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severe sepsis definition

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https://www.readbyqxmd.com/read/28225739/damage-control-laparotomy-utilization-rates-are-highly-variable-among-level-i-trauma-centers-pragmatic-randomized-optimal-platelet-and-plasma-ratios-findings
#1
Justin Jeremiah Joseph Watson, Jamison Nielsen, Kyle Hart, Priya Srikanth, John D Yonge, Christopher R Connelly, Phillip M Kemp Bohan, Hillary Sosnovske, Barbara C Tilley, Gerald van Belle, Bryan A Cotton, Terence S OʼKeeffe, Eileen M Bulger, Karen J Brasel, John B Holcomb, Martin A Schreiber
BACKGROUND: Damage control laparotomy (DCL) is intended to limit deleterious effects from trauma-induced coagulopathy. DCL has been associated with mortality reduction, but may increase complications including sepsis, abscess, respiratory failure, hernia, and gastrointestinal fistula. We hypothesized that (1) DCL incidence would vary between institutions; (2) mortality rates would vary with DCL rates; (3) standard DCL criteria of pH, international normalized ratio, temperature and major intra-abdominal vascular injury would not adequately capture all patients...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#2
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28209139/stroke-caused-by-an-inflammatory-thrombus-a-case-report
#3
Kai Shan, Wei Guo
BACKGROUND: Stroke is the leading cause of mortality and disability worldwide. Several definite risk factors have been identified for stroke, although infectious factors might also contribute to stroke episodes through increased susceptibility or direct induction. CASE PRESENTATION: A 46-year-old Chinese male initially presented with fever, headache, and impaired memory and developed disturbance of consciousness after admission. A clinical diagnosis of Staphylococcus aureus sepsis, massive cerebral infarction and haemorrhagic transformation (left internal carotid arterial system, inflammatory thrombus) were made based on brain radiography, blood culture and postoperative pathological examinations...
February 16, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28207566/the-new-sepsis-definition-limitations-and-contribution-to-research-and-diagnosis-of-sepsis
#4
Franck Verdonk, Alice Blet, Alexandre Mebazaa
PURPOSE OF REVIEW: Based on recent clinical, epidemiological, and pathophysiological data, a third international consensus conference was carried out to define new criteria of sepsis in February 2016. This review presents the different items of this new definition, their limitations and their contribution to research and diagnosis of sepsis, in comparison with the previous definitions. RECENT FINDINGS: Incidence, management, and pathophysiological knowledge of sepsis have improved over the past 20 years...
February 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28178076/pediatric-acute-respiratory-distress-syndrome-in-pediatric-allogeneic-hematopoietic-stem-cell-transplants-a-multicenter-study
#5
Courtney M Rowan, Lincoln S Smith, Ashley Loomis, Jennifer McArthur, Shira J Gertz, Julie C Fitzgerald, Mara E Nitu, Elizabeth A S Moser, Deyin D Hsing, Christine N Duncan, Kris M Mahadeo, Jerelyn Moffet, Mark W Hall, Emily L Pinos, Robert F Tamburro, Ira M Cheifetz
OBJECTIVE: Immunodeficiency is both a preexisting condition and a risk factor for mortality in pediatric acute respiratory distress syndrome. We describe a series of pediatric allogeneic hematopoietic stem cell transplant patients with pediatric acute respiratory distress syndrome based on the recent Pediatric Acute Lung Injury Consensus Conference guidelines with the objective to better define survival of this population. DESIGN: Secondary analysis of a retrospective database...
February 7, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28153504/effect-of-omega-3-polyunsaturated-fatty-acids-derived-from-fish-oil-in-major-burn-patients-a-prospective-randomized-controlled-pilot-trial
#6
Serrana Tihista, Estrella Echavarría
BACKGROUND & AIMS: The burn patient is the clearest example of prolonged inflammatory response. Various nutrients, particularly omega-3 polyunsaturated fatty acids (ω-3 PUFAs), have been demonstrated as attenuating the inflammatory response, and reduce infectious complications. In absence of definitive evidence in major burns the study aimed at investigating the effect particularly on infectious complications of enteral nutrition enriched with ω-3 PUFAs. METHOD: Prospectively randomized controlled trial...
January 16, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28114554/prognostic-accuracy-of-sepsis-3-criteria-for-in-hospital-mortality-among-patients-with-suspected-infection-presenting-to-the-emergency-department
#7
MULTICENTER STUDY
Yonathan Freund, Najla Lemachatti, Evguenia Krastinova, Marie Van Laer, Yann-Erick Claessens, Aurélie Avondo, Céline Occelli, Anne-Laure Feral-Pierssens, Jennifer Truchot, Mar Ortega, Bruno Carneiro, Julie Pernet, Pierre-Géraud Claret, Fabrice Dami, Ben Bloom, Bruno Riou, Sébastien Beaune
Importance: An international task force recently redefined the concept of sepsis. This task force recommended the use of the quick Sequential Organ Failure Assessment (qSOFA) score instead of systemic inflammatory response syndrome (SIRS) criteria to identify patients at high risk of mortality. However, these new criteria have not been prospectively validated in some settings, and their added value in the emergency department remains unknown. Objective: To prospectively validate qSOFA as a mortality predictor and compare the performances of the new sepsis criteria to the previous ones...
17, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28099689/effectiveness-and-safety-of-procalcitonin-evaluation-for-reducing-mortality-in-adults-with-sepsis-severe-sepsis-or-septic-shock
#8
REVIEW
Brenda Ng Andriolo, Regis B Andriolo, Reinaldo Salomão, Álvaro N Atallah
BACKGROUND: Serum procalcitonin (PCT) evaluation has been proposed for early diagnosis and accurate staging and to guide decisions regarding patients with sepsis, severe sepsis and septic shock, with possible reduction in mortality. OBJECTIVES: To assess the effectiveness and safety of serum PCT evaluation for reducing mortality and duration of antimicrobial therapy in adults with sepsis, severe sepsis or septic shock. SEARCH METHODS: We searched the Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE (1950 to July 2015); Embase (Ovid SP, 1980 to July 2015); Latin American Caribbean Health Sciences Literature (LILACS via BIREME, 1982 to July 2015); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO host, 1982 to July 2015), and trial registers (ISRCTN registry, ClinicalTrials...
January 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28063688/crystalloid-fluid-choice-and-clinical-outcomes-in-pediatric-sepsis-a-matched-retrospective-cohort-study
#9
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
#10
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/28053267/assessment-of-resuscitation-as-measured-by-markers-of-metabolic-acidosis-and-features-of-injury
#11
D S Weinberg, A S Narayanan, T A Moore, H A Vallier
AIMS: The best time for definitive orthopaedic care is often unclear in patients with multiple injuries. The objective of this study was make a prospective assessment of the safety of our early appropriate care (EAC) strategy and to evaluate the potential benefit of additional laboratory data to determine readiness for surgery. PATIENTS AND METHODS: A cohort of 335 patients with fractures of the pelvis, acetabulum, femur, or spine were included. Patients underwent definitive fixation within 36 hours if one of the following three parameters were met: lactate < 4...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28052152/types-of-myocardial-infarction-among-human-immunodeficiency-virus-infected-individuals-in-the-united-states
#12
Heidi M Crane, Pathmaja Paramsothy, Daniel R Drozd, Robin M Nance, J A Chris Delaney, Susan R Heckbert, Matthew J Budoff, Greer A Burkholder, James H Willig, Michael J Mugavero, William C Mathews, Paul K Crane, Richard D Moore, Joseph J Eron, Sonia Napravnik, Peter W Hunt, Elvin Geng, Priscilla Hsue, Carla Rodriguez, Inga Peter, Greg S Barnes, Justin McReynolds, William B Lober, Kristina Crothers, Mathew Feinstein, Carl Grunfeld, Michael S Saag, Mari M Kitahata
Importance: The Second Universal Definition of Myocardial Infarction (MI) divides MIs into different types. Type 1 MIs result spontaneously from instability of atherosclerotic plaque, whereas type 2 MIs occur in the setting of a mismatch between oxygen demand and supply, as with severe hypotension. Type 2 MIs are uncommon in the general population, but their frequency in human immunodeficiency virus (HIV)-infected individuals is unknown. Objectives: To characterize MIs, including type; identify causes of type 2 MIs; and compare demographic and clinical characteristics among HIV-infected individuals with type 1 vs type 2 MIs...
January 4, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28050898/impact-of-transfusion-on-patients-with-sepsis-admitted-in-intensive-care-unit-a-systematic-review-and-meta-analysis
#13
REVIEW
Claire Dupuis, Romain Sonneville, Christophe Adrie, Antoine Gros, Michael Darmon, Lila Bouadma, Jean-François Timsit
Red blood cell transfusion (RBCT) threshold in patients with sepsis remains a matter of controversy. A threshold of 7 g/dL for stabilized patients with sepsis is commonly proposed, although debated. The aim of the study was to compare the benefit and harm of restrictive versus liberal RBCT strategies in order to guide physicians on RBCT strategies in patients with severe sepsis or septic shock. Four outcomes were assessed: death, nosocomial infection (NI), acute lung injury (ALI) and acute kidney injury (AKI)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/27997816/recent-early-clinical-drug-development-for-acute-kidney-injury
#14
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...
February 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27942538/sepsis-incidence-a-population-based-study
#15
Lisa Mellhammar, Sven Wullt, Åsa Lindberg, Peter Lanbeck, Bertil Christensson, Adam Linder
BACKGROUND: Although sepsis is a major health problem, data on sepsis epidemiology are scarce. The aim of this study was to assess the incidence of sepsis, based on clinical findings in all adult patients treated with intravenous antibiotic in all parts of all hospitals in an entire population. METHODS: This is a retrospective chart review of patients ≥18 years, living in 2 regions in Sweden, who were started on an intravenous antibiotic therapy on 4 dates, evenly distributed over the year of 2015...
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27941979/impact-and-effectiveness-of-10-and-13-valent-pneumococcal-conjugate-vaccines-on-hospitalization-and-mortality-in-children-aged-less-than-5-years-in-latin-american-countries-a-systematic-review
#16
Lucia Helena de Oliveira, Luiz Antonio B Camacho, Evandro S F Coutinho, Martha S Martinez-Silveira, Ana Flavia Carvalho, Cuauhtemoc Ruiz-Matus, Cristiana M Toscano
BACKGROUND: Several Latin American and Caribbean (LAC) countries have introduced pneumococcal conjugate vaccine (PCV-10 or PCV-13) in their routine national immunization programs. OBJECTIVES: We aimed to summarize the evidence of PCV impact and effectiveness in children under 5 years old in the LAC Region. METHODS: We conducted a systematic review of the literature on impact or effectiveness of PCVs on deaths or hospitalizations due to invasive pneumococcal disease (IPD), pneumonia, meningitis and sepsis...
2016: PloS One
https://www.readbyqxmd.com/read/27940455/sepsis-for-the-anaesthetist
#17
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
#18
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/27909859/sofa-score-and-left-ventricular-systolic-function-as-predictors-of-short-term-outcome-in-patients-with-sepsis
#19
Francesca Innocenti, Vittorio Palmieri, Aurelia Guzzo, Valerio Teodoro Stefanone, Chiara Donnini, Riccardo Pini
In a group of septic patients, we assess the short-term prognostic value of LV systolic performance, evaluated through conventional left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (LV GLS). One hundred forty-seven patients with sepsis were recruited; LVEF by planimetry and peak GLS by 2D speckle tracking could be assessed within 24 h. The study population was stratified according to SOFA tertiles assessed at the time of the echocardiogram (G1: SOFA score <5; G2: SOFA score 5-7; G3: SOFA score >7)...
December 1, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27908326/defining-and-diagnosing-sepsis
#20
REVIEW
Michael C Scott
Sepsis is a heterogeneous clinical syndrome that encompasses infections of many different types and severity. Not surprisingly, it has confounded most attempts to apply a single definition, which has also limited the ability to develop a set of reliable diagnostic criteria. It is perhaps best defined as the different clinical syndromes produced by an immune response to infection that causes harm to the body beyond that of the local effects of the infection.
February 2017: Emergency Medicine Clinics of North America
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