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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/29137105/urgent-laparoscopic-ureterolithotomy-for-proximal-ureter-stones-accompanied-with-obstructive-pyelonephritis-is-it-safe-and-effective-without-preoperative-drainage
#2
Huan Yang, Xiao Yu, Ejun Peng, Cong Li, Lei Cui, Xing Zeng, Shen Wang, Chao Wei, Zhihua Wang, Xiaolin Guo, Zhiqiang Chen, Zhangqun Ye, Shaogang Wang, Chenming Zhao
To evaluate the safety and efficacy of retroperitoneal laparoscopic ureterolithotomy (RLU) in the treatment of proximal ureteral stones accompanied with obstructive pyelonephritis without preoperative drainage.We retrospectively reviewed 21 cases of proximal ureteral stones with infected kidney undergoing RLU between July 2013 and September 2016. Stone-induced obstructive infected hydronephrosis was diagnosed using blood and urine tests and imaging modalities. Empirical effective broad spectrum antibiotic therapy was initiated immediately, and then urgent RLU was performed without preoperative drainage...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29128166/right-ventricle-dysfunction-and-pre-implantation-vasopressors-in-refractory-ards-supported-by-vv-ecmo
#3
Chiara Lazzeri, Manuela Bonizzoli, Giovanni Cianchi, Stefano Batacchi, Cristiana Guetti, Morena Cozzolino, Pasquale Bernardo, Adriano Peris
BACKGROUND: Acute respiratory distress syndrome (ARDS) has been shown to be frequently associated with haemodynamic instability requiring the use of vasopressors. To date, there is still some uncertainty in the use of veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO) in haemodynamically unstable ARDS patients. METHODS: We therefore assessed whether patients receiving pre ECMO vasopressors had a worse prognosis and, furthermore, we reviewed the factors associated with the use of pre ECMO vasopressors in 92 consecutive patients with refractory ARDS treated with VV-ECMO...
October 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29124458/pitfalls-of-cannulation-for-extracorporeal-life-support-review-of-the-literature-and-illustrative-case-presentation
#4
REVIEW
Martin Geyer, Bernhard Gohrbandt, Ingo Sagoschen, Thomas Hartmann, Felix Post, Christian-Friedrich Vahl, Thomas Münzel
Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) are an increasingly established advanced therapy for emerging severe lung and/or cardiocirculatory dysfunction or failure. Several reports have provided evidence for a potential benefit in prognosis by ECLS in cases of cardiogenic shock including cardiopulmonary resuscitation. Routine use in specialized centers reduces the incidence of negative side effects (e.g., vascular/ischemic, embolic, hemorrhagic, hemolytic and, furthermore, septic)...
November 9, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29121301/tissue-doppler-assessment-of-diastolic-function-and-relationship-with-mortality-in-critically-ill-septic-patients-a-systematic-review-and-meta-analysis
#5
F Sanfilippo, C Corredor, A Arcadipane, G Landesberg, A Vieillard-Baron, M Cecconi, N Fletcher
Background: Myocardial dysfunction may contribute to circulatory failure in sepsis. There is growing evidence of an association between left ventricular diastolic dysfunction (LVDD) and mortality in septic patients. Utilizing echocardiography, we know that tissue Doppler imaging (TDI) variables e' and E/e' are reliable predictors of LVDD and are useful measurements to estimate left ventricular (LV) filling pressures. Methods: We conducted a systematic review and meta-analysis to investigate the association of e' and E/e' with mortality of patients with severe sepsis or septic shock...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29118766/the-role-of-endotoxin-in-the-setting-of-cardiorenal-syndrome-type-5
#6
REVIEW
Anna Clementi, Grazia Maria Virzì, Alessandra Brocca, Claudio Ronco
Lipopolysaccharide or endotoxin, the major cell wall component of gram-negative bacteria, plays a pivotal role in the pathogenesis of sepsis. It is able to activate the host defense system through the interaction with Toll-like receptor 4, thus triggering pro-inflammatory mechanisms. When the production of inflammatory mediators becomes uncontrolled and excessive, septic shock develops with multiple organ dysfunction, such as myocardial and renal impairment, which are hallmarks of cardiorenal syndrome type 5...
October 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29118760/septic-shock-and-the-aging-process-a-molecular-comparison
#7
Fabiano Pinheiro da Silva, Marcel Cerqueira César Machado
Aging is a continuous process promoted by both intrinsic and extrinsic factors that each trigger a multitude of molecular events. Increasing evidence supports a central role for inflammation in this progression. Here, we discuss how the low-grade chronic inflammation that characterizes aging is tightly interconnected with other important aspects of this process, such as DNA damage, mitochondrial dysfunction, and epigenetic changes. Similarly, inflammation also plays a critical role in many morbid conditions that affect patients who are admitted to Intensive Care...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29115073/assessment-of-competence-in-emergency-medicine-among-healthcare-professionals-in-cameroon
#8
Sang Chul Kim, Young Sun Ro, Sang Do Shin, Dae Han Wi, Joongsik Jeong, Ju Ok Park, Kyong Min Sun, Kwangsoo Bae
Development of a competence-based curriculum is important. This study aimed to develop competence assessment tools in emergency medicine and use it to assess competence of Cameroonian healthcare professionals. This was a cross-sectional, descriptive study. Through literature review, expert survey, and discrimination tests, we developed a self-survey questionnaire and a scenario-based competence assessment tool for assessing clinical knowledge and self-confidence to perform clinical practices or procedures. The self-survey consisted of 23 domains and 94 questionnaires on a 5-point Likert scale...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29107479/clinical-factors-and-outcomes-of-dialysis-dependent-end-stage-renal-disease-patients-with-emergency-department-septic-shock
#9
Kevin M Lowe, Alan C Heffner, Colleen H Karvetski
BACKGROUND: Infection is the second leading cause of death in end-stage renal disease (ESRD) patients. Prior investigations of acute septic shock in this specific population are limited. OBJECTIVE: We aimed to evaluate the clinical presentation and factors associated with outcome among ESRD patients with acute septic shock. METHODS: We reviewed patients prospectively enrolled in an emergency department (ED) septic shock treatment pathway registry between January 2014 and May 2016...
October 26, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29104224/parameters-of-the-endocannabinoid-system-as-novel-biomarkers-in-sepsis-and-septic-shock
#10
REVIEW
J Daniel Lafreniere, Christian Lehmann
Sepsis represents a dysregulated immune response to infection, with a continuum of severity progressing to septic shock. This dysregulated response generally follows a pattern by which an initial hyperinflammatory phase is followed by a state of sepsis-associated immunosuppression. Major challenges in improving sepsis care include developing strategies to ensure early and accurate identification and diagnosis of the disease process, improving our ability to predict outcomes and stratify patients, and the need for novel sepsis-specific treatments such as immunomodulation...
November 1, 2017: Metabolites
https://www.readbyqxmd.com/read/29094482/maternal-peripartum-septic-shock-caused-by-intrauterine-infection-with-edwardsiella-tarda-a-case-report-and-review-of-the-literature
#11
Yuki Miyazawa, Keisuke Murakami, Yuichiro Kizaki, Yukiko Itaya, Yasushi Takai, Hiroyuki Seki
Edwardsiella tarda (E. tarda) is a rare pathogen in humans, especially during the peripartum period. Only a few cases of fatal neonatal infection with E. tarda have been reported. Herein, we describe a case of maternal septicemia caused by E. tarda following peripartum chorioamnionitis. The mother developed septic shock, disseminated intravascular coagulation and a post-cesarean wound hematoma with abscess. Her condition improved with multidisciplinary therapy including blood transfusion, antimicrobial agents, recombinant thrombomodulin and surgical debridement...
November 2, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29088995/a-multicenter-survey-of-house-staff-knowledge-about-sepsis-and-the-surviving-sepsis-campaign-guidelines-for-management-of-severe-sepsis-and-septic-shock
#12
Richard R Watkins, Nairmeen Haller, Melinda Wayde, Keith B Armitage
BACKGROUND: We aimed to assess the knowledge, attitudes, and perceptions of resident physicians regarding sepsis in general and the Surviving Sepsis Campaign Guidelines in particular. METHODS: After institutional review board approval, we surveyed internal medicine (IM) and emergency medicine (EM) house staff from 3 separate institutions. House staff were notified of the survey via e-mail from their residency director or chief resident. The survey was Internet-based (using http://www...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29082050/a-case-of-rituximab-induced-necrotizing-fasciitis-and-a-review-of-the-literature
#13
Abdullateef Abdulkareem, Ryan S D'Souza, Oluwaseun Shogbesan, Anthony Donato
Necrotizing fasciitis is a fulminant soft tissue infection characterized by rapid progression and high mortality. Rituximab is a generally well-tolerated immunosuppresive medication used for B-cell malignancies and some rheumatological disorders. We report a case of a 69-year-old male with chronic lymphocytic leukemia who suffered necrotizing fasciitis of his left lower extremity secondary to Clostridium septicum 7 weeks after treatment with rituximab. Despite immediate intravenous antimicrobial therapy and emergent fasciotomy with extensive debridement, his hospital course was complicated by septic shock and he required an above-the-knee amputation...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29081854/toxic-shock-in-children-with-bone-and-joint-infections-a-review-of-seven-years-of-patients-admitted-to-one-intensive-care-unit
#14
D L Kerr, E K Loraas, A C Links, T V Brogan, G A Schmale
PURPOSE: The objective of this study was to compare the frequency of severe systemic, multi-organ involvement and toxic shock syndrome (TSS) in patients with Staphylococcus aureus (SA) and Group A β-haemolytic Streptococcus pyogenes (GABS) bone and joint infections. METHODS: We retrospectively reviewed patients treated for septic arthritis or osteomyelitis at one children's hospital between 2002 and 2009. The rates of intensive care unit (ICU) admission for methicillin-sensitive SA (MSSA), methicillin-resistant SA (MRSA) and GABS infections were compared, as were the lengths of stay, number of surgeries, operative procedures and cases of TSS...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081807/necrotizing-fasciitis-secondary-to-aeromonas-infection-presenting-with-septic-shock
#15
Nikhil Bhatia, Manuel Castro-Borobio, John N Greene, Sowmya Nanjappa
This report describes a case of necrotizing fasciitis presenting with septic shock due to an Aeromonas infection. The patient cut his foot while mowing the lawn and then spent time in a pool with black mold. He began feeling ill and developed swelling and a quarter-sized black area on his right lower extremity. Despite being hemodynamically unstable with systolic blood pressure in the low 70s, the patient was transferred to our facility from outside hospital 100 miles away. Upon arriving to facility, the patient appeared to be septic and the infected area of skin had grown...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29079487/what-is-the-preferred-resuscitation-fluid-for-patients-with-severe-sepsis-and-septic-shock
#16
Michael E Winters, Robert Sherwin, Gary M Vilke, Gabriel Wardi
BACKGROUND: Current guidelines for the management of patients with severe sepsis and septic shock recommend crystalloids as the initial fluid solution of choice in the resuscitation of these patients. In recent years, there have been numerous studies published on the type of fluid used in the resuscitation of patients with sepsis. The primary goal of this article is to determine the preferred intravenous fluid for the resuscitation of patients with severe sepsis and septic shock. METHODS: A MEDLINE literature review was completed to identify studies that investigated the type of resuscitation fluid in the management of patients with severe sepsis and septic shock...
October 24, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29079067/clinical-mimics-an-emergency-medicine-focused-review-of-cellulitis-mimics
#17
Garrett Blumberg, Brit Long, Alex Koyfman
BACKGROUND: Cellulitis is a common clinical condition with low rates of morbidity and mortality if treated appropriately. Mimics of cellulitis presenting with erythema, edema, warmth, and pain can be associated with grave morbidity and mortality if misdiagnosed. OBJECTIVE: This review investigates the signs and symptoms of cellulitis, mimics of cellulitis, and an approach to the management of both cellulitis and its mimics. DISCUSSION: The current emergency medicine definition of cellulitis includes erythema, induration, warmth, and swelling...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29065405/risk-factors-for-uroseptic-shock-in-patients-with-urolithiasis-related-acute-pyelonephritis
#18
Hiroaki Kakinoki, Shohei Tobu, Yuka Kakinoki, Kazuma Udo, Jiro Uozumi, Mitsuru Noguchi
OBJECTIVES: To analyze the risk factors of uroseptic shock induced by calculous acute pyelonephritis (APN). METHODS: This study included 69 patients (41 were women and 28 were men) who were admitted to our hospital for APN treatment associated with urolithiasis during the period from January 2005 to December 2012. We reviewed the electronic medical records of these patients to analyze risk factors contributing to the development of uroseptic shock from APN in patients with urolithiasis...
October 24, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/29064179/a-case-of-hypothermia-on-crrt
#19
Gurwant Kaur, Prameela Banoth, Preethi Yerram, Madhukar Misra
A 64-year-old Asian man, with past medical history of hypertension, hypothyroidism, and hyperlipidemia, presented with 3 days history of fever associated with cough and worsening shortness of breath. Subsequent clinical course was complicated by acute lung injury leading to acute respiratory distress syndrome requiring positive pressure ventilation, septic shock requiring inotropic support, and acute kidney injury requiring continuous renal replacement therapy (CRRT). On day 3 of CRRT, the patient developed significant hypothermia (temporal temperature 27...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29061597/high-dose-versus-low-dose-haemofiltration-for-the-treatment-of-critically-ill-patients-with-acute-kidney-injury-an-updated-systematic-review-and-meta-analysis
#20
Peng Li, Li-Ping Qu, Dong Qi, Bo Shen, Yi-Mei Wang, Jia-Rui Xu, Wu-Hua Jiang, Hao Zhang, Xiao-Qiang Ding, Jie Teng
OBJECTIVE: The purpose of this study was to perform a systematic review and meta-analysis to evaluate the effect of high-dose versus low-dose haemofiltration on the survival of critically ill patients with acute kidney injury (AKI). We hypothesised that high-dose treatments are not associated with a higher risk of mortality. DESIGN: Meta-analysis. SETTING: Randomised controlled trials and two-arm prospective and retrospective studies were included...
October 22, 2017: BMJ Open
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