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https://www.readbyqxmd.com/read/27908340/end-points-of-sepsis-resuscitation
#1
REVIEW
John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27843749/mortality-markers-in-nosocomial-klebsiella-pneumoniae-bloodstream-infection
#2
Bulent Durdu, Ismail Necati Hakyemez, Sibel Bolukcu, Gulay Okay, Bilge Gultepe, Turan Aslan
PURPOSE: Klebsiella pneumoniae is the most common endogen agent for nosocomial infections. In this study, mortality markers were investigated in patients with nosocomial K. pneumoniae blood stream infection (NKp BSI). METHODS: The characteristics of patients >16 years who had NKp BSI diagnosis by daily active surveillance between January 2012 and January 2016 were retrospectively evaluated. Patients who died until 28th day of the clinical follow up and those who survived until this time were statistically compared in terms of various risk factors...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27822386/correlation-between-arterial-lactate-and-central-venous-lactate-in-children-with-sepsis
#3
Jaime Fernández Sarmiento, Paula Araque, María Yepes, Hernando Mulett, Ximena Tovar, Fabio Rodriguez
Introduction. Lactate is an important indicator of tissue perfusion. The objective of this study is to evaluate if there are significant differences between the arterial and central venous measurement of lactate in pediatric patients with sepsis and/or septic shock. Methods. Longitudinal retrospective observational study. Forty-two patients were included between the age of 1 month and 17 years, with a diagnosis of sepsis and septic shock, who were admitted to the intensive care unit of a university referral hospital...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27777780/initial-central-venous-pressure-could-be-a-prognostic-marker-for-hemodynamic-improvement-of-polymyxin-b-direct-hemoperfusion-a-retrospective-cohort-study
#4
Hiroyuki Yamada, Tatsuo Tsukamoto, Hiromichi Narumiya, Kazumasa Oda, Satoshi Higaki, Ryoji Iizuka, Motoko Yanagita, Masako Deguchi
BACKGROUND: Direct hemoperfusion with polymyxin B-immobilized fiber column (PMX-DHP) could improve the hemodynamic status of septic shock patients. As PMX-DHP is an invasive and costly procedure, it is desirable to estimate the therapeutic effect before performing the therapy. However, it is still unclear when this therapy should be started and what type of sepsis it should be employed for. In this study, we retrospectively examined the clinical effect of patients treated with PMX-DHP by using central venous pressure (CVP)...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27709274/-injuries-to-blood-vessels-near-the-heart-caused-by-central-venous-catheters
#5
J Abram, J Klocker, N Innerhofer-Pompernigg, M Mittermayr, M C Freund, N Gravenstein, V Wenzel
Injuries to blood vessels near the heart can quickly become life-threatening and include arterial injuries during central venous puncture, which can lead to hemorrhagic shock. We report 6 patients in whom injury to the subclavian artery and vein led to life-threatening complications. Central venous catheters are associated with a multitude of risks, such as venous thrombosis, air embolism, systemic or local infections, paresthesia, hemothorax, pneumothorax, and cervical hematoma, which are not always immediately discernible...
October 5, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27652257/the-effect-of-esmolol-on-tissue-perfusion-and-clinical-prognosis-of-patients-with-severe-sepsis-a-prospective-cohort-study
#6
Xiuling Shang, Kaiyu Wang, Jingqing Xu, Shurong Gong, Yong Ye, Kaihua Chen, Fayang Lian, Wei Chen, Rongguo Yu
Purpose. This study was aimed at investigating the effect of esmolol on tissue perfusion and the clinical prognosis of patients with severe sepsis. Materials and Methods. One hundred fifty-one patients with severe sepsis were selected and divided into the esmolol group (n = 75) or the control group (n = 76), who received conventional antiseptic shock treatment. The esmolol group received a continuous infusion of esmolol via a central venous catheter, and their heart rate (HR) was maintained at 70-100 bpm over 72 hours...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27566006/the-role-of-central-venous-oxygen-saturation-blood-lactate-and-central-venous-to-arterial-carbon-dioxide-partial-pressure-difference-as-a-goal-and-prognosis-of-sepsis-treatment
#7
REVIEW
Borwon Wittayachamnankul, Boriboon Chentanakij, Kamphee Sruamsiri, Nipon Chattipakorn
OBJECTIVE: The current practice in treatment of severe sepsis and septic shock is to ensure adequate oxygenation and perfusion in patients, along with prompt administration of antibiotics, within 6 hours from diagnosis, which is considered the "golden hour" for the patients. One of the goals of treatment is to restore normal tissue perfusion. With this goal in mind, some parameters have been used to determine the success of treatment and mortality rate; however, none has been proven to be the best predictor of mortality rate in sepsis patients...
December 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27546746/early-goal-directed-therapy-for-severe-sepsis-and-septic-shock-a-living-systematic-review
#8
Steven Q Simpson, Melissa Gaines, Youness Hussein, Robert G Badgett
: Studies and meta-analyses conflict regarding the use of early goal-directed therapy (EGDT) for septic shock. We sought to clarify the conflict by performing a living systematic review and meta-regression. METHODS: We performed a meta-analysis and explored heterogeneity with meta-regression. We conformed with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and qualified strength of evidence with a Grading of Recommendations Assessment, Development and Evaluation profile...
June 29, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27434562/-measurement-of-brachial-artery-velocity-variation-and-inferior-vena-cava-variability-to-estimate-fluid-responsiveness
#9
Weihua Zhu, Linjun Wan, Xiaohong Wan, Gang Wang, Meixian Su, Gengjin Liao, Qingqing Huang
OBJECTIVE: To investigate the accuracy and feasibility of brachial artery peak velocity variation (ΔVpeakbrach) and inferior vena cava variability (VIVC) as indicators of fluid responsiveness in critically ill patients. METHODS: A single-center prospective observation was conducted. The patients on mechanical ventilation with spontaneously breathing admitted to Department of Critical Care Medicine of the Second Affiliated Hospital of Kunming Medical University from June 2013 to August 2015 were enrolled...
August 2016: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/27416064/high-mortality-in-severe-sepsis-and-septic-shock-patients-with-do-not-resuscitate-orders-in-east-asia
#10
Chun-Ta Huang, Yu-Chung Chuang, Yi-Ju Tsai, Wen-Je Ko, Chong-Jen Yu
BACKGROUND: Severe sepsis is a potentially deadly illness and always requires intensive care. Do-not-resuscitate (DNR) orders remain a debated issue in critical care and limited data exist about its impact on care of septic patients, particularly in East Asia. We sought to assess outcome of severe sepsis patients with regard to DNR status in Taiwan. METHODS: A retrospective cohort study was conducted in intensive care units (ICUs) between 2008 and 2010. All severe sepsis patients were included for analysis...
2016: PloS One
https://www.readbyqxmd.com/read/27411452/efficacy-and-safety-of-esmolol-in-treatment-of-patients-with-septic-shock
#11
Wei Du, Xiao-Ting Wang, Yun Long, Da-Wei Liu
BACKGROUND: Previous studies have suggested that β1-receptor blockers benefit septic shock patients. This study aimed to determine whether β1-receptor blockers benefit tissue perfusion in sepsis and to identify parameters to reduce the risk of this drug in sepsis. METHODS: Consecutive septic shock patients were recruited from the Intensive Care Unit of Peking Union Medical College Hospital within 48 h of diagnosis. All patients were hemodynamically stable and satisfactorily sedated with a heart rate (HR) ≥100 beats/min...
July 20, 2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27401690/nosocomial-candidemia-in-patients-admitted-to-medicine-wards-compared-to-other-wards-a-multicentre-study
#12
Roberto Luzzati, Maria Merelli, Filippo Ansaldi, Chiara Rosin, Annamaria Azzini, Silvia Cavinato, Pierluigi Brugnaro, Claudio Vedovelli, Annamaria Cattelan, Busetti Marina, Giuseppe Gatti, Ercole Concia, Matteo Bassetti
PURPOSE: Risk factors for nosocomial candidemia, severity of sepsis, treatment, and outcome were compared between patients admitted to medicine wards and those to surgical and intensive care units (ICUs). METHODS: Data were retrospectively collected from patients belonging to six referral hospitals in Italy between January 2011 and December 2013. Risk factors for 30-day mortality were evaluated in the whole patient population. RESULTS: A total of 686 patients (mean age 70 ± 15 years) with candidemia were included...
July 11, 2016: Infection
https://www.readbyqxmd.com/read/27363046/endocrine-and-metabolic-alterations-may-underlie-mortality-of-severe-sepsis-and-septic-shock-patients-admitted-to-icu
#13
Abdelbadee Ameen, Marwa Abdel Rehim, Yasser Hassan Shaaban
The study evaluated endocrinal and metabolic response to sepsis and its applicability for the prediction of outcome of septic patients. Patients were 39 adult with severe infections and within 24 h after onset or suspected clinical tissue hypoperfusion. At enrollment patients were evaluated for acute physiology and chronic health evaluation II score (APACHE II) and Glasgow Coma Scale (GCS). Global hemodynamic parameters including systolic blood pressure (SBP), heart rate (HR) and central venous pressure (CVP) were recorded and monitored...
April 2016: Journal of the Egyptian Society of Parasitology
https://www.readbyqxmd.com/read/27316915/french-intensive-care-society-international-congress-r%C3%A3-animation-2016
#14
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27307767/success-of-applying-early-goal-directed-therapy-for-septic-shock-patients-in-the-emergency-department
#15
Panita Worapratya, Apisit Wanjaroenchaisuk, Jutharat Joraluck, Prasit Wuthisuthimethawee
BACKGROUND: Since early goal-directed therapy (EGDT) became standard care in severe sepsis and septic shock patients in intensive care units many years ago, we suppose that the survival rate of severe sepsis and septic shock patients improves if the resuscitative procedure is quickly implemented and is initiated in the emergency room. OBJECTIVE: We aimed at recording emergency department time to improve our patient care system as well as determine the rate at which EGDT goals can be achieved...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27234947/impact-of-compliance-with-a-sepsis-resuscitation-bundle-in-a-portuguese-emergency-department
#16
Joao Miguel Carvas, Cátia Canelas, Gustavo Montanha, Carlos Silva, Francisco Esteves
INTRODUCTION: Severe sepsis and septic shock are common conditions with high levels of morbi-mortality surpassing those of coronary heart disease or stroke. The reality of hospital treated sepsis is largely unknown outside of the intensive care unit. We therefore aimed to evaluate the level of compliance with the Surviving Sepsis Campaign 6-hour bundle in a Portuguese emergency department and to relate it to the patient clinical outcomes. MATERIAL AND METHODS: We conducted a retrospective, observational cohort study with 178 severe sepsis/septic shock patients admitted to the intensive and intermediate care unit between January 1st 2012 and December 31st 2012...
February 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27132457/-improvement-effect-of-early-goal-directed-therapy-on-the-prognosis-in-patients-with-septic-shock
#17
Chang Li, Dong Yun
OBJECTIVE: To evaluate the effect of the early goal-directed therapy (EGDT) on mortality in patients with septic shock, and to analyze the risk factors of mortality. METHODS: A retrospective controlled study was conducted. Complete clinical data of patients with septic shock admitted to emergency intensive care unit (EICU) of Sichuan Provincial People's Hospital from May 1994 to December 2014 were recorded and analyzed. According to the International Guidelines for Management of Severe Sepsis and Septic Shock ( SSC ) with the time of promulgation as dividing point, the patients were divided into two groups as before and after the publication of the guideline, i...
November 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/27073445/application-strategy-of-picco-in-septic-shock-patients
#18
Xiaoyun Liu, Wenli Ji, Jifeng Wang, Tao Pan
Septic shock, also known as infectious or toxic shock, is a medical condition caused by severe infection and sepsis. Early identification, timely diagnosis and effective treatments are imperative to prevent this medical condition. The aim of the present study was to examine the application of pulse index continuous cardiac output (PiCCO) technique in the treatment of septic shock patients. Fifty septic shock patients were randomly divided into the conventional detection group (group C, n=25) and the PiCCO detection group (group P, n=25)...
April 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27054713/prognostic-value-of-lactate-and-central-venous-oxygen-saturation-after-early-resuscitation-in-sepsis-patients
#19
Young Kun Lee, Sung Yeon Hwang, Tae Gun Shin, Ik Joon Jo, Gee Young Suh, Kyeongman Jeon
The objective of this study was to evaluate the prognostic value of static and dynamic variables of central venous oxygen saturation (ScvO2) and lactate in patients with severe sepsis or septic shock who underwent early quantitative resuscitation. We also investigated whether ScvO2 measured after initial resuscitation could provide additive prognostic value to that of lactate. We analyzed the sepsis registry for patients presenting to the emergency department and included patients with simultaneous measurements of lactate and ScvO2 at the time of presentation (H0) and 6 hours (H6) after resuscitation...
2016: PloS One
https://www.readbyqxmd.com/read/27038480/experts-opinion-on-management-of-hemodynamics-in-ards-patients-focus-on-the-effects-of-mechanical-ventilation
#20
REVIEW
A Vieillard-Baron, M Matthay, J L Teboul, T Bein, M Schultz, S Magder, J J Marini
RATIONALE: Acute respiratory distress syndrome (ARDS) is frequently associated with hemodynamic instability which appears as the main factor associated with mortality. Shock is driven by pulmonary hypertension, deleterious effects of mechanical ventilation (MV) on right ventricular (RV) function, and associated-sepsis. Hemodynamic effects of ventilation are due to changes in pleural pressure (Ppl) and changes in transpulmonary pressure (TP). TP affects RV afterload, whereas changes in Ppl affect venous return...
May 2016: Intensive Care Medicine
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