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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/28426721/diagnosis-treatment-and-prognosis-of-small-bowel-volvulus-in-adults-a-monocentric-summary-of-a-rare-small-intestinal-obstruction
#2
Xiaohang Li, Jialin Zhang, Baifeng Li, Dehui Yi, Chengshuo Zhang, Ning Sun, Wu Lv, Ao Jiao
OBJECTIVES: Small bowel volvulus is a rare disease, which is also challenging to diagnose. The aims of this study were to characterize the clinical and radiological features associated with small bowel volvulus and treatment and to identify risk factors for associated small bowel necrosis. METHODS: Patients with small bowel volvulus who underwent operations from January 2001 to December 2015 at the First Affiliated Hospital of China Medical University (Shenyang, China) were reviewed...
2017: PloS One
https://www.readbyqxmd.com/read/28422777/population-based-epidemiology-of-sepsis-in-a-subdistrict-of-beijing
#3
Jianfang Zhou, Hongcheng Tian, Xueping Du, Xiuming Xi, Youzhong An, Meili Duan, Li Weng, Bin Du
OBJECTIVE: Information about the epidemiology of sepsis in community residents in China remains scarce and incomplete. The purpose of this study was to describe the occurrence rate and outcome of sepsis in Yuetan Subdistrict of Beijing and to estimate the occurrence rate of sepsis in China. DESIGN: Retrospective cohort study. SETTING: All public hospitals serving residents in Yuetan Subdistrict, Beijing. PATIENTS: All patients (n = 1,716) meeting criteria for sepsis based on American College of Chest Physicians/Society of Critical Care Medicine consensus definition...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28420477/-metabolism-of-high-density-lipoprotein-and-the-research-progress-of-its-effects-on-sepsis
#4
Meiyun Liu, Huanping Zhou, Xin Lyu
Sepsis is a high-risk factor for the death of critical patients. High density lipoprotein (HDL) are the major protective serum proteins, and the serum levels of HDL are closely related to the severity of sepsis. The anti-inflammatory and anti-oxidation properties of HDL, may be able to play an important role in the innate immune response. Thereby it may reduce the damage of septic shock and multiple organ dysfunction syndrome (MODS) in animals or human beings, and improve the prognosis. In order to unveil the metabolism of HDL in septic patients and its effects on both progression and prognosis of sepsis, this review not only focuses on the composition and structure of HDL, but also analyzes its pivotal role in inflammatory immune response and anti-oxidation...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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/28409042/nephrologists-hate-the-dialysis-catheters-a-systemic-review-of-dialysis-catheter-associated-infective-endocarditis
#7
Kalyana C Janga, Ankur Sinha, Sheldon Greenberg, Kavita Sharma
A 53-year-old Egyptian female with end stage renal disease, one month after start of hemodialysis via an internal jugular catheter, presented with fever and shortness of breath. She developed desquamating vesiculobullous lesions, widespread on her body. She was in profound septic shock and broad spectrum antibiotics were started with appropriate fluid replenishment. An echocardiogram revealed bulky leaflets of the mitral valve with a highly mobile vegetation about 2.3 cm long attached to the anterior leaflet...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28398176/septic-shock-due-to-nsti-caused-by-actinomyces-turicensis-the-role-of-clinical-pharmacology-case-report-and-review-of-the-literature
#8
Milo Gatti, Laura Elisa Gasparini, Chiara Maria Grimaldi, Daniela Abbati, Stefano Clemente, Paolo Riccardo Brioschi, Roberto Fumagalli, Francesco Scaglione
Critical septic patients affected by necrotizing soft tissue infections (NSTI) require an early, aggressive and multidisciplinary treatment. Pharmacokinetic alterations in antibiotic therapy are peculiar in these infections. Clinical pharmacology represents a first step in this setting. We report a case of septic shock due to NSTI in which clinical pharmacology is taken into account.
April 11, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28391994/usefulness-and-prognostic-value-of-biomarkers-in-patients-with-community-acquired-pneumonia-in-the-emergency-department
#9
REVIEW
Agustín Julián-Jiménez, Juan González Del Castillo, Francisco Javier Candel
Between all patients treated in the Emergency Department (ED), 1.35% are diagnosed with community-acquired pneumonia (CAP). CAP is the main cause of death due to infectious disease (10-14%) and the most frequent reason of sepsis-septic shock in the ED. In the last decade, the search for objective tools to help establishing an early diagnosis, bacterial aetiology, severity, suspicion of bacteremia and the prognosis of mortality has increased. Biomarkers have shown their usefulness in this matter. Procalcitonin (obtains the highest accuracy for CAP diagnosis, bacterial aetiology and the presence of bacteremia), lactate (biomarker of hypoxia and tissue hypoperfusion) and proadrenomedullin (which has the greatest accuracy to predict mortality which in combination with the prognostic severity scales obtains even better results)...
April 6, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28388526/sepsis-associated-in-hospital-cardiac-arrest-epidemiology-pathophysiology-and-potential-therapies
#10
REVIEW
Ryan W Morgan, Julie C Fitzgerald, Scott L Weiss, Vinay M Nadkarni, Robert M Sutton, Robert A Berg
Sepsis-associated cardiac arrest is a relatively common occurrence with especially poor outcomes. Of the greater than 200,000 in-hospital cardiac arrests that occur in the United States annually, between 30,000 and 60,000 occur in patients with underlying sepsis. These patients are less likely to survive than cardiac arrest victims without sepsis. In this review, we discuss the epidemiology of sepsis-associated in-hospital cardiac arrest in adults and children, the relevant physiology responsible for its pathogenesis and poor outcomes, and potential therapeutic interventions based on this pathophysiology...
March 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28381918/evaluation-of-hydrocortisone-continuous-infusion-versus-intermittent-boluses-in-resolution-of-septic-shock
#11
Hoan Hoang, Shan Wang, Shahidul Islam, Adel Hanna, Alexander Axelrad, Collin Brathwaite
PURPOSE: To compare the effectiveness of continuous infusion of hydrocortisone versus intermittent boluses in the resolution of septic shock. METHODS: A retrospective chart review was performed to investigate the effects of low-dose hydrocortisone continuous infusion (200 mg per day) versus intermittent boluses (50 mg every six hours) in septic shock patients who did not respond to fluid resuscitation and vasopressors. The primary outcome was time to resolution of shock, defined by time from the initiation of hydrocortisone to time of vasopressor withdrawal when mean arterial pressure was greater than 65 mm Hg...
April 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28365897/fluoroquinolone-prophylaxis-in-autologous-hematopoietic-stem-cell-transplant-recipients
#12
Dipenkumar Modi, Hyejeong Jang, Seongho Kim, Malini Surapaneni, Kamya Sankar, Abhinav Deol, Lois Ayash, Divaya Bhutani, Lawrence G Lum, Voravit Ratanatharathorn, Richard Manasa, Kendra Mellert, Pranatharthi Chandrasekar, Joseph P Uberti
PURPOSE: Although fluoroquinolone prophylaxis is frequently utilized in autologous hematopoietic stem cell transplant (AHSCT) patients, its impact on morbidity and mortality is uncertain. This study investigates the role of quinolone prophylaxis after AHSCT in recent years. METHODS: We conducted a retrospective review of 291 consecutive adult patients who underwent AHSCT for malignant disorders, between June 2013 and January 2015. Outcomes were compared between patients who received norfloxacin prophylaxis and those who did not...
April 2, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28365269/does-promoting-resolution-instead-of-inhibiting-inflammation-represent-the-new-paradigm-in-treating-infections
#13
REVIEW
Jesmond Dalli
Infections arise when the host response is overwhelmed by pathogens leading to organ dysfunction. In some instances patients progress to more severe conditions, including septic shock, that are associated with increased mortality. Current strategies in treating infections aim at either blocking inflammation using inhibitors to pro-inflammatory molecules and/or inhibiting bacterial growth using antibiotics. These approaches find their origins in studies conducted by Joseph Lister who demonstrated that applying carbolic acid to wounds promoted wound healing without suppuration, reducing both the necessity of amputation and mortality...
April 5, 2017: Molecular Aspects of Medicine
https://www.readbyqxmd.com/read/28355987/acute-acalculous-cholecystitis-in-patients-with-systemic-lupus-erythematosus-a-unique-form-of-disease-flare
#14
H Yang, S Bian, D Xu, F Zhang, X Zhang
Objective We aimed to investigate the clinical features of acute acalculous cholecystitis (AAC) in patients with systemic lupus erythematosus (SLE). Methods SLE patients with AAC hospitalized in the Peking Union Medical College Hospital (PUMCH) from January 2001 to September 2015 were retrospectively analyzed. Their medical records were systematically reviewed. The diagnosis of AAC was based on clinical manifestations and confirmed by radiologic findings including a distended gallbladder with thickened wall, pericholecystic fluid and absence of gallstones...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28351429/corticosteroids-in-septic-shock-a-systematic-review-and-network-meta-analysis
#15
Ben Gibbison, José A López-López, Julian P T Higgins, Tom Miller, Gianni D Angelini, Stafford L Lightman, Djillali Annane
BACKGROUND: Multiple corticosteroids and treatment regimens have been used as adjuncts in the treatment of septic shock. Qualitative and quantitative differences exist at cellular and tissular levels between the different drugs and their patterns of delivery. The objective of this study was to elucidate any differences between the drugs and their treatment regimens regarding outcomes for corticosteroid use in adult patients with septic shock. METHODS: Network meta-analysis of the data used for the recently conducted Cochrane review was performed...
March 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28332876/evaluation-and-management-of-adrenal-insufficiency-in-critically-ill-patientsdisease-state-review
#16
Amir H Hamrahian, Maria Fleseriu
Definition of normal adrenal function in critically ill patients remains controversial, despite a large body of literature. Furthermore, evaluation of adrenal function in these patients is complex. A decrease in cortisol breakdown rather than an increase in cortisol production has been suggested as the main contributor to elevated cortisol levels in critically ill patients. The concept of relative adrenal insufficiency has multiple pathophysiological flaws and is not supported by current evidence. Patients with septic shock who are pressor-dependent or refractory to fluid resuscitation should receive a short course of hydrocortisone regardless of their serum cortisol levels or their response to a Cosyntropin stimulation test (CST)...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28331537/combined-totally-mini-invasive-approach-in-necrotizing-pancreatitis-a-case-report-and-systematic-literature-review
#17
REVIEW
Luca Sorrentino, Osvaldo Chiara, Massimiliano Mutignani, Fabrizio Sammartano, Paolo Brioschi, Stefania Cimbanassi
BACKGROUND: Currently, both the step-up approach, combining percutaneous drainage (PD) and video-assisted retroperitoneal debridement (VARD), and endoscopic transgastric necrosectomy (ETN) are mini-invasive techniques for infected necrosis in severe acute pancreatitis. A combination of these approaches could maximize the management of necrotizing pancreatitis, conjugating the benefits from both the experiences. However, reporting of this combined strategy is anecdotal. This is the first reported case of severe necrotizing pancreatitis complicated by biliary fistula treated by a combination of ETN, PD, VARD, and endoscopic biliary stenting...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28321079/shewanella-algae-bacteremia-in-an-end-stage-renal-disease-patient-a-case-report-and-review-of-the-literature
#18
Tomoaki Takata, Hiroki Chikumi, Shota Morishita, Shintaro Hamada, Shotaro Hoi, Takuji Iyama, Takeaki Fukui, Tomomitsu Matono, Satoko Fukuda, Chishio Munemura, Hajime Isomoto
A 71-year-old man was admitted because of nausea and abdominal pain. He was receiving an erythropoiesis-stimulating agent for anemia and dysregulated iron metabolism due to stage G5 chronic kidney disease. He had a history of raw fish intake and was diagnosed with infectious enterocolitis, which worsened and led to septic shock. Shewanella putrefaciens grew in the blood culture, but Shewanella algae was identified in a 16S rRNA gene sequence analysis. We herein report a case of S. algae bacteremia believed to have been transmitted orally...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28319910/the-role-of-vasopressin-and-the-vasopressin-type-v1a-receptor-agonist-selepressin-in-septic-shock
#19
REVIEW
Antonio F Saad, Marc O Maybauer
Septic shock remains one of the major causes of morbidity and mortality in the critically ill. Despite early goal therapy and administration of cathecholaminergic agents, up to 30% of patients succumb to the disease. In this manuscript, we first summarize the standard of care of patients with septic shock and current guidelines. We review the physiologic role of vasopressin and its role in septic shock management. We then review the most up-to-date evidence on the potential role of V1a receptor agonists such as Selepressin, in septic shock...
March 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28316845/spinal-cord-infarction-in-the-course-of-a-septic-shock-about-one-case-and-review-of-the-literature
#20
P Henin, A Molderez, V Huberlant, H Trine
We report the case of a patient admitted to our intensive care unit in the course of a septic shock, secondary to cholangitis. After rapid hemodynamic stabilization, antibiotherapy, and endoscopic extraction of bile ducts stones, she appeared to have developed flaccid paraplegia. The suspected diagnosis of medullar ischemia was confirmed by typical MRI findings. This case stresses the potential pathogenic role of hypotension in medullar ischemia and the place of magnetic resonance imaging (MRI) as a reliable diagnostic tool...
2017: Case Reports in Critical Care
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