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lactate in sepsis

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https://www.readbyqxmd.com/read/27910086/higher-vs-lower-haemoglobin-threshold-for-transfusion-in-septic-shock-subgroup-analyses-of-the-triss-trial
#1
S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner
BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg...
December 2, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27908340/end-points-of-sepsis-resuscitation
#2
REVIEW
John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27908327/ready-for-prime-time-biomarkers-in-sepsis
#3
REVIEW
Brit Long, Alex Koyfman
Sepsis is a common condition managed in the emergency department. Current diagnosis relies on physiologic criteria and suspicion of a source of infection using history, physical examination, laboratory studies, and imaging studies. The infection triggers a host response with the aim to destroy the pathogen, and this response can be measured. A reliable biomarker for sepsis should assist with earlier diagnosis, improve risk stratification, or improve clinical decision making. Current biomarkers for sepsis include lactate, troponin, and procalcitonin...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27884339/dose-dependent-mortality-and-organ-injury-in-a-cecal-slurry-peritonitis-model
#4
Min Ji Lee, Kyuseok Kim, You Hwan Jo, Jae Hyuk Lee, Ji Eun Hwang
BACKGROUND: The cecal slurry model was introduced as an alternative method for creating an animal sepsis model. This study was performed to evaluate dose-dependent mortality and organ injury in a sepsis model of cecal slurry peritonitis. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 5.0, 7.5, 10, or 15 mL/kg groups, according to the volume of cecal slurry administered into the peritoneal cavity. In the survival study, rats were observed for 14 d after sepsis induction...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27862040/central-extracorporeal-life-support-with-left-ventricular-decompression-to-berlin-heart-excor-a-reliable-bridge-to-bridge-strategy-in-crash-and-burn-patients
#5
Alexander Weymann, Mina Farag, Anton Sabashnikov, Javid Fatullayev, Mohamed Zeriouh, Bastian Schmack, Rawa Arif, Florian Müller, Christina Alt, Philip Raake, Nikhil Prakash Patil, Aron-Frederik Popov, Andre Rüdiger Simon, Matthias Karck, Arjang Ruhparwar
The aim of this study was to compare patients with severe biventricular heart failure who underwent Berlin Heart Excor implantation with (cardiogenic shock [CS] status) or without the need for preoperative extracorporeal life support (ECLS) as a bridge to long-term device. A total of 40 consecutive patients with severe biventricular heart failure underwent Berlin Heart Excor implantation with (CS status, n = 20, 50%) or without (control, n = 20, 50%) the need for preoperative ECLS as a bridge to long-term device from March 2007 to May 2015 at our institution...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27857510/the-diagnostic-accuracy-of-serum-procalcitonin-for-bacteremia-in-critically-ill-children
#6
Marianne E Nellis, Steven Pon, Ashley E Giambrone, Nana E Coleman, Jonathan Reiss, Elizabeth Mauer, Bruce M Greenwald
BACKGROUND: Bacterial sepsis is frequently encountered in children admitted to the Pediatric Intensive Care Unit (PICU) and requires early recognition and treatment. Procalcitonin (PCT) is a serum biomarker with a high sensitivity to predict bacteremia in critically-ill adults. This study sought to evaluate the diagnostic accuracy of PCT for bacteremia in febrile children in the PICU. METHODS: This retrospective observational study used data from children admitted to the PICU from October 2010 to October 2012...
November 2016: Infectious Diseases in Clinical Practice: IDCP
https://www.readbyqxmd.com/read/27851093/1457-the-relationship-between-blood-pressure-variability-and-lactate-in-early-sepsis-resuscitation
#7
Jacob Nouriel, Scott Millis, Jonathon Ottolini, John Wilburn, Robert Sherwin, James Paxton
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27851062/1426-bundle-compliance-effect-greater-in-hemodynamically-stable-sepsis-patients-with-intermediate-lactate
#8
Daniel Leisman, Jason D'Amore, Jeanie Gribben, Mary Ward, John D'Angelo, Kevin Masick, Martin Doerfler
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27851007/1371-using-lactate-and-blood-pressure-to-classify-shock-in-pediatric-sepsis-an-ehr-based-approach
#9
Halden Scott, Lina Brou, Sara Deakyne, Lalit Bajaj
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850967/1331-assessment-of-qsofa-and-other-criteria-in-sepsis-with-normal-blood-pressure-and-intermediate-lactate
#10
Jan Kasal, Barry Stoll, Anup Katyal, David Tannehill, Jackyln O'Brien, Upagya Kompalli, Sanjay Subramanian
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849973/333-serum-lactate-level-predicts-3-day-30-day-and-1-year-mortality-in-patients-with-and-without-sepsis
#11
Julian Villar, Geoffrey Lighthall
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27843178/the-handheld-blood-lactate-analyser-versus-the-blood-gas-based-analyser-for-measurement-of-serum-lactate-and-its-prognostic-significance-in-severe-sepsis
#12
Shivinder Singh, Abhishek Bhardawaj, Ratnesh Shukla, Trimbak Jhadav, Anoop Sharma, D Basannar
BACKGROUND: This study was done to compare the accuracy of the Lactate Pro LT 1710 (Arkray Inc., Kyoto, Japan) with the Combiline Plus (Eschweiler GmbH & Co. KG Holzkoppelweg, Kiel, Germany), and also, to analyze the prognostic significance of serum lactates and Simplified Acute Physiology Score 3 (SAPS 3) in patients of severe sepsis. METHODS: 106 patients of severe sepsis admitted to the ICU were screened. The serum lactate from an arterial sample analyzed in both the machines was recorded at admission and at 48 h...
October 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27836621/analytical-performance-of-three-whole-blood-point-of-care-lactate-devices-compared-to-plasma-lactate-comparison-methods-and-a-flow-injection-mass-spectrometry-method
#13
Nicole V Tolan, Amy M Wockenfus, Christopher D Koch, Bridgit O Crews, Dennis J Dietzen, Brad S Karon
OBJECTIVES: Point of care (POC) whole blood lactate testing may facilitate rapid detection of sepsis. We evaluated three POC methods against both plasma lactate comparison methods and a flow-injection mass spectrometric (MS) method. DESIGN AND METHODS: Nova StatStrip, Abbott i-STAT CG4+ and Radiometer ABL90 POC lactate methods were evaluated against the mean of Cobas Integra 400 and Vitros 350 plasma lactate. POC methods were also compared to a flow-injection mass spectrometric assay measuring lactate in ZnSO4-precipitated whole blood extracts...
November 9, 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27832977/development-and-validation-of-a-parsimonious-and-pragmatic-charm-score-to-predict-mortality-in-patients-with-suspected-sepsis
#14
Kuan-Fu Chen, Su-Hsun Liu, Chih-Huang Li, Chin-Chieh Wu, Chung-Hsien Chaou, I-Shiang Tzeng, Yu-Hsiang Hsieh, Gerald N Blaney, Zhen-Ying Liu, Shih-Tsung Han, Yi-Lin Chan
BACKGROUND: We aimed to derive and validate a parsimonious and pragmatic clinical prediction rule using the concepts of Predisposition, Infection, Response, and Organ Dysfunction to predict in-hospital mortality; and to compare it with other prediction rules, as well as with conventional biomarkers for evaluating the mortality risk of patients with suspected sepsis in the emergency department (ED). METHODS: We conducted a pragmatic cohort study with consecutive ED patients aged 18 or older with documented diagnostic codes of infection and two sets of blood culture ordered by physicians between 2010 and 2012 in a tertiary teaching hospital...
November 3, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27823892/practical-considerations-in-sepsis-resuscitation
#15
Brit Long, Alex Koyfman, Katharine L Modisett, Christian J Woods
BACKGROUND: Sepsis is a common condition managed in the emergency department, and the majority of patients respond to resuscitation measures, including antibiotics and i.v. fluids. However, a proportion of patients will fail to respond to standard treatment. OBJECTIVE: This review elucidates practical considerations for management of sepsis in patients who fail to respond to standard treatment. DISCUSSION: Early goal-directed therapy revolutionized sepsis management...
November 4, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27822386/correlation-between-arterial-lactate-and-central-venous-lactate-in-children-with-sepsis
#16
Jaime Fernández Sarmiento, Paula Araque, María Yepes, Hernando Mulett, Ximena Tovar, Fabio Rodriguez
Introduction. Lactate is an important indicator of tissue perfusion. The objective of this study is to evaluate if there are significant differences between the arterial and central venous measurement of lactate in pediatric patients with sepsis and/or septic shock. Methods. Longitudinal retrospective observational study. Forty-two patients were included between the age of 1 month and 17 years, with a diagnosis of sepsis and septic shock, who were admitted to the intensive care unit of a university referral hospital...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27816133/anesthesia-for-patients-with-concomitant-sepsis-and-cardiac-dysfunction
#17
REVIEW
Abed Abubaih, Charles Weissman
Anesthesiologists faced with a patient with sepsis and concurrent cardiac dysfunction must be cognizant of the patient's cardiac status and cause of the cardiac problem to appropriately adapt physiologic and metabolic monitoring and anesthetic management. Anesthesia in such patients is challenging because the interaction of sepsis and cardiac dysfunction greatly complicates management. Intraoperative anesthesia management requires careful induction and maintenance of anesthesia; optimizing intravascular volume status; avoiding lung injury during mechanical ventilation; and close monitoring of arterial blood gases, serum lactate concentrations, and hematology renal and electrolyte parameters...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27807819/sepsis-3-definitions-predict-icu-mortality-in-a-low-middle-income-country
#18
Bruno Adler Maccagnan Pinheiro Besen, Thiago Gomes Romano, Antonio Paulo Nassar, Leandro Utino Taniguchi, Luciano Cesar Pontes Azevedo, Pedro Vitale Mendes, Fernando Godinho Zampieri, Marcelo Park
BACKGROUND: Sepsis-3 definitions were published recently and validated only in high-income countries. The aim of this study was to assess the new criteria's accuracy in stratifying mortality as compared to its predecessor (Sepsis-2) in a Brazilian public intensive care unit (ICU) and to investigate whether the addition of lactate values would improve stratification. METHODS: Retrospective cohort study conducted between 2010 and 2015 in a public university's 19-bed ICU...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27806995/septic-porcine-blood-does-not-further-activate-coagulation-during-in-vitro-membrane-oxygenation
#19
Christian Bleilevens, Oliver Grottke, Sabine Groening, Markus Honickel, Rüdger Kopp, Smriti Singh, Jutta Arens, Rolf Rossaint
OBJECTIVES: For patients with a severe acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) represents a life-saving measure. Frequently, patients with severe ARDS also show signs of severe sepsis. As blood contact with the membrane oxygenator surface leads to adverse effects due to insufficient biocompatibility partly caused by activation of platelets, coagulation factors and leucocytes, we hypothesized that these adverse effects would be amplified if septic blood in a preactivated state came into contact with the membrane oxygenator...
November 2, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27792125/impact-of-metformin-use-on-lactate-kinetics-in-patients-with-severe-sepsis-and-septic-shock
#20
Joongmin Park, Sung Yeon Hwang, Ik Joon Jo, Kyeongman Jeon, Gee Young Suh, Tae Rim Lee, Hee Yoon, Won Chul Cha, Min Seob Sim, K C Carriere, Seungmin Yeon, Tae Gun Shin
BACKGROUND: We aimed to evaluate the impact of metformin use on lactate kinetics in patients with severe sepsis and septic shock. METHODS: We analyzed data from a registry that included patients who presented to the emergency department and met criteria for severe sepsis or septic shock. Patients were divided into two groups based on metformin use. We compared lactate concentrations, lactate clearance (LC), and normalization at 6 hours (H6) and 24 hours (H24) after the initial (H0) measurement...
October 27, 2016: Shock
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