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Septic shock

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25 papers 1000+ followers
By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
https://www.readbyqxmd.com/read/27423462/qsofa-does-not-replace-sirs-in-the-definition-of-sepsis
#1
Jean-Louis Vincent, Greg S Martin, Mitchell M Levy
No abstract text is available yet for this article.
July 17, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27229641/sepsis-resuscitation-fluid-choice-and-dose
#2
REVIEW
Matthew W Semler, Todd W Rice
Sepsis is a common and life-threatening inflammatory response to severe infection treated with antibiotics and fluid resuscitation. Despite the central role of intravenous fluid in sepsis management, fundamental questions regarding which fluid and in what amount remain unanswered. Recent advances in understanding the physiologic response to fluid administration, and large clinical studies examining resuscitation strategies, fluid balance after resuscitation, colloid versus crystalloid solutions, and high- versus low-chloride crystalloids, inform the current approach to sepsis fluid management and suggest areas for future research...
June 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27011791/sepsis-induced-myocardial-dysfunction-pathophysiology-and-management
#3
REVIEW
Yasuyuki Kakihana, Takashi Ito, Mayumi Nakahara, Keiji Yamaguchi, Tomotsugu Yasuda
Sepsis is aggravated by an inappropriate immune response to invading microorganisms, which occasionally leads to multiple organ failure. Several lines of evidence suggest that the ventricular myocardium is depressed during sepsis with features of diastolic dysfunction. Potential candidates responsible for septic cardiomyopathy include pathogen-associated molecular patterns (PAMPs), cytokines, and nitric oxide. Extracellular histones and high-mobility group box 1 that function as endogenous damage-associated molecular patterns (DAMPs) also contribute to the myocardial dysfunction associated with sepsis...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27217054/sepsis-pathophysiology-and-clinical-management
#4
REVIEW
Jeffrey E Gotts, Michael A Matthay
Sepsis, severe sepsis, and septic shock represent increasingly severe systemic inflammatory responses to infection. Sepsis is common in the aging population, and it disproportionately affects patients with cancer and underlying immunosuppression. In its most severe form, sepsis causes multiple organ dysfunction that can produce a state of chronic critical illness characterized by severe immune dysfunction and catabolism. Much has been learnt about the pathogenesis of sepsis at the molecular, cell, and intact organ level...
May 23, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27085369/association-of-fluid-resuscitation-initiation-within-30-minutes-of%C3%A2-severe-sepsis-and-septic-shock-recognition-with-reduced%C3%A2-mortality-and-length-of-stay
#5
Daniel Leisman, Benjamin Wie, Martin Doerfler, Andrea Bianculli, Mary Frances Ward, Meredith Akerman, John K D'Angelo, Jason A Zemmel D'Amore
STUDY OBJECTIVE: We evaluate the association of intravenous fluid resuscitation initiation within 30 minutes of severe sepsis or septic shock identification in the emergency department (ED) with inhospital mortality and hospital length of stay. We also compare intravenous fluid resuscitation initiated at various times from severe sepsis or septic shock identification's association with the same outcomes. METHODS: This was a review of a prospective, observational cohort of all ED severe sepsis or septic shock patients during 13 months, captured in a performance improvement database at a single, urban, tertiary care facility (90,000 ED visits/year)...
September 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26903338/the-third-international-consensus-definitions-for-sepsis-and-septic-shock-sepsis-3
#6
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/26877875/prognostic-utility-of-plasma-lactate-measured-between-24-and-48%C3%A2-h-after-initiation-of-early-goal-directed-therapy-in-the-management-of-sepsis-severe-sepsis-and-septic-shock
#7
Jason Chertoff, Michael Chisum, Lauren Simmons, Brent King, Michael Walker, Jorge Lascano
BACKGROUND: Based on the proven efficacy of lactate in predicting mortality and morbidity in sepsis when measured early in the resuscitative protocol, our group hypothesized that this utility extends later in the course of care. This study sought to investigate the prognostic potential of plasma lactate clearance measured 24-48 h after the initiation of treatment for nonsurgical patients with sepsis, severe sepsis, and septic shock. METHODS: Plasma lactate values, measured 24-48 h after the initiation of treatment, were collected in nonsurgical septic, severe septic, and septic shock patients...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/26821106/sepsis-kills-early-intervention-saves-lives
#8
MULTICENTER STUDY
Anthony R Burrell, Mary-Louise McLaws, Mary Fullick, Rosemary B Sullivan, Doungkamol Sindhusake
OBJECTIVE: To implement a statewide program for the early recognition and treatment of sepsis in New South Wales, Australia. SETTING: Ninety-seven emergency departments in NSW hospitals. INTERVENTION: A quality improvement program (SEPSIS KILLS) that promoted intervention within 60 minutes of recognition, including taking of blood cultures, measuring serum lactate levels, administration of intravenous antibiotics, and fluid resuscitation. MAIN OUTCOME MEASURES: Time to antibiotics and fluid resuscitation; mortality rates and length of stay...
February 1, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/26722156/frequency-of-fluid-overload-and-usefulness-of-bioimpedance-in-patients-requiring-intensive-care-for-sepsis-syndromes
#9
Timothy R Larsen, Gurbir Singh, Victor Velocci, Mohamed Nasser, Peter A McCullough
Guideline-directed therapy for sepsis calls for early fluid resuscitation. Often patients receive large volumes of intravenous fluids. Bioimpedance vector analysis (BIVA) is a noninvasive technique useful for measuring total body water. In this prospective observational study, we enrolled 18 patients admitted to the intensive care unit for the treatment of sepsis syndromes. Laboratory data, clinical parameters, and BIVA were recorded daily. All but one patient experienced volume overload during the course of treatment...
January 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/26370823/impact-of-intravenous-fluid-composition-on-outcomes-in-patients-with-systemic-inflammatory-response-syndrome
#10
Andrew D Shaw, Carol R Schermer, Dileep N Lobo, Sibyl H Munson, Victor Khangulov, David K Hayashida, John A Kellum
INTRODUCTION: Intravenous (IV) fluids may be associated with complications not often attributed to fluid type. Fluids with high chloride concentrations such as 0.9 % saline have been associated with adverse outcomes in surgery and critical care. Understanding the association between fluid type and outcomes in general hospitalized patients may inform selection of fluid type in clinical practice. We sought to determine if the type of IV fluid administered to patients with systemic inflammatory response syndrome (SIRS) is associated with outcome...
September 12, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26563763/fluid-strategies-and-outcomes-in-patients-with-acute-respiratory-distress-syndrome-systemic-inflammatory-response-syndrome-and-sepsis-a-protocol-for-a-systematic-review-and-meta-analysis
#11
REVIEW
Jonathan A Silversides, Andrew J Ferguson, Daniel F McAuley, Bronagh Blackwood, John C Marshall, Eddy Fan
BACKGROUND: Fluid administration to critically ill patients remains the subject of considerable controversy. While intravenous fluid given for resuscitation may be life-saving, a positive fluid balance over time is associated with worse outcomes in critical illness. The aim of this systematic review is to summarise the existing evidence regarding the relationship between fluid administration or balance and clinically important patient outcomes in critical illness. METHODS: We will search Medline, EMBASE, the Cochrane Central Register of Controlled Trials from 1980 to the present and key conference proceedings from 2009 to the present...
November 12, 2015: Systematic Reviews
https://www.readbyqxmd.com/read/26067924/vasopressor-and-inotrope-use-in-canadian-emergency-departments-evidence-based-consensus-guidelines
#12
REVIEW
Dennis Djogovic, Shavaun MacDonald, Andrea Wensel, Rob Green, Osama Loubani, Patrick Archambault, Simon Bordeleau, David Messenger, Adam Szulewski, Jon Davidow, Janeva Kircher, Sara Gray, Katherine Smith, James Lee, Jean Marc Benoit, Dan Howes
No abstract text is available yet for this article.
February 2015: CJEM
https://www.readbyqxmd.com/read/25270275/lower-versus-higher-hemoglobin-threshold-for-transfusion-in-septic-shock
#13
RANDOMIZED CONTROLLED TRIAL
Lars B Holst, Nicolai Haase, Jørn Wetterslev, Jan Wernerman, Anne B Guttormsen, Sari Karlsson, Pär I Johansson, Anders Aneman, Marianne L Vang, Robert Winding, Lars Nebrich, Helle L Nibro, Bodil S Rasmussen, Johnny R M Lauridsen, Jane S Nielsen, Anders Oldner, Ville Pettilä, Maria B Cronhjort, Lasse H Andersen, Ulf G Pedersen, Nanna Reiter, Jørgen Wiis, Jonathan O White, Lene Russell, Klaus J Thornberg, Peter B Hjortrup, Rasmus G Müller, Morten H Møller, Morten Steensen, Inga Tjäder, Kristina Kilsand, Suzanne Odeberg-Wernerman, Brit Sjøbø, Helle Bundgaard, Maria A Thyø, David Lodahl, Rikke Mærkedahl, Carsten Albeck, Dorte Illum, Mary Kruse, Per Winkel, Anders Perner
BACKGROUND: Blood transfusions are frequently given to patients with septic shock. However, the benefits and harms of different hemoglobin thresholds for transfusion have not been established. METHODS: In this multicenter, parallel-group trial, we randomly assigned patients in the intensive care unit (ICU) who had septic shock and a hemoglobin concentration of 9 g per deciliter or less to receive 1 unit of leukoreduced red cells when the hemoglobin level was 7 g per deciliter or less (lower threshold) or when the level was 9 g per deciliter or less (higher threshold) during the ICU stay...
October 9, 2014: New England Journal of Medicine
https://www.readbyqxmd.com/read/24108526/effect-of-heart-rate-control-with-esmolol-on-hemodynamic-and-clinical-outcomes-in-patients-with-septic-shock-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Andrea Morelli, Christian Ertmer, Martin Westphal, Sebastian Rehberg, Tim Kampmeier, Sandra Ligges, Alessandra Orecchioni, Annalia D'Egidio, Fiorella D'Ippoliti, Cristina Raffone, Mario Venditti, Fabio Guarracino, Massimo Girardis, Luigi Tritapepe, Paolo Pietropaoli, Alexander Mebazaa, Mervyn Singer
IMPORTANCE: β-Blocker therapy may control heart rate and attenuate the deleterious effects of β-adrenergic receptor stimulation in septic shock. However, β-Blockers are not traditionally used for this condition and may worsen cardiovascular decompensation related through negative inotropic and hypotensive effects. OBJECTIVE: To investigate the effect of the short-acting β-blocker esmolol in patients with severe septic shock. DESIGN, SETTING, AND PATIENTS: Open-label, randomized phase 2 study, conducted in a university hospital intensive care unit (ICU) between November 2010 and July 2012, involving patients in septic shock with a heart rate of 95/min or higher requiring high-dose norepinephrine to maintain a mean arterial pressure of 65 mm Hg or higher...
October 23, 2013: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/25358621/predictors-of-hospital-mortality-among-septic-icu-patients-with-acinetobacter-spp-bacteremia-a-cohort-study
#15
Andrew F Shorr, Marya D Zilberberg, Scott T Micek, Marin H Kollef
BACKGROUND: We hypothesized that among septic ICU patients with Acinetobacter spp. bacteremia (Ac-BSI), carbapenem-resistant Acinetobacter spp. (CRAc) increase risk for inappropriate initial antibiotic therapy (non-IAAT), and non-IAAT is a predictor of hospital death. METHODS: We conducted a retrospective cohort study of adult septic ICU patients with Ac-BSI. Non-IAAT was defined as exposure to initially prescribed antibiotics not active against the pathogen based on in vitro susceptibility testing, and having no exposure to appropriate antimicrobial treatment within 24 hours of drawing positive culture...
October 30, 2014: BMC Infectious Diseases
https://www.readbyqxmd.com/read/25231767/vascular-content-tone-integrity-and-haemodynamics-for-guiding-fluid-therapy-a-conceptual-approach
#16
L S Chawla, C Ince, D Chappell, T J Gan, J A Kellum, M Mythen, A D Shaw
BACKGROUND: Despite many clinical trials and investigative efforts to determine appropriate therapeutic intervention(s) for shock, this topic remains controversial. The use of i.v. fluid has represented the cornerstone for the treatment of hypoperfusion for two centuries. METHODS: As a part of International Acute Dialysis Quality Initiative XII Fluids Workgroup meeting, we sought to incorporate recent advances in our understanding of vascular biology into a more comprehensive yet accessible approach to the patient with hypoperfusion...
November 2014: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/25186838/the-impact-of-serial-lactate-monitoring-on-emergency-department-resuscitation-interventions-and-clinical-outcomes-in-severe-sepsis-and-septic-shock-an-observational-cohort-study
#17
Matthew Dettmer, Christopher V Holthaus, Brian M Fuller
Monitoring in the setting of critical illness must be linked to beneficial therapy to affect clinical outcome. Elevated serum lactate is associated with an increase in mortality in emergency department (ED) patients with severe sepsis and septic shock. The reduction of lactate levels toward normal during acute resuscitation is associated with improved clinical outcomes. The majority of data demonstrating the interventions used to achieve a reduction in lactate levels and the associated clinical outcomes have been obtained during protocolized randomized trials...
January 2015: Shock
https://www.readbyqxmd.com/read/25054728/protocol-based-care-for-early-septic-shock
#18
LETTER
Antonio J Dajer
No abstract text is available yet for this article.
July 24, 2014: New England Journal of Medicine
https://www.readbyqxmd.com/read/25054724/protocol-based-care-for-early-septic-shock
#19
LETTER
Derek C Angus, Donald M Yealy, John A Kellum
New England Journal of Medicine, Volume 371, Issue 4, Page 384-387, July 2014.
July 24, 2014: New England Journal of Medicine
https://www.readbyqxmd.com/read/25047428/fluid-resuscitation-in-sepsis-a-systematic-review-and-network-meta-analysis
#20
REVIEW
Bram Rochwerg, Waleed Alhazzani, Anees Sindi, Diane Heels-Ansdell, Lehana Thabane, Alison Fox-Robichaud, Lawrence Mbuagbaw, Wojciech Szczeklik, Fayez Alshamsi, Sultan Altayyar, Wang-Chun Ip, Guowei Li, Michael Wang, Anna Wludarczyk, Qi Zhou, Gordon H Guyatt, Deborah J Cook, Roman Jaeschke, Djillali Annane
BACKGROUND: Fluid resuscitation is the cornerstone of sepsis treatment. However, whether balanced or unbalanced crystalloids or natural or synthetic colloids confer a survival advantage is unclear. PURPOSE: To examine the effect of different resuscitative fluids on mortality in patients with sepsis. DATA SOURCES: MEDLINE, EMBASE, ACP Journal Club, CINAHL, HealthSTAR, the Allied and Complementary Medicine Database, and the Cochrane Central Register of Controlled Trials through March 2014...
September 2, 2014: Annals of Internal Medicine
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