitalized-with-community-acquired-pneumonia-a-systematic-review-and-meta-analysis
#19
REVIEW
Konstantinos Z Vardakas, Kyriakos K Trigkidis, Matthew E Falagas
OBJECTIVE: The best treatment option for hospitalized patients with community-acquired pneumonia (CAP) has not been defined. The effectiveness of β-lactam/fluoroquinolone (BLFQ) vs β-lactam/macrolide (BLM) combination for the treatment of patients with CAP was evaluated. METHODS: PubMed, Scopus and the Cochrane Library were searched for observational cohort studies, non-randomized and randomized controlled trials providing data for patients with CAP receiving BLM or BLFQ...
December 10, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27957633/an-aggressive-parameningeal-rhabdomyosarcoma-with-multiple-spinal-cord-metastases-a-case-report-and-review-of-the-literature
#20
Guler Yavas, Pinar Karabagli, Yahya Paksoy, Cagdas Yavas, Hakan Karabagli, Yavuz Koksal
PURPOSE: Spinal cord metastasis from rhabdomyosarcoma (RMS) is extremely rare, with three cases reported to date. Herein, we report an aggressive case of RMS of the infratemporal fossa who which developed spinal cord metastases during treatment. CASE PRESENTATION: A 6-year-old girl presented with an enlarging painless mass around her right ear for 3 months. An enhanced magnetic resonance imaging (MRI) revealed a 5 × x4 × x4.5 5 cm mass on her right infratemporal fossa...
December 12, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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