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Sepsis care

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https://www.readbyqxmd.com/read/29471109/extensively-drug-resistant-acinetobacter-baumannii-bacteremias-in-a-multidisciplinary-intensive-care-unit-during-a-6-year-period-risk-factors-for-fulminant-sepsis
#1
M Katsiari, A Mavroidi, E D Platsouka, C Nikolaou
OBJECTIVES: The aim of the present study was to determine potential host-, pathogen-, infection- and treatment-related risk factors that might predict a fulminant, fatal course of bacteremia caused extensively drug-resistant A. baumannii (XDR Aba). METHODS: Eighty-seven patients with monomicrobial growth of XDR Aba in blood cultures within a 6-year period were studied. Patients were divided into three groups, according to ICU outcome. Group A (n=40) consisted of patients who survived, Group B (n=10) included patients with fulminant sepsis that died early (<48h), whereas Group C (n=37) included patients that died later (> 48h) after the onset of bacteremia...
February 19, 2018: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29469010/effect-of-blood-thiamine-concentrations-on-mortality-influence-of-nutritional-status
#2
Heitor Pons Leite, Lúcio Flávio Peixoto de Lima, José Augusto de A C Taddei, Ângela Tavares Paes
OBJECTIVE: To test the hypothesis that low blood thiamine concentrations in malnourished critically ill children are associated with higher risk of 30-d mortality. METHODS: Prospective cohort study in 202 consecutively admitted children who had whole blood thiamine concentrations assessed on admission and on days 5 and 10 of intensive care unit (ICU) stay. The primary outcome variable was 30-d mortality. Mean blood thiamine concentrations within the first 10 d of ICU stay, age, sex, malnutrition, C-reactive protein concentration, Pediatric Index of Mortality 2 score, and severe sepsis/septic shock were the main potential exposure variables for outcome...
December 7, 2017: Nutrition
https://www.readbyqxmd.com/read/29468633/prostaglandin-gel-versus-oxytocin-prelabour-rupture-of-membranes-at-term-a-randomised-controlled-trial
#3
Kassam Mahomed, Kellie Wild, Christopher R Weekes
BACKGROUND: Pre-labour rupture of membranes (PROM) at term is a common event with early induction of labour reducing infectious morbidity without increasing the caesarean rate. Syntocinon is commonly used for induction but prostaglandins are also routinely used. Large studies have shown no difference in the maternal and neonatal outcomes with either method. AIM: To assess the safety and efficacy of vaginal prostaglandin (PG) compared to syntocinon for induction of labour in term-PROM...
February 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29468414/-severe-caffeine-poisoning-with-rhabdomyolysis
#4
J Wolter, D Grün, S Otto
We report the case of a young man who took a large amount of caffeine powder dissolved in water in a suicide attempt. He was found comatose. The initial diagnosis was difficult. In hospital he suffered from rhabdomyolysis with renal failure and sepsis rapidly developed. After renal replacement treatment with hemodialysis, long-term artificial ventilation with tracheotomy and a 3‑week stay in the intensive care unit, the patient could be discharged to a rehabilitation center.
February 21, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29467173/qsofa-sirs-and-news-for-predicting-inhospital-mortality-and-icu-admission-in-emergency-admissions-treated-as-sepsis
#5
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
https://www.readbyqxmd.com/read/29467023/protracted-immune-disorders-at-one-year-after-icu-discharge-in-patients-with-septic-shock
#6
Florence Riché, Benjamin G Chousterman, Patrice Valleur, Alexandre Mebazaa, Jean-Marie Launay, Etienne Gayat
BACKGROUND: Sepsis is a leading cause of mortality and critical illness worldwide and is associated with an increased mortality rate in the months following hospital discharge. The occurrence of persistent or new organ dysfunction(s) after septic shock raises questions about the mechanisms involved in the post-sepsis status. The present study aimed to explore the immune profiles of patients one year after being discharged from the intensive care unit (ICU) following treatment for abdominal septic shock...
February 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29467017/adjunctive-ulinastatin-in-sepsis-treatment-in-china-adjust-study-study-protocol-for-a-randomized-controlled-trial
#7
Wei Jiang, Xiangyou Yu, Tongwen Sun, Yanfen Chai, Ping Chang, Zhongqing Chen, Jingye Pan, Zhiyong Peng, Ruilan Wang, Xiaozhi Wang, Yuan Xu, Li Yu, Qingshan Zheng, Bin Du
BACKGROUND: Sepsis is a major challenge in critical care and is associated with high mortality. Current management of sepsis and septic shock remains mainly supportive. Both basic and clinical research has shown that ulinastatin can improve the prognosis of sepsis. The aim of this trial is to evaluate the efficacy and safety profiles of ulinastatin compared with placebo. METHODS/DESIGN: In this multi-center, double-blind, randomized placebo-controlled trial we are recruiting a total of 348 subjects meeting "The Third International Consensus Definitions for Sepsis and Septic Shock" (Sepsis-3)...
February 21, 2018: Trials
https://www.readbyqxmd.com/read/29461429/hospital-variation-in-risk-adjusted-pediatric-sepsis-mortality
#8
Stefanie G Ames, Billie S Davis, Derek C Angus, Joseph A Carcillo, Jeremy M Kahn
OBJECTIVES: With continued attention to pediatric sepsis at both the clinical and policy levels, it is important to understand the quality of hospitals in terms of their pediatric sepsis mortality. We sought to develop a method to evaluate hospital pediatric sepsis performance using 30-day risk-adjusted mortality and to assess hospital variation in risk-adjusted sepsis mortality in a large state-wide sample. DESIGN: Retrospective cohort study using administrative claims data...
February 15, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29460453/severe-maternal-morbidity-due-to-sepsis-the-burden-and-preventability-of-disease-in-new-zealand
#9
Sam Lepine, Beverley Lawton, Stacie Geller, Peter Abels, Evelyn J MacDonald
BACKGROUND: Sepsis is a life-threatening systemic condition that appears to be increasing in the obstetric population. Clinical detection can be difficult and may result in increased morbidity via delays in the continuum of patient care. AIMS: To describe the burden of severe maternal morbidity (SMM) caused by sepsis in New Zealand and investigate the potential preventability. METHODS: A multidisciplinary expert review panel was established to review cases of obstetric sepsis admitted to intensive care or high-dependency units over an 18 month span in New Zealand...
February 20, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29459939/cognitive-outcomes-of-children-born-extremely-or-very-preterm-since-the-1990s-and-associated-risk-factors-a-meta-analysis-and-meta-regression
#10
E Sabrina Twilhaar, Rebecca M Wade, Jorrit F de Kieviet, Johannes B van Goudoever, Ruurd M van Elburg, Jaap Oosterlaan
Importance: Despite apparent progress in perinatal care, children born extremely or very preterm (EP/VP) remain at high risk for cognitive deficits. Insight into factors contributing to cognitive outcome is key to improve outcomes after EP/VP birth. Objective: To examine the cognitive abilities of children of EP/VP birth (EP/VP children) and the role of perinatal and demographic risk factors. Data Sources: PubMed, Web of Science, and PsycINFO were searched without language restriction (last search March 2, 2017)...
February 19, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29459937/treating-sepsis-is-complicated-are-governmental-regulations-for-sepsis-care-too-simplistic
#11
John P Kress, Jesse B Hall
No abstract text is available yet for this article.
February 20, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29459608/distribution-pattern-and-outcome-of-the-patients-in-the-intensive-care-unit-of-bangabandhu-sheikh-mujib-medical-university-a-short-term-analysis
#12
S I Alam, M A Hossain, M Aftabuddin, M A Hye, M K Mondal
The aim of the study was to describe the characteristics of patients admitted to intensive care unit and their outcome in Bangabandhu Sheikh Mujib Medical University, Bangladesh. This retrospective, descriptive study was conducted in the intensive care unit of Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2016 to June 2016. Data was retrieved from hospital records of all admitted patients regarding age, gender, admission source, reason for admission, length of ICU stay, requirement of mechanical ventilation, number of organ failure and their outcome...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29459604/immediate-outcome-of-preterm-neonates-with-respiratory-distress-syndrome-required-mechanical-ventilation
#13
M A Mannan, M A Hossain, J Nasim, Y Sabina, F Navila, D Subir
Since its inception, the neonatal mechanical ventilator has been considered an essential tool for managing preterm neonates with Respiratory Distress Syndrome (RDS) and is still regarded as an integral component in the neonatal respiratory care continuum. Mechanical ventilation of newborn has been practiced for several years with several advances made in the way. This clinical intervention study was done to analyze immediate outcome of preterm neonates with RDS required mechanical ventilation and conducted on preterm neonates with RDS required mechanical ventilation from July 2014 to June 2015...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29459586/risk-factors-and-immediate-neonatal-outcome-of-multiple-pregnancies-in-a-scanu-of-a-tertiary-care-hospital-bangladesh
#14
M N Islam, T Tazmin, M Siddika, M A Hossain, M A Ali, M K Bhuiyan
Multiple pregnancies are a significant risk factor for maternal and perinatal morbidity due to inherent biological risks. The present study was aimed to determine the risk factors and to evaluate the immediate neonatal outcome of multiple pregnancies. This descriptive observational study was conducted in the newly established Special Care Neonatal Unit (SCANU) of Mymensingh Medical College Hospital (MMCH), Bangladesh from January 2015 to March 2015. Total 86 newborns of multiple pregnancies who were admitted during the study period were included in the study...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29456211/risk-factors-associated-with-acute-kidney-injury-in-newborns
#15
Emad E Ghobrial, Salma Z Elhouchi, Sarah S Eltatawy, Lilian O Beshara
Acute kidney injury (AKI) in the newborn is a common problem in the neonatal intensive care unit with many underlying factors such as asphyxia, respiratory distress syndrome (RDS), and urogenital anomalies. The aim of this study is to highlight possible risk factors and profile of neonates developing AKI in the Neonatal Intensive Care Unit (NICU) of Cairo University Pediatric Hospital. The study was carried out on 90 neonates (30 patients and 60 controls), among neonates admitted to NICU. The study was done over two months, from January 2015 to March 2015...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29456210/appraising-the-outcome-and-complications-of-peritoneal-dialysis-patients-in-self-care-peritoneal-dialysis-and-assisted-peritoneal-dialysis-a-5-year-review-of-a-single-saudi-center
#16
Jamal Saleh Al Wakeel, Mohammed A Al Ghonaim, Abdullah Aldohayan, Saira Usama, Saad Al Obaili, Ahmad R Tarakji, Mohammad Alkhowaiter
Our objective is to study the outcomes and complications of peritoneal dialysis (PD) including comparison of self-care PD with home-care assisted PD during a five-year period. A retrospective study of PD data at King Saud University-affiliated hospital in Riyadh from January 1, 2009, to December 31, 2013. One hundred and eleven patients were included (female 55%). The average age was 47.4 (1-83) years. Twenty-one (18.91%) patients were on continuous ambulatory PD and 90 (81.08%) on automated PD. The mean time on PD was 23...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29455711/evaluation-of-the-benefits-of-de-escalation-for-patients-with-sepsis-in-the-emergency-intensive-care-unit
#17
Takahiro Niimura, Yoshito Zamami, Toru Imai, Kanako Nagao, Masafumi Kayano, Hidenori Sagara, Mitsuhiro Goda, Naoto Okada, Masayuki Chuma, Kenshi Takechi, Masaki Imanishi, Toshihiro Koyama, Tadashi Koga, Hironori Nakura, Toshiaki Sendo, Keisuke Ishizawa
PURPOSE: Although the 2016 Japanese guidelines for the management of sepsis recommend de-escalation of treatment after identification of the causative pathogen, adherence to this practice remain unknown. The objective of this study was to evaluate the benefits of de-escalating treatment for sepsis patients at an advanced critical care and emergency medical centre. METHODS: Based on electronic patient information, 85 patients who were transported to the centre by ambulance, and diagnosed with sepsis between January 2008 and September 2013 were enrolled and evaluated...
2018: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29455308/fluid-therapy-and-outcome-a-prospective-observational-study-in-65-german-intensive-care-units-between-2010-and-2011
#18
Christian Ertmer, Bernhard Zwißler, Hugo Van Aken, Michael Christ, Fabian Spöhr, Axel Schneider, Robert Deisz, Matthias Jacob
BACKGROUND: Outcome data on fluid therapy in critically ill patients from randomised controlled trials may be different from data obtained by observational studies under "real-life" conditions. We conducted this prospective, observational study to investigate current practice of fluid therapy (crystalloids and colloids) and associated outcomes in 65 German intensive care units (ICUs). In total, 4545 adult patients who underwent intravenous fluid therapy were included. The main outcome measures were 90-day mortality, ICU mortality and acute kidney injury (AKI)...
February 17, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29452807/incidence-and-outcomes-of-sepsis-after-cardiac-surgery-as-defined-by-the-sepsis-3-guidelines
#19
S H Howitt, M Herring, I Malagon, C N McCollum, S W Grant
BACKGROUND: The Sepsis-3 guidelines diagnose sepsis based on organ dysfunction in patients with either proven or suspected infection. The objective of this study was to assess the incidence and outcomes of sepsis diagnosed using these guidelines in patients in a cardiac intensive care unit (CICU) after cardiac surgery. METHODS: Daily sequential organ failure assessment (SOFA) scores were calculated for 2230 consecutive adult cardiac surgery patients between January 2013 and May 2015...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452323/burr-hole-surgery-for-chronic-subdural-hematoma-with-extensive-scalp-burn-a-case-report
#20
Eijiro Echizen, Kei Miyata, Ken Yamashita, Takeshi Mikami, Eichi Narimatsu, Nobuhiro Mikuni
BACKGROUND: Neurosurgical intervention for a patient with an extensive scalp burn is rare, but it might be associated with the high risk of surgical site infection. CASE DESCRIPTION: An 80-year-old man had a severe and extensive scalp burn. A chronic subdural hematoma (CSDH) was observed on a head CT for the assessment of bacteremia during treatment in the intensive care unit. To evaluate whether the CSDH might underlie his prolonged fever and sepsis pathology, we urgently evacuated the hematoma using one burr hole...
February 13, 2018: World Neurosurgery
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