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https://www.readbyqxmd.com/read/28637738/the-reanimation-low-immune-status-markers-realism-project-a-protocol-for-broad-characterisation-and-follow-up-of-injury-induced-immunosuppression-in-intensive-care-unit-icu-critically-ill-patients
#1
Mary-Luz Rol, Fabienne Venet, Thomas Rimmele, Virginie Moucadel, Pierre Cortez, Laurence Quemeneur, David Gardiner, Andrew Griffiths, Alexandre Pachot, Julien Textoris, Guillaume Monneret
INTRODUCTION: The host response to septic shock is dynamic and complex. A sepsis-induced immunosuppression phase has recently been acknowledged and linked to bad outcomes and increased healthcare costs. Moreover, a marked suppression of the immune response has also been partially described in patients hospitalized in intensive care unit (ICU) for severe trauma or burns. It has been hypothesized that immune monitoring could enable identification of patients who might most benefit from novel, adjunctive immune-stimulating therapies...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28613918/new-sepsis-definition-sepsis-3-and-community-acquired-pneumonia-mortality-a-validation-and-clinical-decision-making-study
#2
Otavio T Ranzani, Elena Prina, Rosario Menéndez, Adrian Ceccato, Catia Cilloniz, Raul Méndez, Albert Gabarrus, Enric Barbeta, Gianluigi Li Bassi, Miquel Ferrer, Antoni Torres
RATIONALE: Sepsis-3 Task Force updated the clinical criteria for sepsis, excluding the need for systemic inflammatory response syndrome (SIRS) criteria. The clinical implications of the proposed flowchart including the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) and SOFA scores are unknown. OBJECTIVE: To perform a clinical decision-making analysis of Sepsis-3 in patients with community-acquired pneumonia (CAP). METHODS: Cohort study including adult patients with CAP from two Spanish university-hospitals...
June 14, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28601273/potential-impact-of-the-2016-consensus-definitions-of-sepsis-and-septic-shock-on-future-sepsis-research
#3
Sandra L Peake, Anthony Delaney, Michael Bailey, Rinaldo Bellomo
STUDY OBJECTIVE: The influence of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) on the conduct of future sepsis research is unknown. We seek to examine the potential effect of the new definitions on the identification and outcomes of patients enrolled in a sepsis trial. METHODS: This was a post hoc analysis of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial of early goal-directed therapy that recruited 1,591 adult patients presenting to the emergency department (ED) with early septic shock diagnosed by greater than or equal to 2 systemic inflammatory response syndrome criteria and either refractory hypotension or hyperlactatemia...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28591964/-new-concept-for-surviving-sepsis-from-phenomenon-to-essence
#4
REVIEW
Xue-Lian Liao, Zhi-Chao Xie, Yan Kang
Sepsis is a critical clinical syndrome which keep puzzling the medical profession for many years. Recently, the results from several large-scale trials challenged the necessity of early goal directed therapy (EGDT) in surviving sepsis bundle, These trials were not opposed to EGDT but bring new concept that it is essential to utilize therapy with multiple monitoring measures in order to minimize injury while guarantee the safety . Deeper understanding in the pathogenesis of sepsis gives rise to the update of its definition based on vital organ dysfunction...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28558733/towards-a-consensus-definition-of-maternal-sepsis-results-of-a-systematic-review-and-expert-consultation
#5
REVIEW
Mercedes Bonet, Vicky Nogueira Pileggi, Marcus J Rijken, Arri Coomarasamy, David Lissauer, João Paulo Souza, Ahmet Metin Gülmezoglu
BACKGROUND: There is a need for a clear and actionable definition of maternal sepsis, in order to better assess the burden of this condition, trigger timely and effective treatment and allow comparisons across facilities and countries. The objective of this study was to review maternal sepsis definitions and identification criteria and to report on the results of an expert consultation to develop a new international definition of maternal sepsis. METHODS: All original and review articles and WHO documents, as well as clinical guidelines providing definitions and/or identification criteria of maternal sepsis were included...
May 30, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28550994/prospective-validation-of-a-near-real-time-ehr-integrated-automated-sofa-score-calculator
#6
Christopher Aakre, Pablo Moreno Franco, Micaela Ferreyra, Jaben Kitson, Man Li, Vitaly Herasevich
OBJECTIVES: We created an algorithm for automated Sequential Organ Failure Assessment (SOFA) score calculation within the Electronic Health Record (EHR) to facilitate detection of sepsis based on the Third International Consensus Definitions for Sepsis and Septic Shock (SEPSIS-3) clinical definition. We evaluated the accuracy of near real-time and daily automated SOFA score calculation compared with manual score calculation. METHODS: Automated SOFA scoring computer programs were developed using available EHR data sources and integrated into a critical care focused patient care dashboard at Mayo Clinic in Rochester, Minnesota...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28526675/iterative-user-interface-design-for-automated-sequential-organ-failure-assessment-score-calculator-in-sepsis-detection
#7
Christopher Ansel Aakre, Jaben E Kitson, Man Li, Vitaly Herasevich
BACKGROUND: The new sepsis definition has increased the need for frequent sequential organ failure assessment (SOFA) score recalculation and the clerical burden of information retrieval makes this score ideal for automated calculation. OBJECTIVE: The aim of this study was to (1) estimate the clerical workload of manual SOFA score calculation through a time-motion analysis and (2) describe a user-centered design process for an electronic medical record (EMR) integrated, automated SOFA score calculator with subsequent usability evaluation study...
May 18, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28523143/sirs-qsofa-and-new-sepsis-definition
#8
EDITORIAL
Paul E Marik, Abdalsamih M Taeb
No abstract text is available yet for this article.
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28521523/sepsis-in-internal-medicine-wards-current-knowledge-uncertainties-and-new-approaches-for-management-optimization
#9
Vincenzo Zaccone, Alberto Tosoni, Giovanna Passaro, Carla Vincenza Vallone, Michele Impagnatiello, Domenica Donatella Li Puma, Salvatore De Cosmo, Raffaele Landolfi, Antonio Mirijello
Sepsis represents a global health problem in terms of morbidity, mortality, social and economic costs. Although usually managed in Intensive Care Units, sepsis showed an increased prevalence among Internal Medicine wards in the last decade. This is substantially due to the ageing of population and to multi-morbidity. These characteristics represent both a risk factor for sepsis and a relative contra-indication for the admission to Intensive Care Units. Although there is a lack of literature on the management of sepsis in Internal Medicine, the outcome of these patients seems to be gradually improving...
May 27, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28504784/current-clinical-controversies-in-the-management-of-sepsis
#10
J Cohen
Sepsis remains a challenging clinical problem requiring prompt diagnosis and optimal clinical management if the continuing high mortality is to be contained. In this brief review I consider four specific questions that are the subject of ongoing controversy. First, whether the new 'Sepsis-3' definitions will be helpful, in particular in improving diagnosis, or whether the rapid move towards precision medicine will make the definition redundant. Second, should we routinely use combinations of antibiotics for the empiric treatment of sepsis...
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28500500/-epistemology-in-the-intensive-care-unit-what-is-the-purpose-of-a-definition-paradigm-shift-in-sepsis-research
#11
P Dickmann, A Scherag, S M Coldewey, C Sponholz, F M Brunkhorst, M Bauer
The adoption of the new sepsis definition in early 2016 introduced a new paradigm for the clinical picture of sepsis. Up until now, sepsis was defined as a systemic inflammatory reaction (systemic inflammatory response syndrome, SIRS) to an infection. Based on a better understanding of the molecular mechanisms, the focus of the new definition is no longer the inflammatory response, but rather the tissue damage and impairment of organ function which this induces. The paradigm thus moves away from the infection and the systemic inflammatory response, and toward that which makes sepsis so dangerous in terms of both disease dynamics and outcome: organ failure due to a dysregulated host response to an infection...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28497242/-new-sepsis-3-definition-do-we-have-to-treat-sepsis-before-we-can-diagnose-it-from-now-on
#12
T Schmoch, M Bernhard, F Uhle, M Gründling, T Brenner, M A Weigand
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) have been available since the beginning of 2016. SEPSIS-3 completely replaces the old SIRS criteria in the definition of sepsis and defines sepsis from now on as "life-threatening organ dysfunction caused by a dysregulated host response to infection". However, it seems questionable whether in clinical practice the new definition is really superior to the old one. The most important question is the following: Is it helpful to have a definition that first recognizes a patient once organ dysfunction has occurred and the patient already needs intensive care?...
May 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28488038/-the-2016-surviving-sepsis-campaign-sepsis-guideline
#13
REVIEW
S Petros, S John
Sepsis is still associated with very high morbidity and mortality. Continuous improvements in the early recognition and management of this syndrome are thus necessary. The 2016 Surviving Sepsis Campaign sepsis guideline presents current evidence and consequences in the management of sepsis. This new guideline came at the beginning of the paradigm shift in sepsis definition, whereby the influence of the current sepsis definition on the management of sepsis is yet to be seen. Despite tremendous research efforts, several recommendations in the new sepsis guideline have a weak to moderate evidence grade...
June 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28448400/comparison-of-the-performance-between-sepsis-1-and-sepsis-3-in-icus-in-china-a-retrospective-multicenter-study
#14
Baoli Cheng, Zhongwang Li, Jingya Wang, Guohao Xie, Xu Liu, Zhipeng Xu, Lihua Chu, Jialian Zhao, Yongming Yao, Xiangming Fang
The definition of sepsis was updated to sepsis-3 in February 2016. However, the performance of the previous and new definition of sepsis remains unclear in China. This was a retrospective multicenter study in 6 ICUs from 5 university-affiliated hospitals to compare the performance between sepsis-1 and sepsis-3 in China. From May 1, 2016 to June 1, 2016, 496 patients were enrolled consecutively. Data were extracted from the electronic clinical records. We evaluated the performance of sepsis-1 and sepsis-3 by measuring the area under the receiver operating characteristic curves (AUROC) to predict 28-day mortality rates...
April 26, 2017: Shock
https://www.readbyqxmd.com/read/28425658/endoscopic-management-of-acute-cholangitis-as-a-result-of-common-bile-duct-stones
#15
Mohan Ramchandani, Partha Pal, D Nageshwar Reddy
Acute cholangitis is infectious disease of the biliary system and potentially can cause significant morbidity and mortality. With advances in intensive care, antibiotic therapy advances and endoscopic and other modalities of biliary drainage, mortality rates have significantly come down of late. Although most cases respond to antibiotics alone, definitive therapy is required later in most of the patients. Increased biliary pressure leads to biliovenous reflux of bacteria and purulent bile into the circulation leading to systemic inflammation and sepsis with subsequent organ dysfunction...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28410332/sepsis-3-on-the-block-what-does-it-mean-for-preclinical-sepsis-modeling
#16
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...
May 2017: Shock
https://www.readbyqxmd.com/read/28342906/citation-analysis-a-new-approach-to-assess-the-uptake-of-core-outcome-sets
#17
Karen L Barnes, Jamie J Kirkham, Mike Clarke, Paula R Williamson
OBJECTIVE: To evaluate citation analysis as an approach to measuring core outcome set (COS) uptake, by assessing whether the number of citations for a COS report could be used as a surrogate measure of uptake of the COS by clinical trialists. STUDY DESIGN AND SETTING: Citation data were obtained for COS reports published before 2010 in five disease areas (systemic sclerosis, rheumatoid arthritis, eczema, sepsis and critical care, and female sexual dysfunction). Those publications identified as a report of a clinical trial were examined to identify whether or not all outcomes in the COS were measured in the trial...
March 22, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28342442/comparison-of-qsofa-and-sirs-for-predicting-adverse-outcomes-of-patients-with-suspicion-of-sepsis-outside-the-intensive-care-unit
#18
Eli J Finkelsztein, Daniel S Jones, Kevin C Ma, Maria A Pabón, Tatiana Delgado, Kiichi Nakahira, John E Arbo, David A Berlin, Edward J Schenck, Augustine M K Choi, Ilias I Siempos
BACKGROUND: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) Task Force recently introduced a new clinical score termed quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) for identification of patients at risk of sepsis outside the intensive care unit (ICU). We attempted to compare the discriminatory capacity of the qSOFA versus the Systemic Inflammatory Response Syndrome (SIRS) score for predicting mortality, ICU-free days, and organ dysfunction-free days in patients with suspicion of infection outside the ICU...
March 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28291766/sepsis-3-on-the-block-what-does-it-mean-for-pre-clinical-sepsis-modeling
#19
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/28262318/an-emergency-department-validation-of-the-sep-3-sepsis-and-septic-shock-definitions-and-comparison-with-1992-consensus-definitions
#20
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
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