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Sepsis guideline

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https://www.readbyqxmd.com/read/28342580/evidence-based-management-of-chylothorax-in-infants
#1
Joseph T Church, Alexis G Antunez, Ashley Dean, Niki Matusko, Kristopher B Deatrick, Mohammad A Attar, Samir K Gadepalli
PURPOSE: Management guidelines for infants with chylothorax lack substantial evidence. We sought to identify variables that impact outcomes in these patients in order to develop an evidence-based management algorithm. METHODS: We retrospectively reviewed the medical records of all infants diagnosed with chylothorax from June 2005 to December 2014 at our institution. Data collected included demographics, chest tube output (CTO), medical and dietary interventions, surgical procedures, and absolute lymphocyte count (ALC)...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28335673/modifiable-risk-factors-for-delirium-in-critically-ill-trauma-patients
#2
Marc-Alexandre Duceppe, David R Williamson, Audrée Elliott, Mélissa Para, Marie-Christine Poirier, Marie-Soleil Delisle, Dan Deckelbaum, Tarek Razek, Monique Desjardins, Jean-Claude Bertrand, Francis Bernard, Philippe Rico, Lisa Burry, Anne Julie Frenette, Marc Perreault
OBJECTIVE: Intensive care unit (ICU)-acquired delirium has been associated with increased morbidity and mortality. Prevention strategies including modification of delirium risk factors are emphasized by practice guidelines. No study has specifically evaluated modifiable delirium risk factors in trauma ICU patients. Our goal was to evaluate modifiable risk factors for delirium among trauma patients admitted to the ICU. DESIGN: Prospective observational study. SETTING: Two level 1 trauma ICU centers...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28330460/sepsis-recognition-in-the-emergency-department-impact-on-quality-of-care-and-outcome
#3
Marius Morr, Alexander Lukasz, Eva Rübig, Hermann Pavenstädt, Philipp Kümpers
BACKGROUND: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED). METHODS: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28326213/a-fatal-sepsis-caused-by-hyaluronate-knee-injection-how-much-the-medical-history-and-the-informed-consent-might-be-important
#4
F Manfreda, G Rinonapoli, A Nardi, P Antinolfi, A Caraffa
The incidence of Osteoarthritis (OA) is gradually increasing worldwide due to two main reasons: longer life expectation and increased functional demand. Several treatment options have been proposed for this disease. Conservative treatment has the goal to improve the quality of life, reduce pain, and prevent the progression of the disease. Hyaluronate viscosupplementation is one of the most used infiltrative treatments for OA, but, despite its common use, clinical efficacy is still under question. Though adverse reactions for this medical option are actually rare, septic arthritis is a very scaring complication...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28321299/successful-emergency-department-interventions-that-reduce-time-to-antibiotics-in-febrile-pediatric-cancer-patients
#5
Sandra Spencer, MIchele Nypaver, Katherine Hebert, Christopher Benner, Rachel Stanley, Daniel Cohen, Alexander Rogers, Jason Goldstick, Prashant Mahajan
Children with cancer and fever are at high risk for sepsis related death. Rapid antibiotic delivery (< 60 minutes) has been shown to reduce mortality. We compared patient outcomes and describe interventions from three separate quality improvement (QI) projects conducted in three United States (US) tertiary care pediatric emergency departments (EDs) with the shared aim to reduce time to antibiotic (TTA) to < 60 minutes in febrile pediatric oncology patients (Temperature > 38.0 C). A secondary objective was to identify interventions amenable to translation to other centers...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28291766/sepsis-3-on-the-block-what-does-it-mean-for-pre-clinical-sepsis-modeling
#6
Marcin F Osuchowski, Christoph Thiemermann, Daniel G Remick
To effectively improve outcomes of septic patients, we first need to elucidate the multifaceted pathogenesis of sepsis syndromes and related inflammatory conditions. In fulfillment of such needs, in February 2016, new definitions for sepsis and septic shock were published under the acronym Sepsis-3. Although aimed at the clinical area, Sepsis-3 will have an inevitable influence upon the field of translational research as well. Sepsis-3 brings a considerable shift regarding the experimental focal point: from inflammatory states (SIRS/CARS) to organ failure (single and multiple) as the decisive factor...
October 25, 2016: Shock
https://www.readbyqxmd.com/read/28286823/protocol-adherence-for-severe-sepsis-and-septic-shock-management-in-the-emergency-department-a-clinical-audit
#7
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/28266699/rapidly-progressive-and-almost-lethal-pneumonia
#8
Juancarlo Martínez-González, Carlos Robles-Arias, William Rodríguez-Cintrón
We herein describe the case of a 65-year-old male patient who presented with Osler's triad, which is the combination of endocarditis, pneumonia, and meningitis. This report is even more unusual since the pathogen isolated was the invasive and virulent strain of Streptococcus pneumoniae serotype 3. The clinical entity described is also called Austrian syndrome. Even though rare in this antibiotic era, the syndrome remains one of high morbidity and mortality. This particular case is of paramount importance for the clinician reader...
March 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28264021/antimicrobial-use-in-paediatric-patients-in-a-teaching-hospital-in-ethiopia
#9
Hafte Kahsay Kebede, Hailay Abrha Gesesew, Tewodros Eyob Woldehaimanot, Kabaye Kumela Goro
BACKGROUND: Antibiotics use in in children are different from adults due to a lack of data on pharmacokinetics, pharmacodynamics, efficacy and safety of drugs, different physiological spectrum, pediatrics populations being vulnerable to the majority of the illnesses, and the adverse effect of their irrational use is more serious. However, antibiotic use is not explored much in a paediatric population. The current study focused on antibiotic use among pediatric population using data from a tertiary hospital in Ethiopia...
2017: PloS One
https://www.readbyqxmd.com/read/28257500/pediatric-emergency-care-capacity-in-a-low-resource-setting-an-assessment-of-district-hospitals-in-rwanda
#10
Celestin Hategeka, Jean Shoveller, Lisine Tuyisenge, Cynthia Kenyon, David F Cechetto, Larry D Lynd
BACKGROUND: Health system strengthening is crucial to improving infant and child health outcomes in low-resource countries. While the knowledge related to improving newborn and child survival has advanced remarkably over the past few decades, many healthcare systems in such settings remain unable to effectively deliver pediatric advance life support management. With the introduction of the Emergency Triage, Assessment and Treatment plus Admission care (ETAT+)-a locally adapted pediatric advanced life support management program-in Rwandan district hospitals, we undertook this study to assess the extent to which these hospitals are prepared to provide this pediatric advanced life support management...
2017: PloS One
https://www.readbyqxmd.com/read/28255806/audit-of-aspects-of-practice-in-relation-to-patients-with-suspected-community-onset-blood-stream-infection
#11
M A Reza, M Cormican
BACKGROUND: Community-onset blood stream infection (C-BSI) is an important cause of sepsis. The urinary tract is an important source for C-BSI. Urinary catheters are a recognized risk factor. Blood culture is the critical diagnostic test. Prompt effective antimicrobial therapy is a key intervention. We reviewed practice in relation to patients presenting with suspected C-BSI. AIM: To review practice in relation to patients presenting with suspected C-BSI. METHODS: Patients were those with blood cultures (BC) submitted from the emergency department over 4 weeks...
March 2, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28255613/intensive-care-medicine-research-agenda-on-invasive-fungal-infection-in-critically-ill-patients
#12
REVIEW
Matteo Bassetti, Jose Garnacho-Montero, Thierry Calandra, Bartjan Kullberg, George Dimopoulos, Elie Azoulay, Arunaloke Chakrabarti, Daniel Kett, Cristobal Leon, Luis Ostrosky-Zeichner, Maurizio Sanguinetti, Jean-Francois Timsit, Malcom D Richardson, Andrew Shorr, Oliver A Cornely
PURPOSE: To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting. METHODS: A systematic review of the medical literature taking account of national and international guidelines and expert opinion...
March 2, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28252537/daily-lowest-hemoglobin-and-risk-of-organ-dysfunctions-in-critically-ill-patients
#13
Sarah J Hemauer, Adam J Kingeter, Xue Han, Matthew S Shotwell, Pratik P Pandharipande, Liza M Weavind
OBJECTIVES: To determine the association between hemoglobin levels and the daily risk of individual organ dysfunctions in critically ill patients. DESIGN: Post hoc analysis of prospectively collected data. SETTING: Vanderbilt University Medical Center and Saint Thomas Hospital Medical and Surgical ICUs. PATIENTS: Medical and surgical ICU patients admitted with respiratory failure or shock. INTERVENTIONS: Baseline demographic data, and detailed in-ICU and hospital data, including daily lowest hemoglobin, were collected up to hospital day 30...
March 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28250600/a-comparison-of-residents-knowledge-regarding-the-surviving-sepsis-campaign-2012-guideline
#14
Onnicha Suntornlohanakul, Bodin Khwannimit
BACKGROUND: Recently, Surviving Sepsis Campaign (SSC) guideline was updated. Our objective was to evaluate the knowledge of residents in different departments regarding the SSC 2012. METHODS: A cross-sectional, descriptive self-questionnaire was distributed to interns and residents in the Departments of Internal Medicine, Surgery, and Emergency Medicine. RESULTS: The response rate was 136 (89%) from 153 residents. The residents included 46 (33%) interns, 42 (31%) internal medicine residents, 41 (30%) surgical residents, and 7 (5%) emergency residents...
February 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28241253/a-quantitative-risk-based-approach-to-the-management-of-neonatal-early-onset-sepsis
#15
Michael W Kuzniewicz, Karen M Puopolo, Allen Fischer, Eileen M Walsh, Sherian Li, Thomas B Newman, Patricia Kipnis, Gabriel J Escobar
Importance: Current algorithms for management of neonatal early-onset sepsis (EOS) result in medical intervention for large numbers of uninfected infants. We developed multivariable prediction models for estimating the risk of EOS among late preterm and term infants based on objective data available at birth and the newborn's clinical status. Objectives: To examine the effect of neonatal EOS risk prediction models on sepsis evaluations and antibiotic use and assess their safety in a large integrated health care system...
February 20, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28240005/surgery-for-diverticulitis-in-the-21st-century-recent-evidence
#16
Arden M Morris, Cindy Kin
Sigmoid diverticulitis is an increasingly common disease in Western countries. As technology has led to increased knowledge about the disease and options for treatment, management strategies have become less certain. In previous years, the rationale for early elective surgery was largely preventive, due to concern that diverticulitis recurrence would result in increased risk of sepsis or the need for a colostomy. New technology has enabled diagnosis, through computed tomography scans, predictive information through clinical and administrative databases, and less invasive treatment options, through laparoscopic techniques...
February 24, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28235686/the-effects-of-massage-therapy-in-hospitalized-preterm-neonates-a-systematic-review
#17
REVIEW
María José Álvarez, Daniel Fernández, Juan Gómez-Salgado, Dolores Rodríguez-González, María Rosón, Santiago Lapeña
OBJECTIVE: The aim of this study was to perform a systematic review to identify, evaluate and summarise studies on the administration of therapeutic massage to preterm neonates during their stay in the NICU, and to assess their methodological quality. DESIGN: systematic review following PRISMA statements guidelines. DATA SOURCES: A comprehensive search was performed including relevant articles between January 2004 and December 2013, using the following electronic databases: Medline, PEDro, Web of Science and Scopus...
February 14, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#18
Craig V Towers, Angela Yates, Nikki Zite, Casey Smith, Lindsey Chernicky, Bobby Howard
BACKGROUND: The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE: We sought to prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early-onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with newborns delivered from mothers without intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28197792/laparoscopic-lavage-versus-surgical-resection-for-acute-diverticulitis-with-generalised-peritonitis-a-systematic-review-and-meta-analysis
#19
REVIEW
R Cirocchi, S Di Saverio, D G Weber, R Taboła, I Abraha, J Randolph, A Arezzo, G A Binda
This systematic review and meta-analysis investigates current evidence on the therapeutic role of laparoscopic lavage in the management of diverticular peritonitis. A systematic review of the literature was performed on PubMed until June 2016, according to preferred reporting items for systematic reviews and meta-analyses guidelines. All randomised controlled trials comparing laparoscopic lavage with surgical resection, irrespective of anastomosis or stoma formation, were analysed. After assessment of titles and full text, 3 randomised trials fulfilled the inclusion criteria...
February 15, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28184340/biomarkers-predicting-survival-of-sepsis-patients-treated-with-continuous-renal-replacement-therapy
#20
Jeong Ho Lee, Ha Yeon Kim, Eun Hui Bae, Soo Wan Kim, Seong Kwon Ma
The present study investigated the prognostic factors predicting survival of patients with sepsis and acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT). This retrospective observational study included 165 sepsis patients treated with CRRT. The patients were divided into two groups; the survivor group (n=73, 44.2%) vs. the nonsurvivor group (n=92, 55.8%). AKI was defined by the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines. We analyzed medical histories, clinical characteristics and laboratory findings of the enrolled patients when they started CRRT...
January 2017: Chonnam Medical Journal
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