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https://www.readbyqxmd.com/read/29161385/are-we-close-to-the-ideal-intravenous-fluid
#1
N MacDonald, R M Pearse
The approach to i.v. fluid therapy for hypovolaemia may significantly influence outcomes for patients who experience a systemic inflammatory response after sepsis, trauma, or major surgery. Currently, there is no single i.v. fluid agent that meets all the criteria for the ideal treatment for hypovolaemia. The physician must choose the best available agent(s) for each patient, and then decide when and how much to administer. Findings from large randomized trials suggest that some colloid-based fluids, particularly starch-based colloids, may be harmful in some situations, but it is unclear whether they should be withdrawn from use completely...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29160639/predictors-of-mortality-in-neonates-with-giant-omphaloceles
#2
Amulya K Saxena, Maja Raicevic
INTRODUCTION: This analysis was performed a review of giant-omphaloceles to determine the predictors of mortality. EVIDENCE ACQUISITION: Pubmed® and KoBson databases were searched for terms "giant" "omphalocele" and "mortality". Primary end points included mortality correlation with gestational age (GA), birth weight (BW), eviscerated organs, associated anomalies and management. To calculate mean and median values IBM SPSS version 23.0 was used. EVIDENCE SYNTHESIS: After de-duplication and review search revealed 42 articles of which 23 met our inclusion criteria with 396 giant-omphaloceles for this analysis...
November 21, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/29151053/protocol-of-the-sepsivit-study-a-prospective-observational-study-to-determine-whether-continuous-heart-rate-variability-measurement-during-the-first-48-hours-of-hospitalisation-provides-an-early-warning-for-deterioration-in-patients-presenting-with-infection
#3
Vincent M Quinten, Matijs van Meurs, Maurits H Renes, Jack J M Ligtenberg, Jan C Ter Maaten
INTRODUCTION: One in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an early warning for deterioration in patients presenting with suspected infection or sepsis to the emergency department (ED). METHODS AND ANALYSIS: The protocol of a prospective observational study in the ED...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150856/defining-sepsis-on-the-wards-results-of-a-multi-centre-point-prevalence-study-comparing-two-sepsis-definitions
#4
T Szakmany, R Pugh, M Kopczynska, R M Lundin, B Sharif, P Morgan, G Ellis, J Abreu, S Kulikouskaya, K Bashir, L Galloway, H Al-Hassan, T Grother, P McNulty, S T Seal, A Cains, M Vreugdenhil, M Abdimalik, N Dennehey, G Evans, J Whitaker, E Beasant, C Hall, M Lazarou, C V Vanderpump, K Harding, L Duffy, A Guerrier Sadler, R Keeling, C Banks, S W Y Ng, S Y Heng, D Thomas, E W Puw, I Otahal, C Battle, O Minik, R A Lyons, J E Hall
Our aim was to prospectively determine the predictive capabilities of SEPSIS-1 and SEPSIS-3 definitions in the emergency departments and general wards. Patients with National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled over a 24-h period in 13 Welsh hospitals. The primary outcome measure was mortality within 30 days. Out of the 5422 patients screened, 431 fulfilled inclusion criteria and 380 (88%) were recruited. Using the SEPSIS-1 definition, 212 patients had sepsis...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29149975/clinical-outcomes-of-living-liver-transplantation-according-to-the-presence-of-sarcopenia-as-defined-by-skeletal-muscle-mass-hand-grip-and-gait-speed
#5
N Harimoto, T Yoshizumi, T Izumi, T Motomura, N Harada, S Itoh, T Ikegami, H Uchiyama, Y Soejima, A Nishie, T Kamishima, R Kusaba, K Shirabe, Y Maehara
BACKGROUND: Sarcopenia is an independent predictor of death after living-donor liver transplantation (LDLT). However, the ability of the Asian Working Group for Sarcopenia criteria for sarcopenia (defined as reduced skeletal muscle mass plus low muscle strength) to predict surgical outcomes in patients who have undergone LDLT has not been determined. METHODS: This study prospectively enrolled 366 patients who underwent LDLT at Kyushu University Hospital. Skeletal muscle area (determined by computed tomography), hand-grip strength, and gait speed were measured in 102 patients before LDLT...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29148638/factors-associated-with-treatment-outcome-of-pediatric-cancerpatients-admitted-with-febrile-neutropenia-in-tikuranbessa-specialized-teaching-hospital-addis-ababa-ethiopia
#6
Selamawit Assefa, Tinsae Alemayehu, Workeabeba Abebe
Background: Cancer treatment is associated with variable degrees of myelosupression. Infection is often a life-threatening complication of chemotherapy-induced neutropenia, and it is also considered an oncologic emergency. Febrile neutropenia is a common, costly and potentially fatal complication in oncology. Objective: To assess factors affecting treatment outcome of cancer patients with chemotherapy induced febrile neutropenia. Method: We conducted a review of records of pediatric patients hospitalized and treated for chemotherapy-induced febrile neutropenia from January 1, 2013 to December 31, 2013 and met the selection criteria...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29138874/using-il-6-concentrations-in-the-first-24%C3%A2-h-following-trauma-to-predict-immunological-complications-and-mortality-in-trauma-patients-a-meta-analysis
#7
REVIEW
Zhi Qiao, Weikang Wang, Luxu Yin, Peng Luo, Johannes Greven, Klemens Horst, Frank Hildebrand
PURPOSE: In previous studies, interleukin-6 (IL-6) has been shown to have a high predictive value for the development of complications and mortality after trauma; however, there is some uncertainty around these results. The aim of this meta-analysis was to assess the value of early IL-6 levels (within the first 24 h after trauma) for predicting post-traumatic complications [acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome (SIRS), sepsis, multiple organ failure (MOF), and multiple organ dysfunction syndrome (MODS)] and mortality...
November 14, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#8
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29135829/chikungunya-virus-infections-among-infants-who-classification-not-applicable
#9
Veronique van Keulen, Minke Huibers, Meindert Manshande, Michaël Boele van Hensbroek, Linda van Rooij
Chikungunya virus (ChikV) caused an epidemic on Curaçao in 2014-2015. Infants are highly at risk for clinical syndromes as sepsis-like illness and central nervous system disease. Clinical recognition is important if laboratory test, polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA), are not available. The World Health Organization (WHO) created criteria for identification of probable ChikV. None of the studied infants met these criteria. We believe the WHO suggested criteria should be modified for infants...
November 11, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29133019/frequency-and-significance-of-qsofa-criteria-during-adult-rapid-response-team-reviews-a-prospective-cohort-study
#10
Maurice LeGuen, Yvonne Ballueer, Richard McKay, Glenn Eastwood, Rinaldo Bellomo, Daryl Jones
AIM: A new definition of sepsis released by an international task-force has introduced the concept of quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA). This study aimed to measure the proportion of patients who fulfilled qSOFA criteria during a Rapid Response Team (RRT) review and to assess their associated outcomes. METHODS: We conducted a prospective study of adult RRT reviews over a one month period between 6th June and 10th July 2016 in a large tertiary hospital in Melbourne Australia RESULTS: Over a one-month period, there were 282 RRT reviews, 258 of which were included...
November 11, 2017: Resuscitation
https://www.readbyqxmd.com/read/29132513/sepsis-and-septic-shock-strategies
#11
REVIEW
Bracken A Armstrong, Richard D Betzold, Addison K May
Three therapeutic principles most substantially improve organ dysfunction and survival in sepsis: early, appropriate antimicrobial therapy; restoration of adequate cellular perfusion; timely source control. The new definitions of sepsis and septic shock reflect the inadequate sensitivity, specify, and lack of prognostication of systemic inflammatory response syndrome criteria. Sequential (sepsis-related) organ failure assessment more effectively prognosticates in sepsis and critical illness. Inadequate cellular perfusion accelerates injury and reestablishing perfusion limits injury...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29130825/late-preterm-infants-early-term-infants-and-timing-of-elective-deliveries-current-status-in-a-korean-medical-center
#12
Hyun Suna Ko, Yu-Ria Jang, Hanggooa Yun, Jeonga Ha Wie, Sae Kyunga Choi, In Yanga Park, Jong Chula Shin
OBJECTIVE: The aim of this study was to examine the current perinatal outcomes among infants born late preterm and early term compared to those born full term and evaluate the optimal gestational age for delivery. METHODS: We performed a retrospective cohort study for births occurred at Seoul St. Mary's Hospital over the past 7 years. Statistical comparison was performed using χ(2) test and multivariable logistic regression models. RESULTS: A total of 7580 women met the study criteria...
November 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29127841/comparison-of-the-performance-of-sofa-qsofa-and-sirs-for-predicting-mortality-and-organ-failure-among-sepsis-patients-admitted-to-the-intensive-care-unit-in-a-middle-income-country
#13
Bodin Khwannimit, Rungsun Bhurayanontachai, Veerapong Vattanavanit
INTRODUCTION: The Sepsis-3 definition provides a change of two or more scores from zero or a known baseline of the Sequential Organ Failure Assessment (SOFA) as criteria of sepsis. The aim of this study was to compare the SOFA score and the quick SOFA (qSOFA) to Systemic Inflammatory Response Syndrome (SIRS) criteria in predictive ability of mortality and organ failure. METHODS: A-10year retrospective cohort study was conducted in a teaching hospital in Thailand...
October 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29121281/epidemiology-of-sepsis-and-septic-shock-in-critical-care-units-comparison-between-sepsis-2-and-sepsis-3-populations-using-a-national-critical-care-database
#14
M Shankar-Hari, D A Harrison, G D Rubenfeld, K Rowan
Background: New sepsis and septic shock definitions could change the epidemiology of sepsis because of differences in criteria. We therefore compared the sepsis populations identified by the old and new definitions. Methods: We used a high-quality, national, intensive care unit (ICU) database of 654 918 consecutive admissions to 189 adult ICUs in England, from January 2011 to December 2015. Primary outcome was acute hospital mortality. We compared old (Sepsis-2) and new (Sepsis-3) incidence, outcomes, trends in outcomes, and predictive validity of sepsis and septic shock populations...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29117331/neurodevelopmental-impairment-in-children-after-group-b-streptococcal-disease-worldwide-systematic-review-and-meta-analyses
#15
Maya Kohli-Lynch, Neal J Russell, Anna C Seale, Ziyaad Dangor, Cally J Tann, Carol J Baker, Linda Bartlett, Clare Cutland, Michael G Gravett, Paul T Heath, Margaret Ip, Kirsty Le Doare, Shabir A Madhi, Craig E Rubens, Samir K Saha, Stephanie Schrag, Ajoke Sobanjo-Ter Meulen, Johan Vekemans, Catherine O'Sullivan, Firdose Nakwa, Hechmi Ben Hamouda, Habib Soua, Kyriaki Giorgakoudi, Shamez Ladhani, Theresa Lamagni, Hilary Rattue, Caroline Trotter, Joy E Lawn
Background: Survivors of infant group B streptococcal (GBS) disease are at risk of neurodevelopmental impairment (NDI), a burden not previously systematically quantified. This is the 10th of 11 articles estimating the burden of GBS disease. Here we aimed to estimate NDI in survivors of infant GBS disease. Methods: We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus) and sought unpublished data on the risk of NDI after invasive GBS disease in infants <90 days of age...
November 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29113409/phase-i-clinical-trial-of-axl1717-for-treatment-of-relapsed-malignant-astrocytomas-analysis-of-dose-and-response
#16
Robert Aiken, Magnus Axelson, Johan Harmenberg, Maria Klockare, Olle Larsson, Cecilia Wassberg
Purpose: Early phase I study of safety of AXL1717 in patients with recurrent or progressive malignant astrocytomas and evaluation of preliminary anti-tumor efficacy. Patients and methods: Nine patients fulfilling the set criteria were enrolled. Eight had recurrent glioblastoma and one gliosarcoma. Patients were treated with an oral suspension of AXL1717 (215-400 mg bid) cycle-by-cycle in 35-day cycles (28 days bid and 7 days off). Patients with progressive disease and/or toxicity-related dose delay of more than 14 days were withdrawn...
October 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/29112081/predictors-prevalence-and-outcomes-of-early-crystalloid-responsiveness-among-initially-hypotensive-patients-with-sepsis-and-septic-shock
#17
Daniel E Leisman, Martin E Doerfler, Sandra M Schneider, Kevin D Masick, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The prevalence of responsiveness to initial fluid challenge among hypotensive sepsis patients is unclear. To avoid fluid overload, and unnecessary treatment, it is important to differentiate these phenotypes. We aimed to 1) determine the proportion of hypotensive sepsis patients sustaining favorable hemodynamic response after initial fluid challenge, 2) determine demographic and clinical risk factors that predicted refractory hypotension, and 3) assess the association between timeliness of fluid resuscitation and refractoriness...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29110830/long-term-outcomes-of-pediatric-intestinal-failure
#18
Brenna S Fullerton, Charles R Hong, Tom Jaksic
Management of pediatric intestinal failure has evolved in recent decades, with improved survival since the advent of specialized multidisciplinary intestinal failure centers. Though sepsis and intestinal failure associated liver disease still contribute to mortality, we now have growing data on the long-term outcomes for this population. While intestinal adaptation and parenteral nutrition weaning is most rapid during the first year on parenteral support, achievement of enteral autonomy is possible even after many years as energy and protein requirements decline dramatically with age...
October 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29100618/incidence-and-evolution-of-sepsis-induced-cardiomyopathy-in-a-cohort-of-patients-with-sepsis-and-septic-shock
#19
I Narváez, A Canabal, C Martín, M Sánchez, A Moron, J Alcalá, S Giacoman, M Magro
OBJETIVE: The aim of this study was to establish the incidence of septic cardiomyopathy (SM) in patients with sepsis and septic shock, to describe its characteristics and testing its evolution. DESIGN: Prospective cohort study. PARTICIPANTS: We included 57 consecutive patients admitted to Intensive Care Unit, who met criteria of sepsis and septic shock. PRINCIPAL VARIABLES OF INTEREST: Clinical and biochemical variables were analyzed...
October 31, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29100549/low-sensitivity-of-qsofa-sirs-criteria-and-sepsis-definition-to-identify-infected-patients-at-risk-of-complication-in-the-prehospital-setting-and-at-the-emergency-department-triage
#20
Selin Tusgul, Pierre-Nicolas Carron, Bertrand Yersin, Thierry Calandra, Fabrice Dami
BACKGROUND: Sepsis is defined as life-threatening organ dysfunction caused by a host response to infection. The quick SOFA (qSOFA) score has been recently proposed as a new bedside clinical score to identify patients with suspected infection at risk of complication (intensive care unit (ICU) admission, in-hospital mortality). The aim of this study was to measure the sensitivity of the qSOFA score, SIRS criteria and sepsis definitions to identify the most serious sepsis cases in the prehospital setting and at the emergency department (ED) triage...
November 3, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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