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severe sepsis definition

Jared Brazg, Phyllis Huang, Corey Weiner, Guneet Singh, Antonios Likourezos, Linda Salem, Eitan Dickman, John Marshall
IMPORTANCE: Emergency Physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). OBJECTIVE: To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. METHODS: The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016...
March 12, 2018: American Journal of Emergency Medicine
Alice G Vassiliou, Anastasia Kotanidou, Zafeiria Mastora, Carlo Tascini, Gianluigi Cardinali, Stylianos E Orfanos
INTRODUCTION: A soluble (s) form of the endothelial protein C receptor (EPCR) circulates in plasma and inhibits activated protein C (APC) activities. The clinical impact of sEPCR and its involvement in the septic process is under investigation. This study determined the frequencies of EPCR haplotypes H1 and H3 to investigate possible associations with plasma admission levels of sEPCR in an intensive care unit (ICU) cohort of septic patients. METHODS: Three polymorphisms in the EPCR gene were genotyped in 239 Caucasian critically ill patients, and their plasma sEPCR levels were also measured at the time of admission to the ICU...
March 2018: Infectious Diseases and Therapy
Carolin Fleischmann-Struzek, David M Goldfarb, Peter Schlattmann, Luregn J Schlapbach, Konrad Reinhart, Niranjan Kissoon
The incidence of sepsis is highest in neonates and children, yet the global burden of sepsis in these age groups has not been assessed. We reviewed available evidence from observational epidemiological studies to estimate the global burden and mortality of sepsis in neonates and children. We did a systematic review and meta-analysis of studies reporting population-based sepsis incidence in neonates and children, published between 1979 and 2016. Our search yielded 1270 studies, 23 of which met the inclusion criteria; 16 were from high-income countries and seven from middle-income countries...
March 2018: Lancet Respiratory Medicine
Aiko Okubo, Ayumu Nakashima, Shigehiro Doi, Toshinori Ueno, Kensuke Sasaki, Takashi Esaki, Takao Masaki
BACKGROUND: The definition of sepsis was updated to sepsis-3 in February 2016. Currently, direct hemoperfusion therapy using the polymyxin B-immobilized fiber cartridge (PMX-DHP) is widely performed to treat sepsis and septic shock. However, the prognostic factors of PMX-DHPs in patients with sepsis using the new definition are unclear. We retrospectively assessed prognostic factors in patients who had received PMX-DHP therapy for sepsis and septic shock. METHODS: We included 71 patients with severe infection who underwent PMX-DHP treatment from January 2006 to August 2015 in this study...
February 24, 2018: Clinical and Experimental Nephrology
Roberta Angelico, Undine A Gerlach, Bridget K Gunson, Desley Neil, Hynek Mergental, John Isaac, Paolo Muiesan, Darius Mirza, M Thamara Pr Perera
BACKGROUND: Causes of severe cholestasis following liver transplantation(LT) are multi-factorial; whilst the aetiology is predictable in some, others culminate in graft/patient loss without a definitive cause identified. Severe cholestasis is usually associated with overlapped histological findings of rejection and biliary features, and diagnostic interpretation may pose a challenge. METHODS: This is 10-year retrospective analysis of patients with unexplained severe cholestasis resulting in death/graft loss within 90-days of LT...
February 20, 2018: Transplantation
Robert Goulden, Marie-Claire Hoyle, Jessie Monis, Darran Railton, Victoria Riley, Paul Martin, Reynaldo Martina, Emmanuel Nsutebu
BACKGROUND: The third international consensus definition for sepsis recommended use of a new prognostic tool, the quick Sequential Organ Failure Assessment (qSOFA), based on its ability to predict inhospital mortality and prolonged intensive care unit (ICU) stay in patients with suspected infection. While several studies have compared the prognostic accuracy of qSOFA to the Systemic Inflammatory Response Syndrome (SIRS) criteria in suspected sepsis, few have compared qSOFA and SIRS to the widely used National Early Warning Score (NEWS)...
February 21, 2018: Emergency Medicine Journal: EMJ
Yukinori Tanoue, Shinsuke Takeno, Fumiaki Kawano, Kousei Tashiro, Rouko Hamada, Yasuyuki Miyazaki, Atsushi Nanashima
INTRODUCTION: An esophagorespiratory fistula (ERF) can cause severe pneumonia or a lung abscess which progresses to life-threatening sepsis. A case of a patient with esophageal cancer and an esophagopulmonary fistula (EPF) who underwent separation surgery with drainage tube-less (DRESS) esophagostomy and was promptly started on definitive chemoradiotherapy (CRT) is reported. PRESENTATION OF CASE: A 79-year-old man visited a clinic with a month-long history of dysphagia...
February 13, 2018: International Journal of Surgery Case Reports
Yutaka Ikeda, Kazuhiro Shoji, Chitho P Feliciano, Shinji Saito, Yukio Nagasaki
Acute inflammatory conditions such as sepsis lead to fatal conditions, including multiple organ failure. Several treatments such as steroidal anti-inflammatory drugs are currently being investigated in order to decrease the blood cytokine level, which increases remarkably. However, any of these therapeutic treatments are not always reliable and effective; none have drastically improved survival rates, and some have mostly ended with failure. Reactive oxygen species (ROS) are signaling molecules responsible for the production of cytokines and chemokines that can mediate hyperactivation of the immune response called cytokine storm...
February 20, 2018: Molecular Pharmaceutics
Cheryl P Z Foo, Jamie A Seabrook, Gurinder Sangha, Jennifer Ruth Foster
OBJECTIVE: The aim of this study was to examine the incidence and outcomes of patients presenting with systemic inflammatory response syndrome (SIRS) in the pediatric emergency department (PED). METHODS: This was a descriptive, retrospective cohort study of all patients from birth to 18 years presenting to the PED of a single center on 16 days distributed over 1 year. The presence of presumed SIRS (pSIRS, defined as noncore temperature measurement and cell count when clinically indicated) and sepsis was determined for all study patients...
February 12, 2018: Pediatric Emergency Care
Dimitrios Velissaris, Nikolaos-Dimitrios Pantzaris, Panagiotis Bountouris, Charalampos Gogos
Introduction The neutrophil-to-lymphocyte ratio (NLR) as calculated from the white cell differential blood count is a marker that has been used as a prognostic index when assessing patients suffering from several clinical syndromes, including sepsis. The aim of this study was to evaluate the relationship between NLR and the commonly used severity scores of sepsis SOFA, APACHE II and SAPS II in a population of emergency admitted adult patients with sepsis in a tertiary center. Methods A prospective observational study was conducted in the Emergency Department of the University Hospital of Patras, Greece, based on data extracted from 50 patients consecutively enrolled, suffering from sepsis of multiple origin...
February 9, 2018: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Matthew D Haslam, Sarka Lisonkova, Dianne Creighton, Paige Church, Junmin Yang, Prakesh S Shah, K S Joseph, Anne Synnes
OBJECTIVE: To assess the impact of variations in the definition of severe neurodevelopmental impairment (NDI) on the incidence of severe NDI and the association with risk factors using the Canadian Neonatal Follow-Up Network cohort. STUDY DESIGN: Literature review of severe NDI definitions and application of these definitions were performed in this database cohort study. Infants born at 23-28 completed weeks of gestation between 2009 and 2011 (n = 2187) admitted to a Canadian Neonatal Network neonatal intensive care unit and assessed at 21 months' corrected age were included...
February 2, 2018: Journal of Pediatrics
Christian Wied, Nicolai B Foss, Peter T Tengberg, Gitte Holm, Anders Troelsen, Morten T Kristensen
Background and purpose - An enhanced treatment program may decrease 30-day mortality below 20% after lower extremity amputations (LEA). The potential and limitations for further reduction are unknown. We analyzed postoperative causes of 30-day mortality, and assessed failure to rescue (FTR) rate in LEA patients who followed an enhanced treatment program. Patients and methods - Medical charts of 195 primary LEA procedures were reviewed independently by 3 of the authors, and deaths during hospitalization following amputation were classified according to consensus...
February 1, 2018: Acta Orthopaedica
Stéphane Gaudry, David Hajage, Frédérique Schortgen, Laurent Martin-Lefevre, Charles Verney, Bertrand Pons, Eric Boulet, Alexandre Boyer, Guillaume Chevrel, Nicolas Lerolle, Dorothée Carpentier, Nicolas de Prost, Alexandre Lautrette, Anne Bretagnol, Julien Mayaux, Saad Nseir, Bruno Megarbane, Marina Thirion, Jean-Marie Forel, Julien Maizel, Hodane Yonis, Philippe Markowicz, Guillaume Thiery, Florence Tubach, Jean-Damien Ricard, Didier Dreyfuss
RATIONALE: The optimal strategy for initiation of renal replacement therapy (RRT) in patients with severe acute kidney injury in the context of septic shock and acute respiratory distress syndrome (ARDS) is unknown. OBJECTIVE: To examine the effect of an early compared to a delayed RRT initiation strategy on 60-day mortality according to the baseline sepsis status, ARDS status and severity. METHODS: Post-hoc analysis of the AKIKI (Artificial-Kidney-Initiation in Kidney-Injury) trial...
January 19, 2018: American Journal of Respiratory and Critical Care Medicine
Zoltán Horváth-Szalai, Péter Kustán, Balázs Szirmay, Ágnes Lakatos, Per Hjort Christensen, Tamás Huber, Beáta Bugyi, Diána Mühl, Andrea Ludány, Attila Miseta, Gábor L Kovács, Tamás Kőszegi
BACKGROUND: Simultaneous determination of the two main actin scavenger proteins in sepsis has not been investigated until now. In our pilot study, we elucidated the predictive values of Gc globulin and gelsolin (GSN) in sepsis by comparing them to classic laboratory and clinical parameters. METHODS: A 5-day follow-up was performed, including 46 septic patients, 28 non-septic patients and 35 outpatients as controls. Serum Gc globulin and GSN levels were determined by automated immune turbidimetric assay on a Cobas 8000/c502 analyzer...
January 10, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Alistair E W Johnson, Jerome Aboab, Jesse D Raffa, Tom J Pollard, Rodrigo O Deliberato, Leo A Celi, David J Stone
OBJECTIVES: To evaluate the relative validity of criteria for the identification of sepsis in an ICU database. DESIGN: Retrospective cohort study of adult ICU admissions from 2008 to 2012. SETTING: Tertiary teaching hospital in Boston, MA. PATIENTS: Initial admission of all adult patients to noncardiac surgical ICUs. INTERVENTIONS: Comparison of five different algorithms for retrospectively identifying sepsis, including the Sepsis-3 criteria...
January 4, 2018: Critical Care Medicine
Theodoros Retsas, Klaus Huse, Lazaros-Dimitrios Lazaridis, Niki Karampela, Michael Bauer, Matthias Platzer, Virginia Kolonia, Eirini Papageorgiou, Evangelos J Giamarellos-Bourboulis, George Dimopoulos
OBJECTIVES: Several manuscripts provide conflicting results for the role of single nucleotide polymorphisms (SNPs) at the promoter region of TNF for susceptibility to sepsis. Former manuscripts were based on previous sepsis definitions. We investigated the influence of TNF haplotypes on sepsis development using the new Sepsis-3 definitions. METHODS: DNA was isolated from patients suffering from infection and systemic inflammatory response syndrome; haplotyping was performed for six SNPs of TNF...
December 20, 2017: International Journal of Infectious Diseases: IJID
Aaron D Storms, Jufu Chen, Lisa A Jackson, James D Nordin, Allison L Naleway, Jason M Glanz, Steven J Jacobsen, Eric S Weintraub, Nicola P Klein, Paul M Gargiullo, Alicia M Fry
BACKGROUND: Pneumonia poses a significant burden to the U.S. health-care system. However, there are few data focusing on severe pneumonia, particularly cases of pneumonia associated with specialized care in intensive care units (ICU). METHODS: We used administrative and electronic medical record data from six integrated health care systems to estimate rates of pneumonia hospitalizations with ICU admissions among adults during 2006 through 2010. Pneumonia hospitalization was defined as either a primary discharge diagnosis of pneumonia or a primary discharge diagnosis of sepsis or respiratory failure with a secondary diagnosis of pneumonia in administrative data...
December 16, 2017: BMC Pulmonary Medicine
Liesa Zabrocki, Frank Marquardt, Klaus Albrecht, Stefan Herget-Rosenthal
PURPOSE: Acute kidney injury (AKI) is a severe complication after infrarenal abdominal aortic aneurysm (iAAA) repair. Little data are available whether endovascular aneurysm (EVAR) or open aortic repair (OAR) differs with respect to AKI frequency and severity, consecutive development of chronic kidney disease (CKD) and potentially preventable and modifiable risk factors of AKI. PATIENTS AND METHODS: We assessed AKI rates, AKI stages and CKD applying current, complete definitions from the kidney disease improving global outcomes initiative in propensity-score-matched cohorts of all patients with elective and urgent iAAA repair at our institution from 2007 to 2011...
February 2018: International Urology and Nephrology
Qinlong Sun, Erzhen Chen
The latest definition of sepsis (Sepsis-3) is the life-threatening organ dysfunction due to overreaction of immune system caused by infection. The situation can develop into multiple organ dysfunction syndromes (MODS). In the pathological process of pathogen invasion, a large number of inflammatory factors directly damage organ function, while dysfunction of coagulation system is also involved in this process. With the overreaction of inflammation, disseminated intravascular coagulation (DIC) occurred, which further exacerbated organ damage...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Simon Li, Ting-Chang Hsieh, Kyle J Rehder, Sholeen Nett, Pradip Kamat, Natalie Napolitano, David A Turner, Michelle Adu-Darko, J Dean Jarvis, Conrad Krawiec, Ashley T Derbyshire, Keith Meyer, John S Giuliano, Joana Tala, Keiko Tarquinio, Michael D Ruppe, Ronald C Sanders, Matthew Pinto, Joy D Howell, Margaret M Parker, Gabrielle Nuthall, Michael Shepherd, Guillaume Emeriaud, Yuki Nagai, Osamu Saito, Jan Hau Lee, Dennis W Simon, Alberto Orioles, Karen Walson, Paula Vanderford, Asha Shenoi, Anthony Lee, Geoffrey L Bird, Michael Miksa, Ana Lia Graciano, Jesse Bain, Peter W Skippen, Lee A Polikoff, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: Oxygen desaturation during tracheal intubation is known to be associated with adverse ICU outcomes in critically ill children. We aimed to determine the occurrence and severity of desaturation during tracheal intubations and the association with adverse hemodynamic tracheal intubation-associated events. DESIGN: Retrospective cohort study as a part of the National Emergency Airway Registry for Children Network's quality improvement project from January 2012 to December 2014...
January 2018: Pediatric Critical Care Medicine
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