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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/29330126/recent-progress-in-the-discovery-of-myeloid-differentiation-2-md2-modulators-for-inflammatory-diseases
#2
REVIEW
Lingfeng Chen, Weitao Fu, Lulu Zheng, Yi Wang, Guang Liang
Myeloid differentiation protein 2 (MD2), together with Toll-like receptor 4 (TLR4), binds lipopolysaccharide (LPS) with high affinity, inducing the formation of the activated homodimer LPS-MD2-TLR4. MD2 directly recognizes the Lipid A domain of LPS, leading to the activation of downstream signaling of cytokine and chemokine production, and initiation of inflammatory and immune responses. However, excessive activation and potent host responses generate severe inflammatory syndromes such as acute sepsis and septic shock...
January 9, 2018: Drug Discovery Today
https://www.readbyqxmd.com/read/29321120/evaluating-vancomycin-and-piperacillin-tazobactam-in-emergency-department-patients-with-severe-sepsis-and-septic-shock
#3
Christina Le, Frank Chu, Ronald Dunlay, Julian Villar, Peter Fedullo, Gabriel Wardi
STUDY OBJECTIVE: To determine the frequency and cause of inadequate initial antibiotic therapy with vancomycin and piperacillin-tazobactam in patients with severe sepsis and septic shock in the emergency department (ED), characterize its impact on patient outcomes, and identify patients who would benefit from an alternative initial empiric regimen. METHODS: Retrospective cohort study conducted between 2012 and 2015 in which 342 patients with culture-positive severe sepsis or septic shock who received initial vancomycin and piperacillin-tazobactam were reviewed to determine appropriateness of antimicrobial therapy, risk factors for inappropriate use, and outcome data...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29314296/successful-use-of-extracorporeal-membrane-oxygenation-support-in-severe-septic-shock-with-associated-acute-cardiomyopathy
#4
S Michelle Perdue, Brian J Poore, Ashok N Babu, W Kyle Stribling
A 24-year-old female presented with sepsis and cardiogenic shock 4 days after vaginal delivery. Veno-arterial extracorporeal membrane oxygenation (VA ECMO) therapy was used for cardiovascular support as a bridge for recovery. The use of VA ECMO in patients with cardiogenic shock secondary to sepsis is reviewed.
January 4, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29288645/the-effect-of-alcohol-consumption-on-the-risk-of-ards-a-systematic-review-and-meta-analysis
#5
Evangelia Simou, Jo Leonardi-Bee, John Britton
BACKGROUND: To conduct a systematic review and meta-analysis evaluating the association between alcohol consumption and the risk of Acute Respiratory Distress Syndrome (ARDS) in adults. METHODS: Medline, EMBASE and Web of Science were searched to identify observational studies evaluating the association between prior alcohol intake and the occurrence of ARDS among adults, published between 1985 and 2015 and with no language restriction. Reference lists were also screened...
December 27, 2017: Chest
https://www.readbyqxmd.com/read/29282149/the-effect-of-angiotensin-ii-on-blood-pressure-in-patients-with-circulatory-shock-a-structured-review-of-the-literature
#6
Laurence W Busse, Michael T McCurdy, Osman Ali, Anna Hall, Huaizhen Chen, Marlies Ostermann
BACKGROUND: Circulatory shock is a common syndrome with a high mortality and limited therapeutic options. Despite its discovery and use in clinical and experimental settings more than a half-century ago, angiotensin II (Ang II) has only been recently evaluated as a vasopressor in distributive shock. We examined existing literature for associations between Ang II and the resolution of circulatory shock. METHODS: We searched PubMed, MEDLINE, Ovid, and Embase to identify all English literature accounts of intravenous Ang II in humans for the treatment of shock (systolic blood pressure [SBP] ≤ 90 mmHg or a mean arterial pressure [MAP] ≤ 65 mmHg), and hand-searched the references of extracted papers for further studies meeting inclusion criteria...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29278987/impact-of-pharmacist-intervention-on-selection-and-timing-of-appropriate-antimicrobial-therapy-in-septic-shock
#7
Melanie E Laine, Jeremy D Flynn, Alexander H Flannery
BACKGROUND: Current guidelines for septic shock management recommend administration of appropriate, broad-spectrum antimicrobials within 1 hour of recognition. OBJECTIVE: To evaluate the interventions pharmacists make as part of a sepsis response team and to determine if these interventions increase the proportion of patients with appropriate empiric antimicrobial therapy. METHODS: A retrospective cohort study was undertaken reviewing adult patients in a large, academic medical center with confirmed septic shock who had an order for a "sepsis bundle," which includes notification of a pharmacist to assess adequacy of empiric therapy...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29273917/recent-advances-in-the-pathogenetic-mechanisms-of-sepsis-associated-acute-kidney-injury
#8
REVIEW
Filippo Fani, Giuseppe Regolisti, Marco Delsante, Vincenzo Cantaluppi, Giuseppe Castellano, Loreto Gesualdo, Gianluca Villa, Enrico Fiaccadori
Sepsis is a serious medical condition that can lead to multi-organ failure and shock, and it is associated with increased mortality. Acute kidney injury (AKI) is a frequent complication of sepsis in critically ill patients, and often requires renal replacement therapy. The pathophysiology of AKI in sepsis has not yet been fully defined. In the past, classic theories were mainly focused on systemic hemodynamic derangements, underscoring the key role of whole kidney hypoperfusion due to reduced renal blood flow...
December 23, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/29245998/effects-of-levosimendan-on-mortality-in-patients-with-septic-shock-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#9
Benji Wang, Rujie Chen, Xianyang Guo, Wenwu Zhang, Jianjian Hu, Yuqiang Gong, Bihuan Cheng
Object: Several studies have investigated a survival benefit for levosimendan treatment in patients with septic shock. However, data are conflicting. We conducted a meta-analysis to evaluate the effect of levosimendan treatment on mortality in patients with septic shock. Materials and Methods: We searched PubMed, EMBASE and Cochrane Library Databases up to March 27, 2017, without language restrictions. We searched for terms related to septic shock, levosimendan, randomized clinical trial...
November 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/29239150/gender-differences-in-septic-intensive-care-unit-patients
#10
Francesco Campanelli, Giovanni Landoni, Luca Cabrini, Alberto Zangrillo
BACKGROUND: The world population is mostly male at birth, although there is a shift in predominance over 55 years of age with more females than males. Male gender was recently hypothesized to be a risk factor for sepsis and septic shock; the reasons and the consequences of this odd discrepancy are yet a matter of debate. We investigated the percentage of males and females in a large number of trials performed on septic adult patients admitted to Intensive Care Units. METHODS: We analysed all the multicentre randomized controlled trials ever published in peer-reviewed Journals reporting a significant effect on mortality in intensive care unit septic adult patients; furthermore, we retrieved all the manuscripts dealing with sepsis or septic shock patients published in the last 3 years in the three medical Journals with the highest impact factor...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29227368/septic-cardiomyopathy
#11
Sarah J Beesley, Gerhard Weber, Todd Sarge, Sara Nikravan, Colin K Grissom, Michael J Lanspa, Sajid Shahul, Samuel M Brown
OBJECTIVES: To describe, with an emphasis on clinical applications, what is known about the pathophysiology, management, and implications of septic cardiomyopathy in the adult ICU. DATA SOURCES AND STUDY SELECTION: A PubMed literature review was performed for relevant articles. Only articles in English that studied human adults with sepsis were included. DATA EXTRACTION AND DATA SYNTHESIS: Multiple competing definitions for septic cardiomyopathy hinder understanding of this entity...
December 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29214536/photonic-monitoring-of-treatment-during-infection-and-sepsis-development-of-new-detection-strategies-and-potential-clinical-applications
#12
REVIEW
Astrid Tannert, Anuradha Ramoji, Ute Neugebauer, Jürgen Popp
Despite the strong decline in the infection-associated mortality since the development of the first antibiotics, infectious diseases are still a major cause of death in the world. With the rising number of antibiotic-resistant pathogens, the incidence of deaths caused by infections may increase strongly in the future. Survival rates in sepsis, which occurs when body response to infections becomes uncontrolled, are still very poor if an adequate therapy is not initiated immediately. Therefore, approaches to monitor the treatment efficacy are crucially needed to adapt therapeutic strategies according to the patient's response...
December 6, 2017: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/29212277/tumor-necrosis-factor-%C3%AE-308-g-a-polymorphism-and-risk-of-sepsis-septic-shock-and-mortality-an-updated-meta-analysis
#13
Hao Wang, Shujin Guo, Chun Wan, Ting Yang, Ni Zeng, Yanqiu Wu, Lei Chen, Yongchun Shen, Fuqiang Wen
Background: The -308G/A polymorphism in the gene encoding tumor necrosis factor-α (TNF-α) has been implicated in sepsis risk in many studies but with variable results. This study aimed to comprehensively assess the evidence of association between this polymorphism and risk of sepsis and sepsis-related mortality. Materials and Methods: PubMed, EMBASE and other databases were searched to identify relevant studies, and data were analyzed using Review Manager 5.0 and STATA 12...
November 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/29204670/polymyxin-b-immobilized-hemoperfusion-and-mortality-in-critically-ill-adult-patients-with-sepsis-septic-shock-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#14
REVIEW
Tomoko Fujii, Riki Ganeko, Yuki Kataoka, Toshi A Furukawa, Robin Featherstone, Kent Doi, Jean-Louis Vincent, Daniela Pasero, René Robert, Claudio Ronco, Sean M Bagshaw
PURPOSE: Polymyxin B-immobilized hemoperfusion (PMX-HP) is an adjuvant therapy for sepsis or septic shock that clears circulating endotoxin. Prior trials have shown that PMX-HP improves surrogate endpoints. We aimed to conduct an evidence synthesis to evaluate the efficacy and safety of PMX-HP in critically ill adult patients with sepsis or septic shock. METHODS: We searched for randomized controlled trials (RCTs) in MEDLINE, EMBASE, the Cochrane Library, the Health Technology Assessment Database, CINAHL, "Igaku Chuo Zasshi", the National Institute of Health Clinical Trials Register, the World Health Organization International Clinical Trials Registry Platform, the University Hospital Medical Information Network Clinical Trials Registry, the reference lists of retrieved articles, and publications by manufacturers of PMX-HP...
December 4, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29201522/clinical-effect-of-discordance-in-empirical-treatment-of-cases-with-urinary-tract-infection-accompanied-by-bacteremia
#15
İlyas Dökmetaş, Aziz Ahmad Hamidi, Mehmet Emin Bulut, Sinan Çetin, Ahsen Öncül, Nuray Uzun
Objective: It has been shown in previous studies that inadequate empirical treatment is associated with mortality in a variety of infections caused by Gram-negative bacteria. In this study, the clinical effect of discordance in empirical treatment was investigated in patients with urinary tract infection (UTI) accompanied by bacteremia. Material and methods: We retrospectively reviewed the files of adult (>18 years old) patients who were diagnosed with UTI in our clinic between January 2014 and December 2015...
December 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/29197958/immunohaemostasis-a-new-view-on-haemostasis-during-sepsis
#16
REVIEW
Xavier Delabranche, Julie Helms, Ferhat Meziani
Host infection by a micro-organism triggers systemic inflammation, innate immunity and complement pathways, but also haemostasis activation. The role of thrombin and fibrin generation in host defence is now recognised, and thrombin has become a partner for survival, while it was seen only as one of the "principal suspects" of multiple organ failure and death during septic shock. This review is first focused on pathophysiology. The role of contact activation system, polyphosphates and neutrophil extracellular traps has emerged, offering new potential therapeutic targets...
December 2, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29176375/vitamin-c-in-sepsis
#17
Sven-Olaf Kuhn, Konrad Meissner, Lena M Mayes, Karsten Bartels
PURPOSE OF REVIEW: This narrative review summarizes recent insights into the role of vitamin C in sepsis. RECENT FINDINGS: Septic shock remains a major source of morbidity and mortality in critically ill patients. Although many nutritional supplements have previously been tested unsuccessfully, vitamins are still being explored as a therapeutic option in septic patients. In particular, vitamin C-containing regimens as adjunctive therapy in sepsis have received much attention...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29173076/non-occlusive-mesenteric-ischemia-two-case-reports-and-a-short-review-of-the-literature
#18
Georges Versyck, Charles de Gheldere, Patrick Vanclooster
INTRODUCTION: Non-occlusive mesenteric ischemia (NOMI) is an infrequent cause of acute mesenteric ischemia with atypical symptoms and a high mortality. PATIENTS AND METHODS: We report two cases of NOMI characterized by their difference in etiology, treatment and outcome. RESULTS: In the first case, the patient developed NOMI after septic shock, she was successfully treated with surgery. The second patient experienced two episodes of cardiac arrest followed by NOMI...
November 25, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29173003/life-threatening-idiopathic-reaction-to-hydrochlorothiazide-treated-with-veno-venous-extracorporeal-membrane-oxygenation
#19
Sean P Kane, Elliott Cohen
Hydrochlorothiazide has been shown to cause rare, but serious non-cardiogenic pulmonary edema. We present a case report of a patient with apparent septic shock and acute respiratory distress syndrome (ARDS) requiring life-sustaining veno-venous extracorporeal membrane oxygenation (VV-ECMO). Upon further review of the literature and the chronology of the patient's presentation, her condition was most likely due to an immune-mediated reaction to hydrochlorothiazide. This represents the first case, to our knowledge, of such a severe reaction to hydrochlorothiazide supported with ECMO therapy...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29172943/tissue-edema-fluid-balance-and-patient-outcomes-in-severe-sepsis-an-organ-systems-review
#20
Will Jaffee, Spencer Hodgins, William T McGee
Severe sepsis and septic shock remain among the deadliest diseases managed in the intensive care unit. Fluid resuscitation has been a mainstay of early treatment, but the deleterious effects of excessive fluid administration leading to tissue edema are becoming clearer. A positive fluid balance at 72 hours is associated with significantly increased mortality, yet ongoing fluid administration beyond a durable increase in cardiac output is common. We review the pathophysiologic and clinical data showing the negative effects of edema on pulmonary, renal, central nervous, hepatic, and cardiovascular systems...
January 1, 2017: Journal of Intensive Care Medicine
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