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https://www.readbyqxmd.com/read/29025165/impact-of-an-emergency-department-electronic-sepsis-surveillance-system-on-patient-mortality-and-length-of-stay
#1
Jonathan S Austrian, Catherine T Jamin, Glenn R Doty, Saul Blecker
Objective: The purpose of this study was to determine whether an electronic health record-based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis. Materials and Methods: We performed a patient-level interrupted time series study of emergency department patients with severe sepsis or septic shock between January 2013 and April 2015. The intervention, introduced in February 2014, was a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results...
August 28, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28952159/bacterial-testing-of-platelets-has-it-prevented-transfusion-transmitted-bacterial-infections-in-australia
#2
J Thyer, Z Perkowska-Guse, S L Ismay, A J Keller, H T Chan, P M Dennington, B Bell, G Kotsiou, J M Pink
BACKGROUND AND OBJECTIVES: Australia introduced bacterial contamination screening (BCS) for platelet components in April 2008. This study presents analysis performed to assess the efficacy of testing. MATERIALS AND METHODS: Seven-day aerobic and anaerobic culture is performed using the BacT/ALERT 3D system. Following an initial machine positive (IMP) flag, all associated components are recalled, and/or clinicians treating already transfused patients are notified...
September 26, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28878521/time-to-positivity-and-antibiotic-sensitivity-of-neonatal-blood-cultures
#3
Sarah Magdy Abdelhamid
BACKGROUND: Sepsis is a commonly encountered and potentially life-threatening problem in neonatal intensive care units, blood culture of neonatal sepsis helps in either optimizing treatment or terminating antibiotics. MATERIALS AND METHODS: We determined the causative agent, time to positivity (TTP), and antibiogram of neonatal blood cultures collected in a tertiary care center, to investigate difference between early- and late-onset neonatal sepsis and to establish the time at which a blood culture could safely be considered negative, using the BacT/ALERT(®) 3D 60...
July 2017: Journal of Global Infectious Diseases
https://www.readbyqxmd.com/read/28653472/residual-risk-of-bacterial-contamination-of-platelets-six-years-of-experience-with-sterility-testing
#4
Sandra Ramirez-Arcos, Caesar DiFranco, Terri McIntyre, Mindy Goldman
BACKGROUND: Canadian Blood Services screens 100% of platelet concentrates (PCs) for bacterial contamination with the BacT/ALERT system. Quality-control sterility testing of 1% (≥10 units) of outdated PCs is performed monthly. Data from routine screening, quality-control testing, and septic reactions obtained from 2010 to 2016 are presented herein. STUDY DESIGN AND METHODS: In total, 601,988 buffy coat PC pools and 186,737 apheresis PCs were routinely screened with aerobic cultures over 6 years...
September 2017: Transfusion
https://www.readbyqxmd.com/read/28625450/vasoplegic-syndrome-an-update-on-perioperative-considerations
#5
REVIEW
Henry Liu, Ling Yu, Longqiu Yang, Michael S Green
Vasoplegic syndrome (VS) is increasingly recognized as an important clinical entity in perioperative medicine. VS is characterized by significant arterial hypotension, normal or high cardiac output, low systemic vascular resistance, and increased requirements for intravenous volume and vasopressors. Tremendous variations exist regarding incidence reported in the literature and management at different institutions; and the incidence of VS is likely significantly higher than many anesthesiologists believe. Thus the aims of this article are to review the pertinent aspects related to VS and alert clinical anesthesiologists to this under-recognized yet very challenging clinical condition...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28600109/the-cardio-respiratory-effects-of-intra-abdominal-hypertension-considerations-for-critical-care-nursing-practice
#6
REVIEW
Martin Christensen, Judy Craft
Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondaryintra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation...
June 6, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28599661/poor-performance-of-quick-sofa-qsofa-score-in-predicting-severe-sepsis-and-mortality-a-prospective-study-of-patients-admitted-with-infection-to-the-emergency-department
#7
COMPARATIVE STUDY
Åsa Askim, Florentin Moser, Lise T Gustad, Helga Stene, Maren Gundersen, Bjørn Olav Åsvold, Jostein Dale, Lars Petter Bjørnsen, Jan Kristian Damås, Erik Solligård
BACKGROUND: We aimed to evaluate the clinical usefulness of qSOFA as a risk stratification tool for patients admitted with infection compared to traditional SIRS criteria or our triage system; the Rapid Emergency Triage and Treatment System (RETTS). METHODS: The study was an observational cohort study performed at one Emergency Department (ED) in an urban university teaching hospital in Norway, with approximately 20,000 visits per year. All patients >16 years presenting with symptoms or clinical signs suggesting an infection (n = 1535) were prospectively included in the study from January 1 to December 31, 2012...
June 9, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28583403/improving-recognition-of-pediatric-severe-sepsis-in%C3%A2-the-emergency-department-contributions-of%C3%A2-a%C3%A2-vital-sign-based-electronic-alert-and-bedside-clinician-identification
#8
Fran Balamuth, Elizabeth R Alpern, Mary Kate Abbadessa, Katie Hayes, Aileen Schast, Jane Lavelle, Julie C Fitzgerald, Scott L Weiss, Joseph J Zorc
STUDY OBJECTIVE: Recognition of pediatric sepsis is a key clinical challenge. We evaluate the performance of a sepsis recognition process including an electronic sepsis alert and bedside assessment in a pediatric emergency department (ED). METHODS: This was a cohort study with quality improvement intervention in a pediatric ED. Exposure was a positive electronic sepsis alert, defined as elevated pulse rate or hypotension, concern for infection, and at least one of the following: abnormal capillary refill, abnormal mental status, or high-risk condition...
June 2, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28560683/the-impact-of-a-multifaceted-intervention-including-sepsis-electronic-alert-system-and-sepsis-response-team-on-the-outcomes-of-patients-with-sepsis-and-septic-shock
#9
Yaseen M Arabi, Hasan M Al-Dorzi, Ahmed Alamry, Ra'ed Hijazi, Sami Alsolamy, Majid Al Salamah, Hani M Tamim, Saad Al-Qahtani, Abdulaziz Al-Dawood, Abdellatif M Marini, Fatimah H Al Ehnidi, Shihab Mundekkadan, Amal Matroud, Mohamed S Mohamed, Saadi Taher
BACKGROUND: Compliance with the clinical practice guidelines of sepsis management has been low. The objective of our study was to describe the results of implementing a multifaceted intervention including an electronic alert (e-alert) with a sepsis response team (SRT) on the outcome of patients with sepsis and septic shock presenting to the emergency department. METHODS: This was a pre-post two-phased implementation study that consisted of a pre-intervention phase (January 01, 2011-September 24, 2012), intervention phase I (multifaceted intervention including e-alert, from September 25, 2012-March 03, 2013) and intervention phase II when SRT was added (March 04, 2013-October 30, 2013) in a 900-bed tertiary-care academic hospital...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28553762/evaluation-of-serum-neutrophil-gelatinase-associated-lipocalin-in-predicting-acute-kidney-injury-in-critically-ill-patients
#10
Chen-Chen Hang, Jun Yang, Shuo Wang, Chun-Sheng Li, Zi-Ren Tang
Objective This investigation evaluated the real-time point-of-care testing (RT-POCT) of neutrophil gelatinase-associated lipocalin (NGAL) for detecting acute kidney injury (AKI) and prognosis of critically ill patients. Methods A total of 249 critically ill patients in the emergency department (ED), who were diagnosed with acute decompensated heart failure, sepsis or diabetic ketoacidosis were enrolled in this study. All enrolled patients were followed up for 28 days or to death and the mortalities were recorded...
June 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28521686/prothymosin-alpha-an-alarmin-and-more
#11
REVIEW
Pinelopi Samara, Chrysoula-Evangelia Karachaliou, Kyriaki Ioannou, Nikos E Papaioannou, Ioannis F Voutsas, Christos Zikos, Ioannis Pirmettis, Minas Papadopoulos, Hubert Kalbacher, Evangelia Livaniou, Ourania E Tsitsilonis, Wolfgang Voelter
BACKGROUND/OBJECTIVE: Prothymosin alpha (proTα) is a ubiquitous polypeptide first isolated by Haritos in 1984, whose role still remains partly elusive. We know that proTα acts both, intracellularly, as an anti-apoptotic and proliferation mediator, and extracellularly, as a biologic response modifier mediating immune responses similarly to molecules termed as "alarmins". Our research team pioneered the elucidation of the mechanisms underlying the observed activities of proTα. RESULTS: We were the first to demonstrate that proTα levels increase during normal and abnormal cell proliferation...
2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28506711/screening-for-sepsis-in-general-hospitalized-patients-a%C3%A2-systematic-review
#12
REVIEW
L Alberto, A P Marshall, R Walker, L M Aitken
BACKGROUND: Sepsis is a condition widely observed outside critical care areas. AIM: To examine the application of sepsis screening tools for early recognition of sepsis in general hospitalized patients to: (i) identify the accuracy of these tools; (ii) determine the outcomes associated with their implementation; and (iii) describe the implementation process. METHODS: A systematic review method was used. PubMed, CINAHL, Cochrane, Scopus, Web of Science, and Embase databases were systematically searched for primary articles, published from January 1990 to June 2016, that investigated screening tools or alert mechanisms for early identification of sepsis in adult general hospitalized patients...
August 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28445172/telehealth-intensive-care-unit-nurse-surveillance-of-sepsis
#13
Teresa A Rincon, E LaVerne Manos, Janet D Pierce
The purpose of this article is to describe the usability and human factors engineering standards used in development of a sepsis alert known as the sepsis prompt. Sensory processing, cognitive processing, signal detection, criterion response, and user satisfaction were evaluated with controlled user testing and critical incident response techniques. Nurses reported that the sepsis prompt was visible and distinct, making it easily detectable. The prompt provided a clear response mechanism and adequately balanced the number of false alerts with the likelihood of misses...
September 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28430045/laparoscopic-sleeve-gastrectomy-changes-in-the-last-decade-differences-in-morbidity-and-weight-loss
#14
Andrea Balla, Silvia Quaresima, Frida Leonetti, Emanuela Paone, Marco Brunori, Teresa Messina, Ardit Seitaj, Alessandro M Paganini
PURPOSE: Aim is to report the learning curve and standardization process of Laparoscopic Sleeve Gastrectomy (LSG), describing the evolution in surgical technique and patient management in the authors' experiences. METHODS: One hundred twenty-seven patients were divided in three Groups (A, B, and C), based on bougie size and technical details, and included 36, 46, and 45 patients, respectively. RESULTS: Mean operative time in Groups A, B, and C was 201...
November 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28425610/bacterial-screening-of-platelet-components-by-national-health-service-blood-and-transplant-an-effective-risk-reduction-measure
#15
Carl McDonald, Jennifer Allen, Susan Brailsford, Anjana Roy, Joanne Ball, Richard Moule, Mariza Vasconcelos, Rachael Morrison, Tyrone Pitt
BACKGROUND: Bacterial contamination of blood components remains a major cause of sepsis in transfusion medicine. Between 2006 and 2010 in the 5 years before the introduction of bacterial screening of platelet (PLT) components by National Health Service Blood and Transplant (NHSBT), seven cases of PLT component-associated transmission of bacterial infection were recorded for 10 patients, three of which were fatal. STUDY DESIGN AND METHODS: Sampling of individual PLT components was undertaken at 36 to 48 hours after donation and tested in the BacT/ALERT system with 8 mL inoculated into each of aerobic and anaerobic culture bottles...
May 2017: Transfusion
https://www.readbyqxmd.com/read/28412015/managing-sepsis-electronic-recognition-rapid-response-teams-and-standardized-care-save-lives
#16
Faheem W Guirgis, Lisa Jones, Rhemar Esma, Alice Weiss, Kaitlin McCurdy, Jason Ferreira, Christina Cannon, Laura McLauchlin, Carmen Smotherman, Dale F Kraemer, Cynthia Gerdik, Kendall Webb, Jin Ra, Frederick A Moore, Kelly Gray-Eurom
PURPOSE: Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. MATERIALS AND METHODS: Retrospective review of patients ≥18years treated for sepsis. RESULTS: There were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p=0.94) and Charlson Comorbidity Scores (2...
August 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28403899/hepato-bronchial-fistula-secondary-to-perforated-sigmoid-diverticulitis-a-case-report
#17
Jun Sunny Yin, Shaylan Govind, Daniele Wiseman, Richard Inculet, Raymond Kao
BACKGROUND: Patients with diverticulitis are predisposed to hepatic abscesses via seeding through the portal circulation. Hepatic abscesses are well-documented sequelae of diverticulitis, however instances of progression to hepato-bronchial fistulization are rare. We present a case of diverticulitis associated with hepatic abscess leading to hepato-bronchial fistulization, which represents a novel disease course not yet reported in the literature. CASE PRESENTATION: A 61-year-old Caucasian man presented with a history of unintentional weight loss and dyspnea both at rest and with exertion...
April 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28316887/comparison-of-methods-of-alert-acknowledgement-by-critical-care-clinicians-in-the-icu-setting
#18
Andrew M Harrison, Charat Thongprayoon, Christopher A Aakre, Jack Y Jeng, Mikhail A Dziadzko, Ognjen Gajic, Brian W Pickering, Vitaly Herasevich
BACKGROUND: Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. OBJECTIVE: To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system...
2017: PeerJ
https://www.readbyqxmd.com/read/28283014/-fungemia-and-septic-arthritis-caused-by-saprochaete-capitata-in-a-patient-with-fanconi-aplastic-anemia-a-case-report
#19
Ömür Mustafa Parkan, Mustafa Altay Atalay, Ayşe Nedret Koç, Çiğdem Pala, Gonca Aydemir, Leylagül Kaynar
Saprochaete capitata (formerly known as Blastoschizomyces capitatus, Trichosporon capitatum, Geotrichum capitatum) is a rare but emerging yeast-like fungus. It is commonly found in environmental sources and can be isolated from skin, gastrointestinal system and respiratory tract of healthy individuals as well. It mainly infects patients with hematological malignancies such as acute myeloid leukemia (AML), especially in the presence of neutropenia; and mortality rates are high in those patients. Although the data about the in vitro antifungal susceptibility are limited, it is being reported that amphotericin B and voriconazole are more effective on S...
January 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28276800/sepsis-alert-a-triage-model-that-reduces-time-to-antibiotics-and-length-of-hospital-stay
#20
Mari Rosenqvist, Emma Fagerstrand, Peter Lanbeck, Olle Melander, Per Åkesson
OBJECTIVE: To study if a modified triage system at an Emergency Department (ED) combined with educational efforts resulted in reduced time to antibiotics and decreased length of hospital stay (LOS) for patients with severe infection. METHODS: A retrospective, observational study comparing patients before and after the start of a new triage model at the ED of a University Hospital. After the implementation of the model, patients with fever and abnormal vital signs were triaged into a designated sepsis line (Sepsis Alert) for rapid evaluation by the attending physician supported by a infectious diseases (IDs) specialist...
July 2017: Infectious Diseases
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