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assessing new clinical criteria for septic shock

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https://www.readbyqxmd.com/read/29607156/clinical-outcome-comparison-of-patients-with-septic-shock-defined-by-the-new-sepsis-3-criteria-and-by-previous-criteria
#1
Seung Mok Ryoo, Gu Hyun Kang, Tae Gun Shin, Sung Yeon Hwang, Kyuseok Kim, You Hwan Jo, Yoo Seok Park, Sung-Hyuk Choi, Young Hoon Yoon, Woon Yong Kwon, Gil Joon Suh, Tae Ho Lim, Kap Su Han, Han Sung Choi, Sung Phil Chung, Won Young Kim
Background: We compared the clinical characteristics and outcomes between the new definition of sepsis-3 septic shock and the definition previously used from 1991 until recently. Methods: We conducted an observational study using a prospective, multi-center registry of septic shock from October 2015 to February 2017. Registry data were collected by 10 emergency departments (EDs) in tertiary hospitals that are members of the Korean Shock Society. Data on septic shock patients who met the previous septic shock definition were collected...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29478200/ph-after-the-first-session-of-direct-hemoperfusion-with-polymyxin-b-immobilized-fibers-predicts-mortality-in-patients-with-sepsis-and-septic-shock
#2
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
https://www.readbyqxmd.com/read/29475445/prognosis-of-patients-excluded-by-the-definition-of-septic-shock-based-on-their-lactate-levels-after-initial-fluid-resuscitation-a-prospective-multi-center-observational-study
#3
Byuk Sung Ko, Kyuseok Kim, Sung-Hyuk Choi, Gu Hyun Kang, Tae Gun Shin, You Hwan Jo, Seung Mok Ryoo, Jin Ho Beom, Woon Yong Kwon, Kap Su Han, Han Sung Choi, Sung Phil Chung, Gil Joon Suh, Tae Ho Lim, Won Young Kim
BACKGROUND: Septic shock can be defined both by the presence of hyperlactatemia and need of vasopressors. Lactate levels should be measured after volume resuscitation (as per the Sepsis-3 definition). However, currently, no studies have evaluated patients who have been excluded by the new criteria for septic shock. The aim of this study was to determine the clinical characteristics and prognosis of these patients, based on their lactate levels after initial fluid resuscitation. METHODS: This observational study was performed using a prospective, multi-center registry of septic shock, with the participation of 10 hospitals in the Korean Shock Society, between October 2015 and February 2017...
February 24, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29370285/severe-community-acquired-pneumonia-characteristics-and-prognostic-factors-in-ventilated-and-non-ventilated-patients
#4
COMPARATIVE STUDY
Miquel Ferrer, Chiara Travierso, Catia Cilloniz, Albert Gabarrus, Otavio T Ranzani, Eva Polverino, Adamantia Liapikou, Francesco Blasi, Antoni Torres
BACKGROUND: Patients with severe community-acquired pneumonia (SCAP) and life-threatening acute respiratory failure may require invasive mechanical ventilation (IMV). Since use of IMV is often associated with significant morbidity and mortality, we assessed whether patients invasively ventilated would represent a target population for interventions aimed at reducing mortality of SCAP. METHODS: We prospectively recruited consecutive patients with SCAP for 12 years...
2018: PloS One
https://www.readbyqxmd.com/read/29181605/symptomatic-heart-failure-after-transjugular-intrahepatic-portosystemic-shunt-placement-incidence-outcomes-and-predictors
#5
Kunjam Modha, Baljendra Kapoor, Rocio Lopez, Mark J Sands, William Carey
PURPOSE: To assess the incidence of symptomatic heart failure (SHF) occurring after transjugular intrahepatic portosystemic shunt (TIPS) placement, identify potential predictors of SHF, and evaluate clinical presentation and outcomes in cases of post-TIPS SHF. MATERIALS AND METHODS: A prospectively maintained TIPS database was used to identify patients who underwent new TIPS placements at a large urban tertiary care center between 1995 and 2014. SHF was defined as otherwise unexplained new-onset dyspnea, hypoxemia, radiologic pulmonary edema, an increased need for diuretics, or need for intubation within 7 days after TIPS placement...
November 27, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28771567/muscle-oxygenation-as-an-indicator-of-shock-severity-in-patients-with-suspected-severe-sepsis-or-septic-shock
#6
Kenneth A Schenkman, David J Carlbom, Eileen M Bulger, Wayne A Ciesielski, Dana M Fisk, Kellie L Sheehan, Karin M Asplund, Jeremy M Shaver, Lorilee S L Arakaki
PURPOSE: The aim of this pilot study was to evaluate the potential of a new noninvasive optical measurement of muscle oxygenation (MOx) to identify shock severity in patients with suspected sepsis. METHODS: We enrolled 51 adult patients in the emergency department (ED) who presented with possible sepsis using traditional Systematic Inflammatory Response Syndrome criteria or who triggered a "Code Sepsis." Noninvasive MOx measurements were made from the first dorsal interosseous muscles of the hand once potential sepsis/septic shock was identified, as soon as possible after admission to the ED...
2017: PloS One
https://www.readbyqxmd.com/read/28687209/new-sepsis-and-septic-shock-definitions-clinical-implications-and-controversies
#7
REVIEW
Chanu Rhee, Michael Klompas
New sepsis definitions shift emphasis from the systemic inflammatory response syndrome to organ dysfunction, quantified using the Sequential Organ Failure Assessment (SOFA) score. The new definitions also propose Quick SOFA criteria to rapidly identify potentially infected patients at risk for poor outcomes. The diagnosis of septic shock requires vasopressor dependence and increased lactate levels. Strengths of these definitions include their simplicity and clear association with adverse outcomes. However, their utility in identifying patients with serious infections before frank sepsis ensues remains to be seen...
September 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28558733/towards-a-consensus-definition-of-maternal-sepsis-results-of-a-systematic-review-and-expert-consultation
#8
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/28342442/comparison-of-qsofa-and-sirs-for-predicting-adverse-outcomes-of-patients-with-suspicion-of-sepsis-outside-the-intensive-care-unit
#9
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/27637985/ibrutinib-for-patients-with-relapsed-or-refractory-chronic-lymphocytic-leukaemia-with-17p-deletion-resonate-17-a-phase-2-open-label-multicentre-study
#10
MULTICENTER STUDY
Susan O'Brien, Jeffrey A Jones, Steven E Coutre, Anthony R Mato, Peter Hillmen, Constantine Tam, Anders Österborg, Tanya Siddiqi, Michael J Thirman, Richard R Furman, Osman Ilhan, Michael J Keating, Timothy G Call, Jennifer R Brown, Michelle Stevens-Brogan, Yunfeng Li, Fong Clow, Danelle F James, Alvina D Chu, Michael Hallek, Stephan Stilgenbauer
BACKGROUND: The TP53 gene, encoding tumour suppressor protein p53, is located on the short arm of chromosome 17 (17p). Patients with 17p deletion (del17p) chronic lymphocytic leukaemia have poor responses and survival after chemoimmunotherapy. We assessed the activity and safety of ibrutinib, an oral covalent inhibitor of Bruton's tyrosine kinase, in relapsed or refractory patients with del17p chronic lymphocytic leukaemia or small lymphocytic lymphoma. METHODS: We did a multicentre, international, open-label, single-arm study at 40 sites in the USA, Canada, Europe, Australia, and New Zealand...
October 2016: Lancet Oncology
https://www.readbyqxmd.com/read/26903338/the-third-international-consensus-definitions-for-sepsis-and-septic-shock-sepsis-3
#11
Mervyn Singer, Clifford S Deutschman, Christopher Warren Seymour, Manu Shankar-Hari, Djillali Annane, Michael Bauer, Rinaldo Bellomo, Gordon R Bernard, Jean-Daniel Chiche, Craig M Coopersmith, Richard S Hotchkiss, Mitchell M Levy, John C Marshall, Greg S Martin, Steven M Opal, Gordon D Rubenfeld, Tom van der Poll, Jean-Louis Vincent, Derek C Angus
IMPORTANCE: Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination. OBJECTIVE: To evaluate and, as needed, update definitions for sepsis and septic shock. PROCESS: A task force (n = 19) with expertise in sepsis pathobiology, clinical trials, and epidemiology was convened by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine...
February 23, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26903336/developing-a-new-definition-and-assessing-new-clinical-criteria-for-septic-shock-for-the-third-international-consensus-definitions-for-sepsis-and-septic-shock-sepsis-3
#12
REVIEW
Manu Shankar-Hari, Gary S Phillips, Mitchell L Levy, Christopher W Seymour, Vincent X Liu, Clifford S Deutschman, Derek C Angus, Gordon D Rubenfeld, Mervyn Singer
IMPORTANCE: Septic shock currently refers to a state of acute circulatory failure associated with infection. Emerging biological insights and reported variation in epidemiology challenge the validity of this definition. OBJECTIVE: To develop a new definition and clinical criteria for identifying septic shock in adults. DESIGN, SETTING, AND PARTICIPANTS: The Society of Critical Care Medicine and the European Society of Intensive Care Medicine convened a task force (19 participants) to revise current sepsis/septic shock definitions...
February 23, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26903335/assessment-of-clinical-criteria-for-sepsis-for-the-third-international-consensus-definitions-for-sepsis-and-septic-shock-sepsis-3
#13
Christopher W Seymour, Vincent X Liu, Theodore J Iwashyna, Frank M Brunkhorst, Thomas D Rea, André Scherag, Gordon Rubenfeld, Jeremy M Kahn, Manu Shankar-Hari, Mervyn Singer, Clifford S Deutschman, Gabriel J Escobar, Derek C Angus
IMPORTANCE: The Third International Consensus Definitions Task Force defined sepsis as "life-threatening organ dysfunction due to a dysregulated host response to infection." The performance of clinical criteria for this sepsis definition is unknown. OBJECTIVE: To evaluate the validity of clinical criteria to identify patients with suspected infection who are at risk of sepsis. DESIGN, SETTINGS, AND POPULATION: Among 1.3 million electronic health record encounters from January 1, 2010, to December 31, 2012, at 12 hospitals in southwestern Pennsylvania, we identified those with suspected infection in whom to compare criteria...
February 23, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26822963/shockomics-multiscale-approach-to-the-identification-of-molecular-biomarkers-in-acute-heart-failure-induced-by-shock
#14
MULTICENTER STUDY
Federico Aletti, Costanza Conti, Manuela Ferrario, Vicent Ribas, Bernardo Bollen Pinto, Antoine Herpain, Emiel Post, Eduardo Romay Medina, Cristina Barlassina, Eliandre de Oliveira, Roberta Pastorelli, Gabriella Tedeschi, Giuseppe Ristagno, Fabio S Taccone, Geert W Schmid-Schönbein, Ricard Ferrer, Daniel De Backer, Karim Bendjelid, Giuseppe Baselli
BACKGROUND: The ShockOmics study (ClinicalTrials.gov identifier NCT02141607) is a multicenter prospective observational trial aimed at identifying new biomarkers of acute heart failure in circulatory shock, by means of a multiscale analysis of blood samples and hemodynamic data from subjects with circulatory shock. METHODS AND DESIGN: Ninety septic shock and cardiogenic shock patients will be recruited in three intensive care units (ICU) (Hôpital Erasme, Université Libre de Bruxelles, Belgium; Hospital Universitari Mutua Terrassa, Spain; Hôpitaux Universitaires de Genève, Switzerland)...
January 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/26623644/clinical-performance-of-a-new-soluble-cd14-subtype-immunochromatographic-test-for-whole-blood-compared-with-chemiluminescent-enzyme-immunoassay-use-of-quantitative-soluble-cd14-subtype-immunochromatographic-tests-for-the-diagnosis-of-sepsis
#15
Masayuki Sato, Gaku Takahashi, Shigehiro Shibata, Makoto Onodera, Yasushi Suzuki, Yoshihiro Inoue, Shigeatsu Endo
We previously reported that a soluble CD14-subtype (sCD14-ST) immunochromatographic test (ICT) for plasma is more convenient than chemiluminescent enzyme immunoassay (CLEIA), but plasma separation makes bedside measurements difficult. We developed a new sCD14-ST ICT for whole blood and investigated whether quantitative determinations of sCD14-ST by ICT were useful for diagnosing sepsis and severe sepsis/septic shock. We studied 20 patients who fulfilled two or more systemic inflammatory response syndrome (SIRS) criteria and 32 patients who had been diagnosed with sepsis or severe sepsis/septic shock...
2015: PloS One
https://www.readbyqxmd.com/read/26072118/design-and-evaluation-of-new-unified-criteria-for-disseminated-intravascular-coagulation-based-on-the-japanese-association-for-acute-medicine-criteria
#16
Yutaka Umemura, Kazuma Yamakawa, Takeyuki Kiguchi, Yoshiaki Yoshikawa, Hiroshi Ogura, Takeshi Shimazu, Toshimitsu Hamasaki, Satoshi Fujimi
BACKGROUND: Current disseminated intravascular coagulation (DIC) criteria are insufficient for predicting mortality. Hemostatic endothelial molecular markers are useful for DIC diagnoses. We aimed to design new DIC criteria involving these markers based on the recently published Japanese Association for Acute Medicine (JAAM) DIC criteria, which exhibit higher sensitivity for mortality. MATERIALS AND METHODS: Patients with severe sepsis or septic shock admitted to a tertiary referral hospital in Japan between September 2009 and November 2011 were included...
March 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/25568981/single-induction-dose-of-etomidate-versus-other-induction-agents-for-endotracheal-intubation-in-critically-ill-patients
#17
REVIEW
Eric A Bruder, Ian M Ball, Stacy Ridi, William Pickett, Corinne Hohl
BACKGROUND: The use of etomidate for emergency airway interventions in critically ill patients is very common. In one large registry trial, etomidate was the most commonly used agent for this indication. Etomidate is known to suppress adrenal gland function, but it remains unclear whether or not this adrenal gland dysfunction affects mortality. OBJECTIVES: The primary objective was to assess, in populations of critically ill patients, whether a single induction dose of etomidate for emergency airway intervention affects mortality...
January 8, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/24559080/procalcitonin-as-a-marker-of-candida-species-detection-by-blood-culture-and-polymerase-chain-reaction-in-septic-patients
#18
Andrea Cortegiani, Vincenzo Russotto, Francesca Montalto, Grazia Foresta, Giuseppe Accurso, Cesira Palmeri, Santi Maurizio Raineri, Antonino Giarratano
BACKGROUND: The aim of our study is to test procalcitonin (PCT) as surrogate marker of identification of Candida spp. by blood culture (BC) and real-time-polymerase chain reaction (PCR), whether alone or in association with bacteria, in septic patients. METHODS: We performed a single-centre retrospective study. We reviewed the clinical charts of patients with a diagnosis of severe sepsis or septic shock treated at our general intensive care unit from March 2009 to March 2013...
February 21, 2014: BMC Anesthesiology
https://www.readbyqxmd.com/read/24225212/-the-clinical-value-of-atrial-natriuretic-peptide-in-early-diagnosis-of-sepsis
#19
Yue Liu, Qing Li, Jin-jin Li, Bin Geng
OBJECTIVE: To evaluate the clinical value and specificity of atrial natriuretic peptide (ANP) in early diagnosis of sepsis. METHODS: A prospective study was performed. Data of patients with sepsis were consecutively collected from September 2007 to December 2012 according to the international criteria for the diagnosis of sepsis, and that of 114 patients admitted to intensive care unit (ICU) and the cadre health care ward were divided into three groups: systemic inflammatory response syndrome (SIRS) group (n=37), sepsis group (n=41) and severe sepsis group (including severe sepsis and septic shock, n=36)...
November 2013: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/24133545/adult-patients-with-nosocomial-pneumonia-epidemiology-diagnosis-and-treatment
#20
Klaus Dalhoff, Santiago Ewig, Marianne Abele-Horn, Stefan Andreas, Torsten T Bauer, Heike von Baum, Maria Deja, Petra Gastmeier, Sören Gatermann, Herwig Gerlach, Beatrice Grabein, Gert Höffken, Winfried Kern, Evelyn Kramme, Christoph Lange, Joachim Lorenz, Konstantin Mayer, Irit Nachtigall, Matthias Pletz, Gernot Rohde, Simone Rosseau, Bernhard Schaaf, Reiner Schaumann, Dirk Schreiter, Hartwig Schütte, Harald Seifert, Helmut Sitter, Claudia Spies, Tobias Welte
BACKGROUND: Nosocomial pneumonia is among the most common types of infection in hospitalized patients. The increasing prevalence of multi-drug resistant organisms (MDROs) in recent years points to the need for an up-to-date clinical guideline. METHODS: An interdisciplinary S3 guideline was created on the basis of a systematic literature review in the PubMed and Cochrane Library databases, with assessment and grading of the evidence according to the GRADE system...
September 2013: Deutsches Ärzteblatt International
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