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https://www.readbyqxmd.com/read/29730383/fulminant-septic-shock-caused-by-capnocytophaga-canimorsus-in-italy-case-report
#1
Giorgio Piccinelli, Francesca Caccuri, Elena De Peri, Andrea Tironi, Silvia Odolini, Lucia Dora Notarangelo, Franco Gargiulo, Francesco Castelli, Nicola Latronico, Fabio Facchetti, Arnaldo Caruso
Capnocytophaga canimorsus infection was recently recognized as a zoonosis. We report the first case of fulminant septic shock in Italy caused by this pathogen. The patient, with a history of splenectomy, died at the main hospital in Brescia with a presumptive diagnosis of sepsis. PCR and sequencing on post mortem samples confirmed C. canimorsus as a causative organism. Our purpose is to alert medical professionals to the virulence of C. canimorsus in asplenic and immunocompromised patients.
May 3, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29724447/using-heuristic-evaluation-to-improve-sepsis-alert-usability
#2
REVIEW
Ariani Arista Putri Pertiwi, Dan Fraczkowski, Sheryl L Stogis, Karen Dunn Lopez
Sepsis, life-threatening organ dysfunction in response to infection, is an alarmingly common and aggressive illness in US hospitals, especially for intensive care patients. Preventing sepsis deaths rests on the clinicians' ability to promptly recognize and treat sepsis. To aid early recognition, many organizations have employed clinician-facing electronic sepsis alert systems. However, the effectiveness of the alert relies on heavily on the visual interface, textual information, and overall usability. This article reports a usability inspection of a sepsis alert system...
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29666161/implementation-of-the-sepsis-risk-calculator-at-an-academic-birth-hospital
#3
Miren B Dhudasia, Sagori Mukhopadhyay, Karen M Puopolo
BACKGROUND: Multivariate predictive models for estimating the risk of neonatal early-onset sepsis (EOS) are available as a Web-based sepsis risk calculator (SRC) and may reduce the proportion of newborns empirically treated with antibiotics after birth. EOS risk assessment based on such models would require workflow changes at most birth hospitals. METHODS: A multidisciplinary team of obstetric, neonatal, and information technology staff at a large, academic, birth hospital collaborated to implement the SRC...
April 17, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29587875/evaluation-of-a-novel-device-for-the-management-of-high-blood-pressure-and-shock-in-pregnancy-in-low-resource-settings-study-protocol-for-a-stepped-wedge-cluster-randomised-controlled-trial-cradle-3-trial
#4
Hannah L Nathan, Kate Duhig, Nicola Vousden, Elodie Lawley, Paul T Seed, Jane Sandall, Mrutyunjaya B Bellad, Adrian C Brown, Lucy C Chappell, Shivaprasad S Goudar, Muchabayiwa F Gidiri, Andrew H Shennan
BACKGROUND: Obstetric haemorrhage, sepsis and pregnancy hypertension account for more than 50% of maternal deaths worldwide. Early detection and effective management of these conditions relies on vital signs. The Microlife® CRADLE Vital Sign Alert (VSA) is an easy-to-use, accurate device that measures blood pressure and pulse. It incorporates a traffic-light early warning system that alerts all levels of healthcare provider to the need for escalation of care in women with obstetric haemorrhage, sepsis or pregnancy hypertension, thereby aiding early recognition of haemodynamic instability and preventing maternal mortality and morbidity...
March 27, 2018: Trials
https://www.readbyqxmd.com/read/29508700/crying-wolf-the-growing-fatigue-around-sepsis-alerts
#5
EDITORIAL
The Lancet Respiratory Medicine
No abstract text is available yet for this article.
March 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29384879/amputation-of-multiple-limbs-caused-by-use-of-inotropics-case-report-a-report-of-4-cases
#6
Ki Jin Jung, Jae-Hwi Nho, Hyeung-Kyu Cho, Sijohn Hong, Sung Hun Won, Dong-Il Chun, Byungsung Kim
RATIONALE: We present 4 cases of symmetrical peripheral gangrene (SPG) associated with use of inotropic agent to elevate blood pressure. SPG is a relatively rare phenomenon characterized by symmetrical distal ischemic damage that leads to gangrene of 2 or more sites in the absence of large blood vessel obstruction, where vasoconstriction rather than thrombosis is implicated as the underlying pathophysiology. We present 4 SPG cases of the multiple limbs amputation, associated with inevitable use of inotropic agents...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29371779/hyperferritinemia-in-hemophagocytic-lymphohistiocytosis-a-single-institution-experience-in-pediatric-patients
#7
Surupa Basu, Biplab Maji, Santanu Barman, Apurba Ghosh
Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory condition that may run a rapid fatal course and calls for prompt diagnosis. Early intervention with steroids and other immunosuppressive drugs can contain the disease process and favours positive outcome. Ferritin ≥500 ng/ml is a HLH diagnostic criterion. We evaluated the diagnostic potential of admission ferritin, in children with HLH. Pediatric patients of a referral teaching hospital from Feb 2010-Oct 2013 having been investigated for ferritin on admission were included...
January 2018: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/29351876/vital-signs-analysis-algorithm-detects-inflammatory-response-in-premature-infants-with-late-onset-sepsis-and-necrotizing-enterocolitis
#8
Leena B Mithal, Ram Yogev, Hannah L Palac, Daniel Kaminsky, Ilan Gur, Karen K Mestan
BACKGROUND: Nonspecific clinical signs and suboptimal diagnostic tests limit accurate identification of late onset sepsis (LOS) and necrotizing enterocolitis (NEC) in premature infants, resulting in significant morbidity and antibiotic overuse. An infant's systemic inflammatory response may be identified earlier than clinical suspicion through analysis of multiple vital signs by a computerized algorithm (RALIS). AIM: To evaluate the revised RALIS algorithm for detection of LOS and NEC in preterm infants...
February 2018: Early Human Development
https://www.readbyqxmd.com/read/29315023/sepsis-screening-current-evidence-and-available-tools
#9
Natacha Villegas, Laura J Moore
BACKGROUND: Early recognition of sepsis is challenging, especially in the surgical patient. Because of the non-specific nature of the initial signs and symptoms, delays in recognition are all too common. To improve the early identification of sepsis, screening tools have been developed, and several papers have described their results. This article reviews the available sepsis screening tools. METHODS: A PubMed search was performed using the search terms "sepsis" and "shock," "electronic alert," "clinical decision support," and "early warning systems...
February 2018: Surgical Infections
https://www.readbyqxmd.com/read/29304812/the-cradle-vital-signs-alert-qualitative-evaluation-of-a-novel-device-designed-for-use-in-pregnancy-by-healthcare-workers-in-low-resource-settings
#10
Hannah L Nathan, Helena Boene, Khatia Munguambe, Esperança Sevene, David Akeju, Olalekan O Adetoro, Umesh Charanthimath, Mrutyunjaya B Bellad, Annemarie de Greeff, John Anthony, David R Hall, Wilhelm Steyn, Marianne Vidler, Peter von Dadelszen, Lucy C Chappell, Jane Sandall, Andrew H Shennan
BACKGROUND: Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis...
January 5, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29025165/impact-of-an-emergency-department-electronic-sepsis-surveillance-system-on-patient-mortality-and-length-of-stay
#11
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...
May 1, 2018: 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
#12
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...
January 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/28878521/time-to-positivity-and-antibiotic-sensitivity-of-neonatal-blood-cultures
#13
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
#14
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
#15
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
#16
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 secondary intra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation...
February 2018: 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
#17
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-the-emergency-department-contributions-of-a-vital-sign-based-electronic-alert-and-bedside-clinician-identification
#18
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...
December 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
#19
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
#20
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
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