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https://www.readbyqxmd.com/read/28063688/crystalloid-fluid-choice-and-clinical-outcomes-in-pediatric-sepsis-a-matched-retrospective-cohort-study
#1
Scott L Weiss, Luke Keele, Fran Balamuth, Neika Vendetti, Rachael Ross, Julie C Fitzgerald, Jeffrey S Gerber
OBJECTIVE: To test the hypothesis that resuscitation with balanced fluids (lactated Ringer [LR]) is associated with improved outcomes compared with normal saline (NS) in pediatric sepsis. STUDY DESIGN: We performed matched analyses using data from 12 529 patients <18 years of age with severe sepsis/septic shock at 382 US hospitals between 2000 and 2013 to compare outcomes with vs without LR as part of initial resuscitation. Patients receiving LR were matched 1:1 to patients receiving only NS (NS group), including separate matches for any (LR-any group) or exclusive (LR-only group) LR use...
January 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28060151/new-or-progressive-multiple-organ-dysfunction-syndrome-in-pediatric-severe-sepsis-a-sepsis-phenotype-with-higher-morbidity-and-mortality
#2
John C Lin, Philip C Spinella, Julie C Fitzgerald, Marisa Tucci, Jenny L Bush, Vinay M Nadkarni, Neal J Thomas, Scott L Weiss
OBJECTIVES: To describe the epidemiology, morbidity, and mortality of new or progressive multiple organ dysfunction syndrome in children with severe sepsis. DESIGN: Secondary analysis of a prospective, cross-sectional, point prevalence study. SETTING: International, multicenter PICUs. PATIENTS: Pediatric patients with severe sepsis identified on five separate days over a 1-year period. INTERVENTIONS: None...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28011419/implications-of-the-new-sepsis-definition-on-research-and-practice
#3
EDITORIAL
Brian C Peach
INTRODUCTION: The Society of Critical-Care Medicine and the European Society of Intensive Care Medicine recently announced a marked change in the sepsis definition. A task force of 19 sepsis clinicians and researchers made the change based on advances in the pathobiological understanding of the septic process. SUMMARY OF CHANGE: The task force determined that there were numerous justifications for a revision of the sepsis definition, which are outlined in this article...
November 24, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27997816/recent-early-clinical-drug-development-for-acute-kidney-injury
#4
Kevin M Gallagher, Stephen O'neill, Ewen M Harrison, James A Ross, Stephen J Wigmore, Jeremy Hughes
Despite significant need and historical trials, there are no effective drugs in use for the prevention or treatment of acute kidney injury (AKI). There are several promising agents in early clinical development for AKI and two trials have recently been terminated. There are also exciting new findings in pre-clinical AKI research. There is a need to take stock of current progress in the field to guide future drug development for AKI. Areas covered: The main clinical trial registries, PubMed and pharmaceutical company website searches were used to extract the most recent clinical trials for sterile, transplant and sepsis-associated AKI...
December 27, 2016: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27984536/interleukin-1-receptor-2-a-new-biomarker-for-sepsis-diagnosis-and-gram-negative-gram-positive-bacterial-differentiation
#5
Yuejiao Lang, Yu Jiang, Min Gao, Wenmei Wang, Nian Wang, Kangkai Wang, Huali Zhang, Guangwen Chen, Ke Liu, Meidong Liu, Mingshi Yang, Xianzhong Xiao
This study was undertaken to explore the value of interleukin-1 receptor 2 (IL1R2) as a novel potential biomarker for diagnosis of sepsis and discrimination of gram-negative (G)/gram-positive (G) bacterial sepsis. The study was performed in Kunming mice and septic patients. Inactive Escherichia coli or Staphylococcus aureus were used to stimulate Kunming mice (10 CFU/kg). In clinical study, septic patients with different pathogen infection were studied, and healthy volunteers and patients with systemic inflammatory response syndrome without definite infection were enrolled as control...
January 2017: Shock
https://www.readbyqxmd.com/read/27975124/-updated-definition-of-sepsis-implications-for-diagnostics-and-therapy-principles
#6
N Schlegel
Until a short time ago the criteria for sepsis were based on the assumption that sepsis is primarily caused by the inflammatory reaction of the body to an infection, which does not correspond to the current knowledge on the pathophysiology of sepsis. Accordingly, sepsis is now defined as a life-threatening organ dysfunction due to a falsely regulated response of the body to an infection. Septic shock occurs when a condition of persisting hypotension with the continuous need for vasopressor agents and serum lactate levels of >2 mmol/l despite administration of sufficient volume and fluid is present...
December 14, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27965233/research-in-review-advancing-critical-care-practice
#7
Elizabeth Bridges, Margaret M McNeill, Nancy Munro
Research published in 2016 identified strategies to enhance acute and critical care, initiated discussions on professional roles and responsibilities, clarified complex care issues, and led to robust debate. Some of this important work addressed strategies to prevent delirium and pressure ulcers, considerations for pain management within the context of the opioid abuse crisis, strategies to guide fluid resuscitation in patients with sepsis and heart failure, and ways to enhance care for family members of intensive care patients...
December 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27940455/sepsis-for-the-anaesthetist
#8
M E Nunnally
Sepsis is as a dysregulated systemic response to infection. Morbidity and mortality of the syndrome are very high worldwide. Recent definitions have redefined criteria for sepsis. The new definition (Sepsis-3) classifies sepsis as infection with organ dysfunction (the old 'severe sepsis'). Septic patients are at risk for secondary injuries, thus aggressive source control, resuscitation, and antibiotic therapy are the mainstays of management. Central to sepsis physiology is vasodilated shock. Many patients respond to i...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27910086/higher-vs-lower-haemoglobin-threshold-for-transfusion-in-septic-shock-subgroup-analyses-of-the-triss-trial
#9
S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner
BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg...
February 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27856268/validation-of-the-new-sepsis-3-definitions-proposal-for-improvement-in-early-risk-identification
#10
E J Giamarellos-Bourboulis, T Tsaganos, I Tsangaris, M Lada, C Routsi, D Sinapidis, M Koupetori, M Bristianou, G Adamis, K Mandragos, G N Dalekos, I Kritselis, G Giannikopoulos, I Koutelidakis, M Pavlaki, E Antoniadou, G Vlachogiannis, V Koulouras, A Prekates, G Dimopoulos, A Koutsoukou, I Pnevmatikos, A Ioakeimidou, A Kotanidou, S E Orfanos, A Armaganidis, C Gogos
OBJECTIVES: Sepsis-3 definitions generated controversies regarding their general applicability. The Sepsis-3 Task Force outlined the need for validation with emphasis on the quick Sequential Organ Failure Assessment (qSOFA) score. This was done in a prospective cohort from a different healthcare setting. METHODS: Patients with infections and at least two signs of systemic inflammatory response syndrome (SIRS) were analysed. Sepsis was defined as total SOFA ≥2 outside the intensive care unit (ICU) or as an increase of ICU admission SOFA ≥2...
November 14, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27851016/1380-time-motion-analysis-and-economic-impact-of-sofa-score-integration-into-the-new-sepsis-3-definition
#11
Christopher Aakre, Jaben Kitson, Vitaly Herasevich
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850983/1347-usefulness-of-sepsis-biomarkers-according-to-the-new-definitions-of-sepsis
#12
Yasumasa Kawano, Kota Hoshino, Yuhei Irie, Yoshito Izutani, Kentaro Muranishi, Tomoko Tamura, Taisuke Kitamura, Hiroyasu Ishikura
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850741/1104-the-potential-financial-consequence-of-the-new-sepsis-3-sepsis-definitions
#13
Mustafa Baldawi, Mustafa Al-Jubouri, Jenna Watson, Anja Kathrin Jaehne, Victor Coba, Richard Belanger, Jasreen Gill, Emanuel Rivers
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27846034/an-update-on-classification-and-management-of-urosepsis
#14
Florian M E Wagenlehner, Zafer Tandogdu, Truls E Bjerklund Johansen
PURPOSE OF REVIEW: The urinary tract is the infection site in severe sepsis/septic shock in 10-30%. RECENT FINDINGS: There is a new Sepsis definition focusing on severe sepsis. Urosepsis is mainly due to obstructed uropathy of the upper urinary tract. The pathogenesis of sepsis is complex and is driven by the innate immune system. In the further course immunosuppression is developing.Management of urosepsis includes early diagnosis, early initiation of treatment such as identification and control of the complicating factor in the urinary tract and the specific sepsis therapy...
November 14, 2016: Current Opinion in Urology
https://www.readbyqxmd.com/read/27815588/the-new-sepsis-consensus-definitions-the-good-the-bad-and-the-ugly
#15
EDITORIAL
Charles L Sprung, Roland M H Schein, Robert A Balk
No abstract text is available yet for this article.
December 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27815587/the-new-sepsis-consensus-definitions-sepsis-3-the-good-the-not-so-bad-and-the-actually-quite-pretty
#16
EDITORIAL
Mervyn Singer
No abstract text is available yet for this article.
November 3, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27807819/sepsis-3-definitions-predict-icu-mortality-in-a-low-middle-income-country
#17
Bruno Adler Maccagnan Pinheiro Besen, Thiago Gomes Romano, Antonio Paulo Nassar, Leandro Utino Taniguchi, Luciano Cesar Pontes Azevedo, Pedro Vitale Mendes, Fernando Godinho Zampieri, Marcelo Park
BACKGROUND: Sepsis-3 definitions were published recently and validated only in high-income countries. The aim of this study was to assess the new criteria's accuracy in stratifying mortality as compared to its predecessor (Sepsis-2) in a Brazilian public intensive care unit (ICU) and to investigate whether the addition of lactate values would improve stratification. METHODS: Retrospective cohort study conducted between 2010 and 2015 in a public university's 19-bed ICU...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27789087/adipose-tissue-at-the-nexus-of-systemic-and-cellular-immunometabolism
#18
REVIEW
Ayano C Kohlgruber, Nelson M LaMarche, Lydia Lynch
At the simplest interpretation of the word, Immunometabolism describes the intersection of the fields of immunology and metabolism. With rapidly growing interest in this field, the term has expanded, and now encompasses a variety of concepts and definitions shaped by an individual's scientific area of expertise, cell-type and tissue of interest, and biological approach. One scientist may be interested in investigating the intrinsic metabolic checkpoints that drive a M1 versus M2 macrophage response, while another may be interested in how macrophages affect systemic metabolism during obesity...
October 2016: Seminars in Immunology
https://www.readbyqxmd.com/read/27771965/reviewing-the-diagnostic-criteria-for-acute-on-chronic-liver-failure
#19
Ankur Jindal, Archana Rastogi, Shiv Kumar Sarin
For over 20 years, acute-on-chronic liver failure (ACLF) has taken multiple definitions and/or classifications. The definition outlines the acute and chronic insults to include a homogenous patient group with liver failure and an expected outcome in a specific time frame. Early and accurate diagnosis is essential as this inflammation of the liver may tilt the balance of liver destruction and regeneration adversely. Various factors such as superadded systemic sepsis, liver reserve, cause of primary chronic liver disease, state of immune system or the state of gut microbial flora might determine the ultimate prognosis...
December 2016: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27749763/the-new-sepsis-definitions-implications-for-the-basic-and-translational-research-communities
#20
Craig M Coopersmith, Clifford S Deutschman
New definitions of sepsis and septic shock were published in early 2016, updating old definitions that have not been revisited since 2001. These new definitions should profoundly affect sepsis research. In addition, these paper present clinical criteria for identifying infected patients who are highly likely to have or to develop sepsis or septic shock. In contrast to previous approaches, these new clinical criteria are evidence based. In this review, two of the authors of the new definitions detail the content of the papers and explore the implications for shock and sepsis researchers...
September 29, 2016: Shock
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