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https://www.readbyqxmd.com/read/28425079/outcome-of-patients-with-septic-shock-and-high-dose-vasopressor-therapy
#1
Thomas Auchet, Marie-Alix Regnier, Nicolas Girerd, Bruno Levy
BACKGROUND: Despite the dissemination of international guidelines, mortality from septic shock remains high. Norepinephrine is recommended as first-line vasopressor therapy with a target mean arterial pressure of 65 mmHg. High-dose vasopressor (HDV) may also be required. This study aimed to assess survival in patients with septic shock requiring HDV. We conducted a retrospective study of patients admitted between January 2008 and December 2013 to a 13-bed ICU for septic shock and receiving high-dose vasopressor therapy (defined by a dose >1 µg/kg/min)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28411114/circulating-biologically-active-adrenomedullin-bio-adm-predicts-hemodynamic-support-requirement-and-mortality-during-sepsis
#2
Pietro Caironi, Roberto Latini, Joachim Struck, Oliver Hartmann, Andreas Bergmann, Giuseppe Maggio, Marco Cavana, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Serge Masson
BACKGROUND: The biological role of adrenomedullin, a hormone involved in hemodynamic homeostasis, is controversial in sepsis, since administration of either the peptide or an antibody against it may be beneficial. METHODS: Plasma bio-ADM was assessed on days 1, 2 and 7 after randomization of 956 patients with sepsis or septic shock to albumin or crystalloids for fluid resuscitation in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. We tested the association of bio-ADM and its time-dependent variation with fluid therapy, vasopressor administration, organ failures and mortality...
April 11, 2017: Chest
https://www.readbyqxmd.com/read/28406862/a-randomized-controlled-trial-of-corticosteroids-in-pediatric-septic-shock-a-pilot-feasibility-study
#3
Kusum Menon, Dayre McNally, Katharine O'Hearn, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVE: To determine the feasibility of conducting a randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: Randomized, double-blind, placebo controlled trial. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years old inclusive with suspected septic shock. INTERVENTION: Administration of IV hydrocortisone versus placebo until hemodynamic stability is achieved or for a maximum of 7 days...
April 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28381918/evaluation-of-hydrocortisone-continuous-infusion-versus-intermittent-boluses-in-resolution-of-septic-shock
#4
Hoan Hoang, Shan Wang, Shahidul Islam, Adel Hanna, Alexander Axelrad, Collin Brathwaite
PURPOSE: To compare the effectiveness of continuous infusion of hydrocortisone versus intermittent boluses in the resolution of septic shock. METHODS: A retrospective chart review was performed to investigate the effects of low-dose hydrocortisone continuous infusion (200 mg per day) versus intermittent boluses (50 mg every six hours) in septic shock patients who did not respond to fluid resuscitation and vasopressors. The primary outcome was time to resolution of shock, defined by time from the initiation of hydrocortisone to time of vasopressor withdrawal when mean arterial pressure was greater than 65 mm Hg...
April 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28363592/a-survey-of-critical-care-nurses-practices-and-perceptions-surrounding-early-intravenous-antibiotic-initiation-during-septic-shock
#5
Russel J Roberts, Abdullah M Alhammad, Lindsay Crossley, Eric Anketell, LeeAnn Wood, Greg Schumaker, Erik Garpestad, John W Devlin
BACKGROUND: Delays in antibiotic administration after severe sepsis recognition increases mortality. While physician and pharmacy-related barriers to early antibiotic initiation have been well evaluated, those factors that affect the speed by which critical care nurses working in either the emergency department or the intensive care unit setting initiate antibiotic therapy remains poorly characterized. AIM: To evaluate the knowledge, practices and perceptions of critical care nurses regarding antibiotic initiation in patients with newly recognised septic shock...
March 28, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28358883/-r%C3%A3-anet-the-internet-utilization-among-surrogates-of-critically-ill-patients-with-sepsis
#6
Yên-Lan Nguyen, Raphaël Porcher, Laurent Argaud, Lise Piquilloud, Christophe Guitton, Fabienne Tamion, Sami Hraiech, Jean-Paul Mira
CONTEXT: Health-related Internet utilization is common but its use by proxies of critically ill patients is unknown. Our objective was to describe the prevalence and the Internet utilization characteristics among surrogates of critically ill septic patients. We conducted a prospective observational study in French ICUs. Three survey instruments were used to describe ICU organization regarding information delivery, patients and surrogates characteristics. RESULTS: 169 surrogates of 146 septic patients hospitalized in 19 ICUs were included...
2017: PloS One
https://www.readbyqxmd.com/read/28350646/association-between-hospital-case-volume-of-sepsis-adherence-to-evidence-based-processes-of-care-and-patient-outcomes
#7
Ashraf Fawzy, Allan J Walkey
OBJECTIVES: We sought to explore potential mechanisms underlying hospital sepsis case volume-mortality associations by investigating implementation of evidence-based processes of care. DESIGN: Retrospective cohort study. We determined associations of sepsis case volume with three evidence-based processes of care (lactate measurement during first hospital day, norepinephrine as first vasopressor, and avoidance of starch-based colloids) and assessed their role in mediation of case volume-mortality associations...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28345066/correlation-of-central-venous-pressure-with-venous-blood-gas-analysis-parameters-a-diagnostic-study
#8
Sima Rahim-Taleghani, Alireza Fatemi, Mostafa Alavi Moghaddam, Majid Shojaee, Abdelrahman Ibrahim Abushouk, Mohammad Mehdi Forouzanfar, Alireza Baratloo
OBJECTIVE: This study was conducted to assess the correlation between central venous pressure (CVP) and venous blood gas (VBG) analysis parameters, to facilitate management of severe sepsis and septic shock in emergency department. MATERIAL AND METHODS: This diagnostic study was conducted from January 2014 until June 2015 in three major educational medical centers, Tehran, Iran. For patients selected with diagnosis of septic shock, peripheral blood sample was taken for testing the VBG parameters and the anion gap (AG) was calculated...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343834/evaluating-the-impact-of-obesity-on-safety-and-efficacy-of-weight-based-norepinephrine-dosing-in-septic-shock-a-single-center-retrospective-study
#9
Paul J Wong, Komal A Pandya, Alexander H Flannery
OBJECTIVE: Norepinephrine is the first-line vasopressor recommended for patients in septic shock. Weight-based dosing may increase drug exposure and the risk of adverse effects in obese patients. The objective was to evaluate the safety and efficacy of weight-based norepinephrine dosing using actual body weight in the morbidly obese compared with normal weight patients. METHODS: This was a single centre, retrospective study of adult patients admitted with septic shock requiring norepinephrine for at least 12hours...
March 23, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28333759/the-absence-of-fever-is-associated-with-higher-mortality-and-decreased-antibiotic-and-iv-fluid-administration-in-emergency-department-patients-with-suspected-septic-shock
#10
Daniel J Henning, Jeremy R Carey, Kimie Oedorf, Danielle E Day, Colby S Redfield, Colin J Huguenel, Jonathan C Roberts, Leon D Sanchez, Richard E Wolfe, Nathan I Shapiro
OBJECTIVE: This study evaluates whether emergency department septic shock patients without a fever (reported or measured) receive less IV fluids, have decreased antibiotic administration, and suffer increased in-hospital mortality. DESIGN: This was a secondary analysis of a prospective, observational study of patients with shock. SETTING: The study was conducted in an urban, academic emergency department. PATIENTS: The original study enrolled consecutive adult (aged 18 yr or older) emergency department patients from November 11, 2012, to September 23, 2013, who met one of the following shock criteria: 1) systolic blood pressure less than 90 mm Hg after at least 1L IV fluids, 2) new vasopressor requirement, or 3) systolic blood pressure less than 90 mm Hg and IV fluids held for concern of fluid overload...
March 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28322415/association-between-us-norepinephrine-shortage-and-mortality-among-patients-with-septic-shock
#11
Emily Vail, Hayley B Gershengorn, May Hua, Allan J Walkey, Gordon Rubenfeld, Hannah Wunsch
Importance: Drug shortages in the United States are common, but their effect on patient care and outcomes has rarely been reported. Objective: To assess changes to patient care and outcomes associated with a 2011 national shortage of norepinephrine, the first-line vasopressor for septic shock. Design, Setting, and Participants: Retrospective cohort study of 26 US hospitals in the Premier Healthcare Database with a baseline rate of norepinephrine use of at least 60% for patients with septic shock...
April 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28320242/early-goal-directed-therapy-for-septic-shock-a-patient-level-meta-analysis
#12
(no author information available yet)
Background After a single-center trial and observational studies suggesting that early, goal-directed therapy (EGDT) reduced mortality from septic shock, three multicenter trials (ProCESS, ARISE, and ProMISe) showed no benefit. This meta-analysis of individual patient data from the three recent trials was designed prospectively to improve statistical power and explore heterogeneity of treatment effect of EGDT. Methods We harmonized entry criteria, intervention protocols, outcomes, resource-use measures, and data collection across the trials and specified all analyses before unblinding...
March 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28319910/the-role-of-vasopressin-and-the-vasopressin-type-v1a-receptor-agonist-selepressin-in-septic-shock
#13
REVIEW
Antonio F Saad, Marc O Maybauer
Septic shock remains one of the major causes of morbidity and mortality in the critically ill. Despite early goal therapy and administration of cathecholaminergic agents, up to 30% of patients succumb to the disease. In this manuscript, we first summarize the standard of care of patients with septic shock and current guidelines. We review the physiologic role of vasopressin and its role in septic shock management. We then review the most up-to-date evidence on the potential role of V1a receptor agonists such as Selepressin, in septic shock...
March 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28286823/protocol-adherence-for-severe-sepsis-and-septic-shock-management-in-the-emergency-department-a-clinical-audit
#14
Mostafa Alavi-Moghaddam, Ali Anvari, Reaza Soltani Delgosha, Hamid Kariman
INTRODUCTION: Although significant development in the field of medicine is achieved, sepsis is still a major issue threatening humans' lives. This study was aimed to audit the management of severe sepsis and septic shock patients in emergency department (ED) according to the present standard guidelines. METHOD: This is a prospective audit on approaching adult septic patients who were admitted to ED. The audit checklist was created based on the protocols of Surviving Sepsis Campaign and British Royal College recommendations...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28281216/a-hypoperfusion-context-may-aid-to-interpret-hyperlactatemia-in-sepsis-3-septic-shock-patients-a-proof-of-concept-study
#15
Leyla Alegría, Magdalena Vera, Jorge Dreyse, Ricardo Castro, David Carpio, Carolina Henriquez, Daniela Gajardo, Sebastian Bravo, Felipe Araneda, Eduardo Kattan, Pedro Torres, Gustavo Ospina-Tascón, Jean-Louis Teboul, Jan Bakker, Glenn Hernández
BACKGROUND: Persistent hyperlactatemia is particularly difficult to interpret in septic shock. Besides hypoperfusion, adrenergic-driven lactate production and impaired lactate clearance are important contributors. However, clinical recognition of different sources of hyperlactatemia is unfortunately not a common practice and patients are treated with the same strategy despite the risk of over-resuscitation in some. Indeed, pursuing additional resuscitation in non-hypoperfusion-related cases might lead to the toxicity of fluid overload and vasoactive drugs...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28279723/physiologic-cryoamputation-in-managing-critically-ill-patients-with-septic-advanced-acute-limb-ischemia
#16
Samuel L Chen, Isabella J Kuo, Nii-Kabu Kabutey, Roy M Fujitani
OBJECTIVES: Certain critically ill patients with advanced acute limb ischemia with a non-viable extremity may be unsuitable for transport to the operating room to undergo definitive amputation. In these unstable patients, rapid regional cryotherapy allows for prompt infectious source control and correction of hemodynamic and metabolic abnormalities, thereby lessening the risk associated with definitive surgical amputation. We describe our refined technique for lower extremity physiologic cryoamputation and review our institutional experience...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28270914/sepsis-induced-cardiac-dysfunction-and-%C3%AE-adrenergic-blockade-therapy-for-sepsis
#17
REVIEW
Takeshi Suzuki, Yuta Suzuki, Jun Okuda, Takuya Kurazumi, Tomohiro Suhara, Tomomi Ueda, Hiromasa Nagata, Hiroshi Morisaki
Despite recent advances in medical care, mortality due to sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, remains high. Fluid resuscitation and vasopressors are the first-line treatment for sepsis in order to optimize hemodynamic instability caused by vasodilation and increased vascular permeability. However, these therapies, aimed at maintaining blood pressure and blood flow to vital organs, could have deleterious cardiac effects, as cardiomyocyte damage occurs in the early stages of sepsis...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28262318/an-emergency-department-validation-of-the-sep-3-sepsis-and-septic-shock-definitions-and-comparison-with-1992-consensus-definitions
#18
Daniel J Henning, Michael A Puskarich, Wesley H Self, Michael D Howell, Michael W Donnino, Donald M Yealy, Alan E Jones, Nathan I Shapiro
STUDY OBJECTIVE: The Third International Consensus Definitions Task Force (SEP-3) proposed revised criteria defining sepsis and septic shock. We seek to evaluate the performance of the SEP-3 definitions for prediction of inhospital mortality in an emergency department (ED) population and compare the performance of the SEP-3 definitions to that of the previous definitions. METHODS: This was a secondary analysis of 3 prospectively collected, observational cohorts of infected ED subjects aged 18 years or older...
March 2, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28261769/evaluation-of-risk-factors-and-development-of-acute-kidney-injury-in-aneurysmal-subarachnoid-hemorrhage-head-injury-and-severe-sepsis-septic-shock-patients-during-icu-treatment
#19
Ceren Kamar, Achmet Ali, Demet Altun, Günseli Orhun, Akın Sabancı, Altay Sencer, İbrahim Özkan Akıncı
BACKGROUND: There are few studies examining development of acute kidney injury (AKI) in the various types of patients in intensive care units (ICUs). Presently described is evaluation of risk factors and development of AKI in different groups of ICU patients. METHODS: Present study was performed in 3 different ICUs. Development of AKI was measured using Acute Kidney Injury Network (AKIN) classification system. Total of 300 patients who were treated in trauma, neurosurgery, or general ICU departments (due to head injury, aneurysmal subarachnoid hemorrhage [aSAH], or severe sepsis/septic shock, respectively) were assessed for incidence, risk factors, and development of AKI...
January 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28261297/comparison-of-prognostic-value-of-n-terminal-pro-brain-natriuretic-peptide-in-septic-and-non-septic-intensive-care-patients
#20
Namik Ozcan, Ayse Ozcan, Cetin Kaymak, Hulya Basar, Mustafa Kotanoglu, Bektas Kose
INTRODUCTION: The aim of this study is to compare the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in septic and non-septic intensive care patients. MATERIAL AND METHODS: Fifty consecutive patients admitted to the intensive care unit (ICU) were enrolled in either the septic or non-septic group according to the criteria in the International Sepsis Definitions Conference in 2001. Demographic and clinical data, procalcitonin and lactate levels at admission, and death within 28 days were registered...
March 1, 2017: Archives of Medical Science: AMS
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