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neonatal sepsis shock

Luc Morin, Samiran Ray, Clare Wilson, Solenn Remy, Mohamed Rida Benissa, Nicolaas J G Jansen, Etienne Javouhey, Mark J Peters, Martin Kneyber, Daniele De Luca, Simon Nadel, Luregn Jan Schlapbach, Graeme Maclaren, Pierre Tissieres
PURPOSE: Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and neonatal intensive care (ESPNIC) experts' definition of paediatric RSS. METHODS: We conducted a two-round Delphi study followed by an observational multicentre retrospective study...
December 2016: Intensive Care Medicine
Yu He, Wei Xia Du, Hong Yan Jiang, Qing Ai, Jinxing Feng, Zhengqiu Liu, Jia Lin Yu
BACKGROUND: Early onset sepsis (EOS) remains a major cause of mortality and morbidity in neonates, and traditional clinical markers effective for adults are less effective in these patients. This study aimed to assess the value of individual plasma biomarkers as well as biomarker combinations for predicting EOS in neonates. METHODS: This prospective study included 151 neonates with suspected EOS. Plasma levels of interleukin (IL)-27, IL-6, IL-8, tumor necrosis factor (TNF)-α, heat shock protein (HSP) 70, macrophage inflammatory protein (MIP)-1α, MIP-1β, granzyme B, and matrix metalloproteinase (MMP)-8 were measured through multiplex cytokine profiling and assessed along with C-reactive protein (CRP) and procalcitonin (PCT)...
September 19, 2016: Shock
Laurel A Despins
Severe sepsis and septic shock are global issues with high mortality rates. Early recognition and intervention are essential to optimize patient outcomes. Automated detection using electronic medical record (EMR) data can assist this process. This review describes automated sepsis detection using EMR data. PubMed retrieved publications between January 1, 2005 and January 31, 2015. Thirteen studies met study criteria: described an automated detection approach with the potential to detect sepsis or sepsis-related deterioration in real or near-real time; focused on emergency department and hospitalized neonatal, pediatric, or adult patients; and provided performance measures or results indicating the impact of automated sepsis detection...
September 13, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
Rotem Orbach, Dror Mandel, Ronit Lubetzky, Amit Ovental, Alon Haham, Ora Halutz, Galia Grisaru-Soen
BACKGROUND: Prematurity is an important risk factor for the fulminate form of neonatal enteroviral infection. Pulmonary hemorrhage is a morbid complication that should be anticipated and managed aggressively due to its fatal outcome. OBJECTIVE: To emphasize the significance of pulmonary hemorrhage as a complication of severe enterovirus infection in preterm neonates. STUDY DESIGN: This report is a description of the clinical history, medical management and clinical outcomes of two pairs of preterm twin newborns (30 weeks and 36 weeks) with fulminant infection due to Coxsackievirus B (CBV) infection...
September 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
M A Kornienko, V N Kopyltsov, N V Shevlyagina, L V Didenko, L A Lyubasovskaya, T V Priputnevich, E N Ilina
The urgency of the staphylococcus research is due to its ability to cause severe infections: softtissue infections, endocarditis, sepsis, toxic shock syndrome, and food poisoning. Coagulase-positive Staphylococcus aureus is the main infection agent of intrahospital infections. This agent has many factors of pathogenicity, which are well known. Among the coagulase-negative staphylococcus (CNS) strains, S. haemolyticus and S. epidermidis are clinically important, because they cause infections in patients with weak immune system...
2016: Molekuliarnaia Genetika, Mikrobiologiia i Virusologiia
Lorenza Pugni, Andrea Ronchi, Bianca Bizzarri, Dario Consonni, Carlo Pietrasanta, Beatrice Ghirardi, Monica Fumagalli, Stefano Ghirardello, Fabio Mosca
Septic shock, occurring in about 1% of neonates hospitalized in neonatal intensive care unit (NICU), is a major cause of death in the neonatal period. In the 1980s and 90s, exchange transfusion (ET) was reported by some authors to be effective in the treatment of neonatal sepsis and septic shock. The main aim of this retrospective study was to compare the mortality rate of neonates with septic shock treated only with standard care therapy (ScT group) with the mortality rate of those treated with ScT and ET (ET group)...
2016: International Journal of Molecular Sciences
Nina Méndez-Domínguez, Jorge Augusto Achach-Asaf, Luis Manuel Basso-García, Yazmín Berenice Quiñones-Pacheco, Salvador Gómez-Carro
INTRODUCTION: A chikungunya outbreak took place in the State of Yucatan starting in the second half of 2015 OBJECTIVE: To analyse the clinical course of a case of chikungunya in a previously healthy infant, providing practical evidence to guide future diagnoses and treatment during outbreak seasons in endemic areas CASE REPORT: Clinical manifestation started with a sudden onset of fever and a diffuse macular-papillary erythema, originally treated in the community with non-steroidal anti-inflammatory drugs...
March 2016: Revista Chilena de Pediatría
E Kovaleva, V Pokhylko, Yu Chernyavskaya, E Kalyuzka, V Poltoropavlov
The rate of neonatal sepsis is not reduced varying inversely proportional to the gestational age at birth, and may reach 60% in the most immature infants. The high mortality rate of this disease and adverse neurological effects are associated with the development of cardiovascular changes and shock. The main leadership role in the regulation of blood pressure and blood volume in the body plays a renin-angiotensin system. Synthesis of angiotensin-converting enzyme is regulated by the ACE gene. The aim of the study was to identify and analyze the associations between the development of arterial hypotension in premature infants and insertion-deletion (I/D) polymorphism of the ACE gene...
November 2015: Georgian Medical News
Christopher Langdon Fielding, Kiragos Gary Magdesian
Sepsis and septic shock represent a major cause of morbidity and mortality in equine neonates and in all species. Early recognition of the condition is important, but definitive examination and laboratory variables to predict equine neonatal sepsis are lacking. Early and aggressive treatment should include broad-spectrum antimicrobial coverage, source control, and hemodynamic support. Field practitioners and intensive care clinicians work together in the management of this condition because the recognition and initial treatment should begin as early as possible...
December 2015: Veterinary Clinics of North America. Equine Practice
Yuta Aizawa, Yuko Suzuki, Kanako Watanabe, Tomohiro Oishi, Akihiko Saitoh
During the 2014 human parechovirus type 3 (HPeV3) epidemic in Niigata, Japan, this prospective observational study identified HPeV3 from 43/85 (51%) febrile young infants <4 months using PCR analysis of serum (n = 42) and/or cerebrospinal fluid (CSF) (n = 32) and genetic sequencing of the VP1 region of HPeV3. HPeV3-infected patients (median age, 32 days; range, 4-113 days) were diagnosed as having sepsis (79%), sepsis-like syndrome (19%), or encephalitis with septic shock (2%). Other than fever, mottled skin (67%) was significantly more frequent in HPeV3-infected patients than other virus-infected patients (P = 0...
February 2016: Journal of Infection
Jaqueline Beppler, Patrícia Koehler-Santos, Gabriela Pasqualim, Ursula Matte, Clarice Sampaio Alho, Fernando Suparregui Dias, Thayne Woycinck Kowalski, Irineu Tadeu Velasco, Renato C Monteiro, Fabiano Pinheiro da Silva
Sepsis is a devastating disease that can affect humans at any time between neonates and the elderly and is associated with mortality rates that range from 30 to 80%. Despite intensive efforts, its treatment has remained the same over the last few decades. Fc receptors regulate multiple immune responses and have been investigated in diverse complex diseases. FcγRIIA (CD32A) is an immunoreceptor, tyrosine-based activation motif-bearing receptor that binds immunoglobulin G and C-reactive protein, important opsonins in host defense...
April 2016: Inflammation
Qazi Iqbal, Mir M Younus, Asif Ahmed, Ikhlas Ahmad, Javed Iqbal, Bashir A Charoo, S Wajid Ali
BACKGROUND AND AIMS: Decreasing mortality in sick and ventilated neonates is an endeavor of all neonatologists. To reduce the high mortality in this group of neonates, identification of risk factors is important. This study was undertaken to find out the indications of ventilation and complications in ventilated neonates and also study possible predictors of outcome. SUBJECTS: Age <1-month; mechanically ventilated; not having suspected metabolic disorders or congenital anomalies; excluding postoperative patients...
September 2015: Indian Journal of Critical Care Medicine
Mehmet Saldir, Turan Tunc, Ferhat Cekmez, Merih Cetinkaya, Tugce Kalayci, Kursat Fidanci, Oguzhan Babacan, Galip Erdem, Necmettin Kocak, Erkan Sari, Emin Ozgur Akgul, Mustafa Kul
BACKGROUND: Neonatal sepsis is an important cause of neonatal morbidity and mortality in the neonatal intensive care unit. Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) has been evaluated in sepsis and septic shock, and it was found to be valuable in distinguishing septic cases from nonseptic cases. Endocan is constitutively expressed by endothelial cells, and high levels of endocan may be of relevance for the promotion of systemic inflammation. The aim of this study was to investigate whether the levels of sTREM-1 and endocan were increased in late-onset neonatal sepsis...
December 2015: Pediatrics and Neonatology
Mei-Yin Lai, Ming-Horng Tsai, Chiang-Wen Lee, Ming-Chou Chiang, Reyin Lien, Ren-Huei Fu, Hsuan-Rong Huang, Shih-Ming Chu, Jen-Fu Hsu
BACKGROUND: Elevated C-reactive protein (CRP) level is widely used in clinical practice as a marker to distinguish between neonates with or without sepsis. However, some neonates with bacteremia have a CRP level within the normal range and they are not well characterized. METHODS: All episodes of neonatal culture-proven bloodstream infections (BSIs) between July 2004 and June 2012 were enrolled. Patients characteristics were compared for three CRP groups (low, ≤ 10 mg/L; intermediate, 11-100 mg/L; and high, > 100 mg/L) using the Chi-square test and one-way ANOVA...
2015: BMC Infectious Diseases
Michele Mussap, Elisabetta Puxeddu, Melania Puddu, Giovanni Ottonello, Ferdinando Coghe, Paola Comite, Francesco Cibecchini, Vassilios Fanos
Neonatal sepsis still remains a major cause of morbidity and mortality in neonatal intensive care unit (NICU). Recently, soluble CD14 subtype (sDC14-ST) also named presepsin, was proposed as an effective biomarker for diagnosing, monitoring, and assessing the risk of neonatal sepsis and septic shock. The aim of this study was to investigate the diagnostic accuracy of sCD14-ST presepsin in diagnosing neonatal bacterial sepsis and in discriminating non-bacterial systemic inflammatory response syndrome (SIRS) from bacterial sepsis...
December 7, 2015: Clinica Chimica Acta; International Journal of Clinical Chemistry
Ben Gelbart, Neil J Glassford, Rinaldo Bellomo
OBJECTIVES: To review systematically data from randomized and nonrandomized studies of fluid bolus therapy in hospitalized children with septic shock. DATA SOURCES: Medline, EMBASE, and Cochrane Central Register of Controlled Trials. STUDY SELECTION: We searched for randomized controlled studies of fluid bolus therapy in children with severe sepsis. We identified retrospective, prospective, and observational studies. We excluded studies of severe sepsis/septic shock due to a specific microbiological etiology, neonatal studies, and studies where advanced supportive therapies were unavailable...
October 2015: Pediatric Critical Care Medicine
Werner C Albrich, Stephan Harbarth
INTRODUCTION: Patients in the intensive care unit (ICU) frequently receive prolonged or even unnecessary antibiotic therapy, which selects for antibiotic-resistant bacteria. Over the last decade there has been great interest in biomarkers, particularly procalcitonin, to reduce antibiotic exposure. METHODS: In this narrative review, we discuss the value of biomarkers and provide additional information beyond clinical evaluation in order to be clinically useful and review the literature on sepsis biomarkers outside the neonatal period...
October 2015: Intensive Care Medicine
D Sharma, T Dasi, S Murki, T P Oleti
Kluyvera ascorbata belongs to Enterobacteriaceae family and is a gram negative micro-organism. This bacteria is usually considered a commensal, however it can cause significant infections rarely. This organism is usually resistant to most commonly used antibiotics used as first line in neonatal units. Antimicrobial agents active against Kluyvera strains include third-generation cephalosporins, fluoroquinolones, and aminoglycosides. We report a case of an extremely low birth weight male infant who presented on day 4 of life with clinical features of sepsis, multi-organ dysfunction, shock and pulmonary haemorrhage...
July 2015: Indian Journal of Medical Microbiology
Hiroaki Ito, Navina Kuss, Bastian E Rapp, Masatoshi Ichikawa, Thomas Gutsmann, Klaus Brandenburg, Johannes M B Pöschl, Motomu Tanaka
In this study, we physically modeled the influence of endotoxin-induced sepsis symptoms on human red blood cells (RBCs) by quantifying the impact of endotoxins on the cell mechanics by the analysis of Fourier-transformed mean square amplitude of shape fluctuation, called flicker spectroscopy. With the aid of a microfluidic diffusion chamber, we noninvasively determined principal mechanical parameters of human RBCs in the absence and presence of endotoxins for individual RBCs for the first time. Because of the elongation of saccharide chain length of endotoxins, we found an increase in the morphological transition from discocytes to echinocytes, and monotonic changes in the mechanical parameters...
June 25, 2015: Journal of Physical Chemistry. B
Nesibe Eroğlu-Ertuğrul, Özge Sürmeli-Onay, Murat Yurdakök
Sepsis-related mortality and morbidity are the leading issues that neonatal intensive care units struggle with worldwide. We report a preterm infant with septic shock and intractable metabolic acidosis whose postmortem microbiologic examination revealed Chryseobacterium meningosepticum meningitis. We would like to alert clinicians about this uncommon sepsis agent, and to call into question the treatment modalities for metabolic acidosis.
September 2014: Turkish Journal of Pediatrics
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