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The Third International Consensus Definitions for Sepsis and Septic Shock

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https://www.readbyqxmd.com/read/29467017/adjunctive-ulinastatin-in-sepsis-treatment-in-china-adjust-study-study-protocol-for-a-randomized-controlled-trial
#1
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/29447109/sepsis-2018-definitions-and-guideline-changes
#2
Lena M Napolitano
BACKGROUND: Sepsis is a global healthcare issue and continues to be the leading cause of death from infection. Early recognition and diagnosis of sepsis is required to prevent the transition into septic shock, which is associated with a mortality rate of 40% or more. DISCUSSION: New definitions for sepsis and septic shock (Third International Consensus Definitions for Sepsis and Septic Shock [Sepsis-3]) have been developed. A new screening tool for sepsis (quick Sequential Organ Failure Assessment [qSOFA]) has been proposed to predict the likelihood of poor outcome in out-of-intensive care unit (ICU) patients with clinical suspicion of sepsis...
February 2018: Surgical Infections
https://www.readbyqxmd.com/read/29394149/outcomes-of-surgical-sepsis
#3
Philip S Barie
BACKGROUND: Discussion of outcomes of surgical sepsis is no longer straightforward. Definitions of sepsis have changed recently and updated data are scant. Surgical patient populations are often heterogeneous; the patient population being considered must be described with precision. Traditional 30-d operative mortality may not be the most relevant outcome to consider. What should change or be the emphasis going forward? METHODS: Review and synthesis of pertinent English-language literature...
February 2018: Surgical Infections
https://www.readbyqxmd.com/read/29364019/nice-guidance-on-sepsis-is-of-limited-value-in-postoperative-colorectal-patients-the-scores-that-cry-wolf
#4
COMPARATIVE STUDY
Pjj Herrod, M Cox, H Keevil, Kje Smith, J N Lund
Background and aims Late recognition of sepsis and consequent death remains a problem. To address this, the National Institute for Health and Care Excellence has published updated guidance recommending the use of the Quick Sequential Organ Failure Assessment (Q-SOFA) score when assessing patients at risk of sepsis following the publication of the Third International Consensus Definitions for Sepsis and Septic Shock. The trauma from major surgery produces a systemic inflammatory response syndrome (SIRS) postoperatively as part of its natural history, which may falsely trigger scoring systems...
April 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#5
Mary Beth Flynn Makic, Elizabeth Bridges
: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence. The SSC guidelines have been updated every four years, with the most recent update completed in 2016...
February 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29023361/procalcitonin-and-mr-proadrenomedullin-combination-with-sofa-and-qsofa-scores-for-sepsis-diagnosis-and-prognosis-a-diagnostic-algorithm
#6
Silvia Spoto, Eleonora Cella, Marina de Cesaris, Luciana Locorriere, Silvia Mazzaroppi, Edoardo Nobile, Arcangela M Lanotte, Lucia Pedicino, Marta Fogolari, Sebastiano Costantino, Giordano Dicuonzo, Massimo Ciccozzi, Silvia Angeletti
PURPOSE: The third Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as an organ dysfunction consequent to infection. A SOFA score ≥2 identifies sepsis. In this study, PCT and MR-proADM were evaluated along with SOFA and qSOFA scores in patients with sepsis or septic shock. METHODS: One hundred and nine septic patients and 50 patients with non-infectious disease admitted at the Department of Internal Medicine and General Surgery of the University Hospital Campus Bio-Medico of Rome were enrolled...
October 11, 2017: Shock
https://www.readbyqxmd.com/read/28903154/incidence-and-trends-of-sepsis-in-us-hospitals-using-clinical-vs-claims-data-2009-2014
#7
COMPARATIVE STUDY
Chanu Rhee, Raymund Dantes, Lauren Epstein, David J Murphy, Christopher W Seymour, Theodore J Iwashyna, Sameer S Kadri, Derek C Angus, Robert L Danner, Anthony E Fiore, John A Jernigan, Greg S Martin, Edward Septimus, David K Warren, Anita Karcz, Christina Chan, John T Menchaca, Rui Wang, Susan Gruber, Michael Klompas
Importance: Estimates from claims-based analyses suggest that the incidence of sepsis is increasing and mortality rates from sepsis are decreasing. However, estimates from claims data may lack clinical fidelity and can be affected by changing diagnosis and coding practices over time. Objective: To estimate the US national incidence of sepsis and trends using detailed clinical data from the electronic health record (EHR) systems of diverse hospitals. Design, Setting, and Population: Retrospective cohort study of adult patients admitted to 409 academic, community, and federal hospitals from 2009-2014...
October 3, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28841902/markers-of-acute-kidney-injury-in-patients-with-sepsis-the-role-of-soluble-thrombomodulin
#8
Shinshu Katayama, Shin Nunomiya, Kansuke Koyama, Masahiko Wada, Toshitaka Koinuma, Yuya Goto, Ken Tonai, Jun Shima
BACKGROUND: Endothelial activation and damage occur early during sepsis, with activated coagulopathy and playing a major role in the pathophysiology of sepsis-induced acute kidney injury (AKI). The aim of this study was to compare the various biomarkers of endothelial injury with the biomarkers of coagulation and inflammation and to determine a significant predictor of AKI in patients with sepsis. METHODS: We conducted a single-center, retrospective, observational study on patients with sepsis fulfilling the Third International Consensus Definitions for Sepsis and Septic Shock criteria admitted to an adult intensive care unit (ICU) at a university hospital from June 2011 to December 2016...
August 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28783810/adaptation-and-validation-of-a-pediatric-sequential-organ-failure-assessment-score-and-evaluation-of-the-sepsis-3-definitions-in-critically-ill-children
#9
Travis J Matics, L Nelson Sanchez-Pinto
Importance: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) uses the Sequential Organ Failure Assessment (SOFA) score to grade organ dysfunction in adult patients with suspected infection. However, the SOFA score is not adjusted for age and therefore not suitable for children. Objectives: To adapt and validate a pediatric version of the SOFA score (pSOFA) in critically ill children and to evaluate the Sepsis-3 definitions in patients with confirmed or suspected infection...
October 2, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28601273/potential-impact-of-the-2016-consensus-definitions-of-sepsis-and-septic-shock-on-future-sepsis-research
#10
Sandra L Peake, Anthony Delaney, Michael Bailey, Rinaldo Bellomo
STUDY OBJECTIVE: The influence of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) on the conduct of future sepsis research is unknown. We seek to examine the potential effect of the new definitions on the identification and outcomes of patients enrolled in a sepsis trial. METHODS: This was a post hoc analysis of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial of early goal-directed therapy that recruited 1,591 adult patients presenting to the emergency department (ED) with early septic shock diagnosed by greater than or equal to 2 systemic inflammatory response syndrome criteria and either refractory hypotension or hyperlactatemia...
October 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28558733/towards-a-consensus-definition-of-maternal-sepsis-results-of-a-systematic-review-and-expert-consultation
#11
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/28550994/prospective-validation-of-a-near-real-time-ehr-integrated-automated-sofa-score-calculator
#12
Christopher Aakre, Pablo Moreno Franco, Micaela Ferreyra, Jaben Kitson, Man Li, Vitaly Herasevich
OBJECTIVES: We created an algorithm for automated Sequential Organ Failure Assessment (SOFA) score calculation within the Electronic Health Record (EHR) to facilitate detection of sepsis based on the Third International Consensus Definitions for Sepsis and Septic Shock (SEPSIS-3) clinical definition. We evaluated the accuracy of near real-time and daily automated SOFA score calculation compared with manual score calculation. METHODS: Automated SOFA scoring computer programs were developed using available EHR data sources and integrated into a critical care focused patient care dashboard at Mayo Clinic in Rochester, Minnesota...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28542029/the-impact-of-the-sepsis-3-septic-shock-definition-on-previously-defined-septic-shock-patients
#13
MULTICENTER STUDY
Sarah A Sterling, Michael A Puskarich, Andrew F Glass, Faheem Guirgis, Alan E Jones
OBJECTIVE: The Third International Consensus Definitions Task Force (Sepsis-3) recently recommended changes to the definitions of sepsis. The impact of these changes remains unclear. Our objective was to determine the outcomes of patients meeting Sepsis-3 septic shock criteria versus patients meeting the "old" (1991) criteria of septic shock only. DESIGN: Secondary analysis of two clinical trials of early septic shock resuscitation. SETTING: Large academic emergency departments in the United States...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28497242/-new-sepsis-3-definition-do-we-have-to-treat-sepsis-before-we-can-diagnose-it-from-now-on
#14
T Schmoch, M Bernhard, F Uhle, M Gründling, T Brenner, M A Weigand
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) have been available since the beginning of 2016. SEPSIS-3 completely replaces the old SIRS criteria in the definition of sepsis and defines sepsis from now on as "life-threatening organ dysfunction caused by a dysregulated host response to infection". However, it seems questionable whether in clinical practice the new definition is really superior to the old one. The most important question is the following: Is it helpful to have a definition that first recognizes a patient once organ dysfunction has occurred and the patient already needs intensive care?...
August 2017: Der Anaesthesist
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
#15
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/28286656/are-you-ernest-shackleton-the-polar-explorer-refining-the-criteria-for-delirium-and-brain-dysfunction-in-sepsis
#16
EDITORIAL
Frank Anthony Rasulo, Giuseppe Bellelli, Eugene Wesley Ely, Alessandro Morandi, Pratik Pandharipande, Nicola Latronico
The Third International Consensus Definitions for Sepsis and Septic Shock has recently defined sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunctions in this consensus definition were identified as an organ-specific Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score ≥ 2 points. The quick SOFA (qSOFA) considers altered mentation indicating brain dysfunction when the Glasgow Coma Scale (GCS) score is ≤13 or ≤14. However, concern has been expressed that the revised criteria may lead to a failure in recognizing the signs of potentially lethal organ dysfunction and thus sepsis...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28268067/application-of-the-third-international-consensus-definitions-for-sepsis-sepsis-3-classification-a-retrospective-population-based-cohort-study
#17
John P Donnelly, Monika M Safford, Nathan I Shapiro, John W Baddley, Henry E Wang
BACKGROUND: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) present clinical criteria for the classification of patients with sepsis. We investigated incidence and long-term outcomes of patients diagnosed with these classifications, which are currently unknown. METHODS: We did a retrospective analysis using data from 30 239 participants from the USA who were aged at least 45 years and enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort...
June 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28262318/an-emergency-department-validation-of-the-sep-3-sepsis-and-septic-shock-definitions-and-comparison-with-1992-consensus-definitions
#18
Daniel J Henning, Michael A Puskarich, Wesley H Self, Michael D Howell, Michael W Donnino, Donald M Yealy, Alan E Jones, Nathan I Shapiro
STUDY OBJECTIVE: The Third International Consensus Definitions Task Force (SEP-3) proposed revised criteria defining sepsis and septic shock. We seek to evaluate the performance of the SEP-3 definitions for prediction of inhospital mortality in an emergency department (ED) population and compare the performance of the SEP-3 definitions to that of the previous definitions. METHODS: This was a secondary analysis of 3 prospectively collected, observational cohorts of infected ED subjects aged 18 years or older...
October 2017: Annals of Emergency Medicine
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
#19
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...
January 17, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27599399/prognostic-value-of-neglected-biomarker-in-sepsis-patients-with-the-old-and-new-criteria-predictive-role-of-lactate-dehydrogenase
#20
Ali Duman, Ayhan Akoz, Mucahit Kapci, Mevlut Ture, Serhat Orun, Kıvanc Karaman, Kenan Ahmet Turkdogan
OBJECTIVES: This study examined the pH, lactate dehydrogenase (LDH), and heart rate values on the first day of hospitalization in patients with a prediagnosis of sepsis and biomarkers that may predict mortality. METHODS: Patients hospitalized in an emergency intensive care unit with a diagnosis of systemic inflammatory response syndrome were classified as having sepsis (n = 28), septic shock (n = 8), or severe sepsis (n = 8) according to International Sepsis Guidelines (old criteria)...
November 2016: American Journal of Emergency Medicine
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