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Pediatric sepsis

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77 papers 25 to 100 followers Papers relating to pediatric sepsis severe sepsis and septic shock. Thanks for following!!
Julie C Fitzgerald, Scott L Weiss, Niranjan Kissoon
OBJECTIVE: To review important articles in the field of pediatric shock and pediatric septic shock published subsequent to the Fifth Edition of the Rogers' Textbook of Pediatric Intensive Care. DATA SOURCES: The U.S. National Library of Medicine PubMed ( was searched for combination of the term "pediatric" and the following terms: "sepsis, septic shock, shock, antibiotics, extracorporeal membrane oxygenation, and steroid." The abstract lists generated by these searches were screened for potential inclusion...
November 2016: Pediatric Critical Care Medicine
Melanie K Prusakowski, Audrey P Chen
Pediatric sepsis is distinct from adult sepsis in its definitions, clinical presentations, and management. Recognition of pediatric sepsis is complicated by the various pediatric-specific comorbidities that contribute to its mortality and the age- and development-specific vital sign and clinical parameters that obscure its recognition. This article outlines the clinical presentation and management of sepsis in neonates, infants, and children, and highlights some key populations who require specialized care.
February 2017: Emergency Medicine Clinics of North America
Brittany Mathias, Juan C Mira, Shawn D Larson
PURPOSE OF REVIEW: Sepsis is the leading cause of pediatric death worldwide. In the United States alone, there are 72 000 children hospitalized for sepsis annually with a reported mortality rate of 25% and an economic cost estimated to be $4.8 billion. However, it is only recently that the definition and management of pediatric sepsis has been recognized as being distinct from adult sepsis. RECENT FINDINGS: The definition of pediatric sepsis is currently in a state of evolution, and there is a large disconnect between the clinical and research definitions of sepsis which impacts the application of research findings into clinical practice...
June 2016: Current Opinion in Pediatrics
Sunit C Singhi, Suresh Kumar
Gut microflora contribute greatly to immune and nutritive functions and act as a physical barrier against pathogenic organisms across the gut mucosa. Critical illness disrupts the balance between host and gut microflora, facilitating colonization, overgrowth, and translocation of pathogens and microbial products across intestinal mucosal barrier and causing systemic inflammatory response syndrome and sepsis. Commonly used probiotics, which have been developed from organisms that form gut microbiota, singly or in combination, can restore gut microflora and offer the benefits similar to those offered by normal gut flora, namely immune enhancement, improved barrier function of the gastrointestinal tract (GIT), and prevention of bacterial translocation...
2016: F1000Research
John S Giuliano, Barry P Markovitz, Joe Brierley, Richard Levin, Gary Williams, Lucy Chai See Lum, Tavey Dorofaeff, Pablo Cruces, Jenny L Bush, Luke Keele, Vinay M Nadkarni, Neal J Thomas, Julie C Fitzgerald, Scott L Weiss
OBJECTIVES: Pediatric severe sepsis remains a significant global health problem without new therapies despite many multicenter clinical trials. We compared children managed with severe sepsis in European and U.S. PICUs to identify geographic variation, which may improve the design of future international studies. DESIGN: We conducted a secondary analysis of the Sepsis PRevalence, OUtcomes, and Therapies study. Data about PICU characteristics, patient demographics, therapies, and outcomes were compared...
June 2016: Pediatric Critical Care Medicine
Samiran Ray, Mirjana Cvetkovic, Joe Brierley, Daniel H Lutman, Nazima Pathan, Padmanabhan Ramnarayan, David P Inwald, Mark J Peters
BACKGROUND: Shock index (SI) (heart rate [HR]/systolic blood pressure [SBP]) has been used to predict outcome in both adult and pediatric sepsis within the intensive care unit (ICU). We aimed to evaluate the utility of SI before pediatric ICU (PICU) admission. PATIENTS AND METHODS: We conducted a retrospective observational study of children referred to a pediatric intensive care transport service (PICTS) between 2005 and 2011. The predictive value of SI, HR, and blood pressure at three prespecified time points (at referral to PICTS, at PICTS arrival at the referring hospital, and at PICU admission) and changes in SI between the time points were evaluated...
September 2016: Shock
Ari Joffe, Natalie Anton, Laurance Lequier, Ben Vandermeer, Lisa Tjosvold, Bodil Larsen, Lisa Hartling
BACKGROUND: Nutritional support in the critically ill child has not been well investigated and is a controversial topic within paediatric intensive care. There are no clear guidelines as to the best form or timing of nutrition in critically ill infants and children. This is an update of a review that was originally published in 2009. . OBJECTIVES: The objective of this review was to assess the impact of enteral and parenteral nutrition given in the first week of illness on clinically important outcomes in critically ill children...
2016: Cochrane Database of Systematic Reviews
Daniela Carla de Souza, Eliane Roseli Barreira, Lucília Santana Faria
BACKGROUND: Sepsis, or systemic inflammatory response to infection, is a major childhood disease and a common cause of death in children. Despite its importance, a global perspective on the epidemiology and mortality of pediatric sepsis across the world is still lacking. METHODS: A non-systematic review of the medical articles published in Medline from 2005 to 2015. RESULTS: Studies suggest that there has been a rise in the number of pediatric sepsis cases along the last two decades, which may relate to the increased survival of preterm and low birth-weight infants and children with severe chronic conditions...
January 2017: Shock
Fran Balamuth, Scott L Weiss, Julie C Fitzgerald, Katie Hayes, Sierra Centkowski, Marianne Chilutti, Robert W Grundmeier, Jane Lavelle, Elizabeth R Alpern
OBJECTIVES: To determine whether treatment with a protocolized sepsis guideline in the emergency department was associated with a lower burden of organ dysfunction by hospital day 2 compared to nonprotocolized usual care in pediatric patients with severe sepsis. DESIGN: Retrospective cohort study. SETTING: Tertiary care children's hospital from January 1, 2012, to March 31, 2014. SUBJECTS: Patients older than 56 days old and younger than 18 years old with international consensus defined severe sepsis and who required PICU admission within 24 hours of emergency department arrival were included...
September 2016: Pediatric Critical Care Medicine
Nishkantha Arulkumaran, Clifford S Deutschman, Michael R Pinsky, Brian Zuckerbraun, Paul T Schumacker, Hernando Gomez, Alonso Gomez, Patrick Murray, John A Kellum
Mitochondria are an essential part of the cellular infrastructure, being the primary site for high-energy adenosine triphosphate production through oxidative phosphorylation. Clearly, in severe systemic inflammatory states, like sepsis, cellular metabolism is usually altered, and end organ dysfunction is not only common, but also predictive of long-term morbidity and mortality. Clearly, interest is mitochondrial function both as a target for intracellular injury and response to extrinsic stress have been a major focus of basic science and clinical research into the pathophysiology of acute illness...
March 2016: Shock
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
Stefanie G Ames, Jennifer K Workman, Jared A Olson, E Kent Korgenski, Susan Masotti, Elizabeth D Knackstedt, Susan L Bratton, Gitte Y Larsen
BACKGROUND: Septic shock remains an important cause of death and disability in children. Optimal care requires early recognition and treatment. METHODS: We evaluated a retrospective cohort of children (age <19) treated in our emergency department (ED) for septic shock during 2008-2012 to investigate the association between timing of antibiotic therapy and outcomes. The exposures were (1) receipt of empiric antibiotics in ≤1 hour and (2) receipt of appropriate antibiotics in ≤1 hour...
February 1, 2016: Journal of the Pediatric Infectious Diseases Society
Laura C Whitmore, Jessica S Hook, Amanda R Philiph, Brieanna M Hilkin, Xinyu Bing, Chul Ahn, Hector R Wong, Polly J Ferguson, Jessica G Moreland
Polymorphonuclear leukocytes (PMN) achieve an intermediate or primed state of activation following stimulation with certain agonists. Primed PMN have enhanced responsiveness to subsequent stimuli, which can be beneficial in eliminating microbes but may cause host tissue damage in certain disease contexts, including sepsis. As PMN priming by TLR4 agonists is well described, we hypothesized that ligation of TLR2/1 or TLR2/6 would prime PMN. Surprisingly, PMN from only a subset of donors were primed in response to the TLR2/1 agonist, Pam3CSK4, although PMN from all donors were primed by the TLR2/6 agonist, FSL-1...
February 1, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
Guro Grindheim, Jo Eidet, Gunnar Bentsen
BACKGROUND: The PiCCO system, based on transpulmonary thermodilution, is one of the few tools available for continuous hemodynamic monitoring in children. However, published data for some of the derived variables reveal indexed values that seem questionable. AIMS: The aim of this study was to collect data from hemodynamically normal children and compare these to existing reference values. Furthermore, we sought to explore if indexing some of the variables differently could improve the clinical application of the obtained values...
April 2016: Paediatric Anaesthesia
Lars Broksø Holst
BACKGROUND: Transfusion of red blood cells (RBCs) is widely used for non-bleeding patients with septic shock in the intensive care unit (ICU). The evidence for effect and safety are limited showing conflicting results and transfused RBCs have the potential to harm subgroups of critically ill patients. Our aim was to assess the benefits and harms of RBC transfusion in patients with septic shock in a randomised clinical trial and to conduct an up-to-date systematic review with meta-analysis of all randomised clinical trials comparing different transfusion strategies...
February 2016: Danish Medical Journal
Laura A Boomer, Jennifer N Cooper, Seema Anandalwar, Sara Childress Fallon, Daniel Ostlie, Charles M Leys, Shawn Rangel, Peter Mattei, Susan W Sharp, Shawn D St Peter, J Ruben Rodriguez, Brian Kenney, Gail E Besner, Katherine J Deans, Peter C Minneci
OBJECTIVES: To investigate the association between time to appendectomy and the risk of surgical site infections (SSIs) in children with appendicitis across multiple NSQIP-Pediatrics institutions. BACKGROUND: Several recently published single institution retrospective studies have reported conflicting relationships between delaying appendectomy and the risk of increasing surgical site infections (SSI) in both children and adults. This study combines data from NSQIP-Pediatrics with institutional data to perform a multi-institutional analysis to examine the effects of delaying appendectomy on surgical site infections...
July 2016: Annals of Surgery
Halden F Scott, Lina Brou, Sara J Deakyne, Diane L Fairclough, Allison Kempe, Lalit Bajaj
OBJECTIVES: To evaluate whether lactate clearance and normalization during emergency care of pediatric sepsis is associated with lower rates of persistent organ dysfunction. STUDY DESIGN: This was a prospective cohort study of 77 children <18 years of age in the emergency department with infection and acute organ dysfunction per consensus definitions. In consented patients, lactate was measured 2 and/or 4 hours after an initial lactate; persistent organ dysfunction was assessed through laboratory and physician evaluation at 48 hours...
March 2016: Journal of Pediatrics
James L Wynn
PURPOSE OF REVIEW: Although infection rates have modestly decreased in the neonatal intensive care unit (NICU) as a result of ongoing quality improvement measures, neonatal sepsis remains a frequent and devastating problem among hospitalized preterm neonates. Despite multiple attempts to address this unmet need, there have been minimal advances in clinical management, outcomes, and accuracy of diagnostic testing options over the last 3 decades. One strong contributor to a lack of medical progress is a variable case definition of disease...
April 2016: Current Opinion in Pediatrics
Paul E Marik
No abstract text is available yet for this article.
January 2016: Journal of Pediatrics
Mohammed Abdul Moety Al-Biltagi, Ahmed Abd ElBasset Abo-Elezz, Maher Ahmed Abd-Elhafez, Maaly Mohamed Mabrouk, Ghada Abudelmomen Suliman
OBJECTIVE: The objective was to investigate the benefits of supplementing enteral feeding with omega-3 fatty acids in children with mild to moderate sepsis and its effects on acute-phase reactants and interleukin 6 (IL-6) level. METHODS: The study was a prospective randomized, double-blind, placebo-controlled study from January 2012 to June 2014, which included 2 groups of children with mild to moderate sepsis tolerating enteral feeding. Group A included 60 children supplemented with omega-3 fatty acids, whereas group B included 60 children who received enteral feeding without omega-3 supplementation...
December 23, 2015: Journal of Intensive Care Medicine
2016-01-04 12:26:35
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