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lactate in sepsis

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https://www.readbyqxmd.com/read/29347908/management-and-outcomes-of-patients-presenting-with-sepsis-and-septic-shock-to-the-emergency-department-during-nursing-handover-a-retrospective-cohort-study
#1
Sami Alsolamy, Atheer Al-Sabhan, Najla Alassim, Musharaf Sadat, Eman Al Qasim, Hani Tamim, Yaseen M Arabi
BACKGROUND: Clinical handover is an important process for the transition of patient-care responsibility to the next healthcare provider, but it may divert the attention of the team away from active patients. This is challenging in the Emergency Department (ED) because of highly dynamic patient conditions and is likely relevant in conditions that requires time-sensitive therapies, such as sepsis. We aimed to examine the management and outcomes of patients presenting with sepsis and septic shock to the ED during nursing handover...
January 18, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29344053/an-overview-of-exposure-to-ethanol-containing-substances-and-ethanol-intoxication-in-children-based-on-three-illustrated-cases
#2
REVIEW
Kam Lun Hon, Alexander Kc Leung, Eddie Cheung, Bryan Lee, Michelle Mc Tsang, Alcy R Torres
Alcohol addiction and intoxication are major health problems worldwide. Acute alcohol intoxication is well reported in adults and adolescents but less frequently reported in children of younger ages. We report three anonymized cases of pediatric ethanol exposure and illustrate the different mechanisms of intoxication. In all cases, a focused history is the key to prompt diagnosis and timely management. Physicians should be aware of this potential poison in children presented with acute confusional or encephalopathic state...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29341498/review-article-sepsis-in-the-emergency-department-part-2-investigations-and-monitoring
#3
REVIEW
Amith Shetty, Stephen Pj Macdonald, Gerben Keijzers, Julian M Williams, Benjamin Tang, Bas de Groot, Kelly Thompson, John F Fraser, Simon Finfer, Rinaldo Bellomo, Jonathan Iredell
Sepsis is characterised by organ dysfunction resulting from infection, with no reliable single objective test and current diagnosis based on clinical features and results of investigations. In the ED, investigations may be conducted to diagnose infection as the cause of the presenting illness, identify the source, distinguish sepsis from uncomplicated infection (i.e. without organ dysfunction) and/ or risk stratification. Appropriate sample collection for microbiological testing remains key for subsequent confirmation of diagnosis and rationalisation of antimicrobials...
January 16, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29320362/predictive-value-of-serum-gelsolin-and-gc-globulin-in-sepsis-a-pilot-study
#4
Zoltán Horváth-Szalai, Péter Kustán, Balázs Szirmay, Ágnes Lakatos, Per Hjort Christensen, Tamás Huber, Beáta Bugyi, Diána Mühl, Andrea Ludány, Attila Miseta, Gábor L Kovács, Tamás Kőszegi
BACKGROUND: Simultaneous determination of the two main actin scavenger proteins in sepsis has not been investigated until now. In our pilot study, we elucidated the predictive values of Gc globulin and gelsolin (GSN) in sepsis by comparing them to classic laboratory and clinical parameters. METHODS: A 5-day follow-up was performed, including 46 septic patients, 28 non-septic patients and 35 outpatients as controls. Serum Gc globulin and GSN levels were determined by automated immune turbidimetric assay on a Cobas 8000/c502 analyzer...
January 10, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29317968/b-type-natriuretic-peptide-a-predictor-for-mortality-intensive-care-unit-length-of-stay-and-hospital-length-of-stay-in-patients-with-resolving-sepsis
#5
Harsimar Singh, Daryl Ramai, Harshil Patel, Marina Iskandir, Sarina Sachdev, Rabjot Rai, Jay Patolia, Getaw Worku Hassen
Background: B-type natriuretic peptide (BNP) is a hormone secreted by cardiomyocytes in response to myocardial ischemia, increased ventricular wall tension, and overload. BNP is utilized as a diagnostic and prognostic marker in congested heart failure (CHF). Its prognostic value in sepsis is unknown. The aim of this study is to determine if BNP correlates with increased in-hospital mortality for septic patients. Methods: This was a retrospective study of 505 patients admitted for sepsis or severe sepsis or septic shock during the period of January 2013 and August 2014...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29310566/analysis-of-oxidative-stress-related-markers-in-critically-ill-polytrauma-patients-an-observational-prospective-single-center-study
#6
Mihai Sandesc, Alexandru Florin Rogobete, Ovidiu Horea Bedreag, Anca Dinu, Marius Papurica, Carmen Alina Cradigati, Mirela Sarandan, Sonia Elena Popovici, Lavinia Melania Bratu, Tiberiu Bratu, Adrian Tudor Stan, Dorel Sandesc
Critically ill polytrauma patients have increased production of free radicals (FRs) and consequent alterations in biochemical pathways, as well as disruption of cellular integrity, due to increased lipid peroxidation. The aim of this study was to investigate several biomarkers associated with increased oxidative stress in critically ill polytrauma patients, and to evaluate the effect of antioxidant treatment on the clinical outcome in these patients. A total of 67 polytrauma patients from an intensive care unit met the selection criteria...
January 9, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29306875/serum-lactate-cut-offs-as-a-risk-stratification-tool-for-in-hospital-adverse-outcomes-in-emergency-department-patients-screened-for-suspected-sepsis
#7
Amith L Shetty, Kelly Thompson, Karen Byth, Petra Macaskill, Malcolm Green, Mary Fullick, Harvey Lander, Jonathan Iredell
OBJECTIVES: We investigated specific lactate thresholds for adverse outcomes in patients presenting to emergency departments (EDs) with suspected sepsis identified based on the performance of a sepsis screening algorithm. DESIGN AND SETTING: A standardised sepsis bundle was implemented across public hospitals in New South Wales, Australia, as a quality improvement initiative. A register of all adult ED presentations (≥18 years) meeting predefined criteria for sepsis was created, using a combination of data linkage and direct reporting from 97 participating sites...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29298189/delay-within-the-3-hour-surviving-sepsis-campaign-guideline-on-mortality-for-patients-with-severe-sepsis-and-septic-shock
#8
Lisiane Pruinelli, Bonnie L Westra, Pranjul Yadav, Alexander Hoff, Michael Steinbach, Vipin Kumar, Connie W Delaney, Gyorgy Simon
OBJECTIVES: To specify when delays of specific 3-hour bundle Surviving Sepsis Campaign guideline recommendations applied to severe sepsis or septic shock become harmful and impact mortality. DESIGN: Retrospective cohort study. SETTING: One health system composed of six hospitals and 45 clinics in a Midwest state from January 01, 2011, to July 31, 2015. PATIENTS: All adult patients hospitalized with billing diagnosis of severe sepsis or septic shock...
January 2, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29297372/detailing-the-cardiovascular-profile-in-shock-patients
#9
REVIEW
Daniel De Backer
Evaluation of the cardiovascular profile of critically ill patients is one of the most important actions performed in critically ill patients. It allows recognition that the patient is in shock and characterization of the type of circulatory failure. This step is crucial to initiate supportive interventions and to cure the cause responsible for the development of shock. Evaluation of tissue perfusion allows identification of the patient insufficiently resuscitated and also to trigger therapeutic interventions...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29290897/dose-related-effects-of-dexmedetomidine-on-immunomodulation-and-mortality-to-septic-shock-in-rats
#10
Yan Ma, Xiang-You Yu, Yi Wang
BACKGROUND: Dexmedetomidine has already been used in septic patients as a new sedative agent, few studies have examined its effects on immunomodulation. Therefore, the authors have designed a controlled experimental study to characterize the immunomodulation effects of dexmedetomidine in the cecal ligation and puncture (CLP) model in rats. METHODS: After CLP, 48 Wistar rats were randomly allocated into four groups: (1) CLP group; (2) small-dose treatment group (2...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29289378/prognostic-power-of-biomarkers-for-short-term-mortality-in-the-elderly-patients-seen-in-emergency-departments-due-to-infections
#11
Agustín Julián-Jiménez, María Cecilia Yañez, Juan González-Del Castillo, Manuel Salido-Mota, Begoña Mora-Ordoñez, María Jesús Arranz-Nieto, Manuel R Chanovas-Borras, Ferrán Llopis-Roca, Josep María Mòdol-Deltell, Gema Muñoz
OBJECTIVES: To analyse and compare 30-day mortality prognostic power of several biomarkers (C-reactive protein, procalcitonin, lactate, suPAR and pro-adremomedullin) in elderly patients seen in Emergency Departments (ED) due to infections. Secondly, if these could improve the prognostic accuracy of sepsis criteria (systemic inflammatory response syndrome and quick Sepsis-related Organ Failure Assessment [qSOFA]). METHODS: A prospective, observational, multicentre and analytical study...
December 27, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29284433/adaptation-of-the-who-maternal-near-miss-tool-for-use-in-sub-saharan-africa-an-international-delphi-study
#12
Abera K Tura, Jelle Stekelenburg, Sicco A Scherjon, Joost Zwart, Thomas van den Akker, Jos van Roosmalen, Sanne J Gordijn
BACKGROUND: Assessments of maternal near miss (MNM) are increasingly used in addition to those of maternal mortality measures. The World Health Organization (WHO) has introduced an MNM tool in 2009, but this tool was previously found to be of limited applicability in several low-resource settings. The aim of this study was to identify adaptations to enhance applicability of the WHO MNM tool in sub-Saharan Africa. METHODS: Using a Delphi consensus methodology, existing MNM tools were rated for applicability in sub-Saharan Africa over a series of three rounds...
December 29, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29282084/r-100-improves-pulmonary-function-and-systemic-fluid-balance-in-sheep-with-combined-smoke-inhalation-injury-and-pseudomonas-aeruginosa-sepsis
#13
Hiroshi Ito, Erik Malgerud, Sven Asmussen, Ernesto Lopez, Andrew L Salzman, Perenlei Enkhbaatar
BACKGROUND: Septic shock is a major cause of death in intensive care units around the world . The aim of the study was to investigate whether the novel drug R-100 (a superoxide degradation catalyst and nitric oxide donor) improves pulmonary function in a sheep model of septic shock caused by Pseudomonas aeruginosa and smoke inhalation. METHODS: Eleven female sheep were prepared surgically and randomly assigned to a treatment group (n = 5) or a control group (n = 6) after inhalation of cooled cotton smoke and airway instillation of live P...
December 28, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29276032/the-utility-of-presepsin-in-diagnosis-and-risk-stratification-for-the-emergency-patients-with-sepsis
#14
Bin Lu, Yan Zhang, Chen Li, Chenyan Liu, Ying Yao, Minghuan Su, Songtao Shou
OBJECTIVES: To evaluate the value of presepsin in diagnosis and risk stratification of septic patients in emergency department, and investigate the utility in differentiation of gram-positive and gram-negative bacterial infection. METHODS: We enrolled 72 patients with sepsis and 23 nonbacterial patients with systemic inflammatory response syndrome (SIRS) who were admitted to the emergency department of Tianjin Medical University General Hospital. Meanwhile, 20 healthy volunteers were included...
December 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29260243/-perioperative-handling-of-antidiabetic-drugs
#15
REVIEW
J Wagner, V Luber, J F Lock, U A Dietz, S Lichthardt, N Matthes, K Krajinovic, C-T Germer, S Knop, A Wiegering
Diabetes mellitus is the most frequent metabolic disorder in the western world with a prevalence of 3% in adults under 65 years of age and 14.3% in adults over 65 years of age. Due to the increasing age of our population, the number of patients taking oral antidiabetic drugs has increased. Thus, operating physicians must make a risk-adapted decision whether the medication can be continued perioperatively or if certain drugs must be paused, and if so, with what risks. Operative interventions can lead to a number of metabolic shifts, which change the normal glucose metabolism...
December 19, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29246637/usefulness-of-midregional-pro-adrenomedullin-as-a-marker-of-organ-damage-and-predictor-of-mortality-in-patients-with-sepsis
#16
Enrique Bernal-Morell, Eva García-Villalba, Maricarmen Vera, Blanca Medina, Monica Martinez, Victoria Callejo, Salvador Valero, Cesar Cinesi, Pascual Piñera, Antonia Alcaraz, Irene Marin, Angeles Muñoz, Alfredo Cano
BACKGROUND: Midregional proadrenomedullin (MR-proADM) is a prognostic biomarker in patients with community-acquired pneumonia (CAP) and sepsis. In this paper, we examined the ability of MR-proADM to predict organ damage and long-term mortality in sepsis patients, compared to that of procalcitonin, C-reactive protein and lactate. METHODS: This was a prospective observational cohort, enrolling severe sepsis or septic shock patients admitted to internal service department...
December 12, 2017: Journal of Infection
https://www.readbyqxmd.com/read/29246581/combined-therapy-with-gas-gangrene-antitoxin-and-recombinant-human-soluble-thrombomodulin-for-clostridium-perfringens-sepsis-in-a-rat-model
#17
Toru Hifumi, Daisuke Nakano, Joe Chiba, Motohide Takahashi, Akihiko Yamamoto, Yoshihide Fujisawa, Kenya Kawakita, Yasuhiro Kuroda, Akira Nishiyama
Cases of Clostridium perfringens septicemia, such as liver abscess, often develop a rapidly progressive intravascular hemolysis and coagulation; the mortality rate with current standard care including antibiotics and surgery is high. Herein, we firstly investigated the effects of gas gangrene antitoxin (GGA) (antitoxin against C. perfringens) and recombinant human soluble thrombomodulin (rTM) on the hemolysis, coagulation status, inflammatory process, and mortality in α-toxin-treated rats. Male 11-week-old Sprague Dawley rats were randomly divided into five groups: control group, α-toxin group, GGA group, rTM group, and combined GGA and rTM (combination group)...
December 12, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29225011/effect-of-platelet-lymphocyte-ratio-and-lactate-levels-obtained-on-mortality-with-sepsis-and-septic-shock
#18
Ebru Biyikli, Afsin Emre Kayipmaz, Cemil Kavalci
BACKGROUND: Sepsis is a potentially fatal condition with high treatment costs, and is especially common among the elderly population. The emergency management of septic patients has gained importance. OBJECTIVE: Herein, we investigated the effect of admission lactate levels and the platelet-lymphocyte ratio (PLR) on the 30-day mortality among patients older than 65years who were diagnosed with sepsis and septic shock according to the qSOFA criteria at our hospital's emergency department...
December 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29206765/the-new-york-sepsis-severity-score-development-of-a-risk-adjusted-severity-model-for-sepsis
#19
Gary S Phillips, Tiffany M Osborn, Kathleen M Terry, Foster Gesten, Mitchell M Levy, Stanley Lemeshow
OBJECTIVES: In accordance with Rory's Regulations, hospitals across New York State developed and implemented protocols for sepsis recognition and treatment to reduce variations in evidence informed care and preventable mortality. The New York Department of Health sought to develop a risk assessment model for accurate and standardized hospital mortality comparisons of adult septic patients across institutions using case-mix adjustment. DESIGN: Retrospective evaluation of prospectively collected data...
December 4, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29205045/colon-ascendens-stent-peritonitis-casp-induces-excessive-inflammation-and-systemic-metabolic-dysfunction-in-a-septic-rat-model
#20
Limin Zhang, Yuan Tian, Jianfen Yang, Jieshou Li, Huiru Tang, Yulan Wang
The colon ascendens stent peritonitis (CASP) surgery creates a leakage of intestinal contents, resulting in polymicrobial sepsis associated with a high risk for postoperative multiple organ failure and death in surgical patients. To evaluate the effects of CASP on multiple organs, we analyzed the systemic metabolic consequences in liver, kidney, lung and heart of rats after CASP by employing a combination of metabolomics, clinical chemistry and biological assays. We found that CASP surgery after 18 h caused significant elevations of lipid, amino acids, acetate, choline, PC and GPC in rat liver together with significant depletion of glucose and glycogen...
December 5, 2017: Journal of Proteome Research
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