collection
https://read.qxmd.com/read/36592205/how-to-use-biomarkers-of-infection-or-sepsis-at-the-bedside-guide-to-clinicians
#1
REVIEW
Pedro Póvoa, Luís Coelho, Felipe Dal-Pizzol, Ricard Ferrer, Angela Huttner, Andrew Conway Morris, Vandack Nobre, Paula Ramirez, Anahita Rouze, Jorge Salluh, Mervyn Singer, Daniel A Sweeney, Antoni Torres, Grant Waterer, Andre C Kalil
Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. In this context, biomarkers could be considered as indicators of either infection or dysregulated host response or response to treatment and/or aid clinicians to prognosticate patient risk. More than 250 biomarkers have been identified and evaluated over the last few decades, but no biomarker accurately differentiates between sepsis and sepsis-like syndrome. Published data support the use of biomarkers for pathogen identification, clinical diagnosis, and optimization of antibiotic treatment...
January 2, 2023: Intensive Care Medicine
https://read.qxmd.com/read/36154486/impact-of-piperacillin-tazobactam-dosing-in-septic-shock-patients-using-real-world-evidence-an-observational-retrospective-cohort-study
#2
MULTICENTER STUDY
John M Allen, Devi Surajbali, Dalena Q Nguyen, Jolanta Kuczek, Maithi Tran, Brianna Hachey, Carinda Feild, Bethany R Shoulders, Steven M Smith, Stacy A Voils
BACKGROUND: Sepsis and septic shock are associated with significant morbidity and mortality. Rapid initiation of appropriate antibiotic therapy is essential, as inadequate therapy early during septic shock has been shown to increase the risk of mortality. However, despite the importance of appropriate antibiotic initiation, in clinical practice, concerns for renal dysfunction frequently lead to antibiotic dose reduction, with scant evidence on the impact of this practice in septic shock patients...
June 2023: Annals of Pharmacotherapy
https://read.qxmd.com/read/35644899/timing-of-vasoactive-agents-and-corticosteroid-initiation-in-septic-shock
#3
REVIEW
Mahmoud A Ammar, Abdalla A Ammar, Patrick M Wieruszewski, Brittany D Bissell, Micah T Long, Lauren Albert, Ashish K Khanna, Gretchen L Sacha
Septic shock remains a health care concern associated with significant morbidity and mortality. The Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock recommend early fluid resuscitation and antimicrobials. Beyond initial management, the guidelines do not provide clear recommendations on appropriate time to initiate vasoactive therapies and corticosteroids in patients who develop shock. This review summarizes the literature regarding time of initiation of these interventions. Clinical data regarding time of initiation of these therapies in relation to shock onset, sequence of treatments with regard to each other, and clinical markers evaluated to guide initiation are summarized...
May 30, 2022: Annals of Intensive Care
https://read.qxmd.com/read/35704311/monocyte-distribution-width-in-children-with-systemic-inflammatory-response-retrospective-cohort-examining-association-with-early-sepsis
#4
JOURNAL ARTICLE
Sen-Kuang Hou, Hui-An Lin, Hung-Wei Tsai, Chiou-Feng Lin, Sheng-Feng Lin
OBJECTIVES: To investigate the association between increased monocyte distribution width (MDW) and pediatric sepsis in the emergency department (ED). DESIGN: Retrospective cohort study. SETTING: A single academic hospital study. PATIENTS: Patients from birth to the age of 18 years who presented at the ED of an academic hospital with systemic inflammatory response syndrome (SIRS) were consecutively enrolled. Sepsis was diagnosed using the International Pediatric Surviving Sepsis Campaign criteria...
September 1, 2022: Pediatric Critical Care Medicine
https://read.qxmd.com/read/35413788/methods-of-assessing-fluid-responsiveness-in-septic-shock-patients-a%C3%A2-narrative-review
#5
REVIEW
Wojciech Weigl, Jan Adamski, Dariusz Onichimowski, Piotr Nowakowski, Bodo Wagner
A growing body of evidence shows that some septic patients experience fluid overload, which leads to an increased number of serious complications and death. This is because the majority of septic patients are fluid non-responders. Therefore, a reliable distinction of which patient would benefit from fluid boluses is crucial in current sepsis mana-gement. Several methods used to assess fluid responsiveness have been developed. The principle of "dynamic" measurements (in contrast to static indices such as central venous pressure) involves the induction of a change in cardiac preload and the measurement of its effect on stroke volume...
2022: Anaesthesiology Intensive Therapy
https://read.qxmd.com/read/35337346/vasopressor-choice-and-timing-in-vasodilatory-shock
#6
REVIEW
Patrick M Wieruszewski, Ashish K Khanna
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2022. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2022 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901 .
March 22, 2022: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/34872910/management-of-pneumonia-in-critically-ill-patients
#7
REVIEW
Catia Cillóniz, Antoni Torres, Michael S Niederman
Severe pneumonia is associated with high mortality (short and long term), as well as pulmonary and extrapulmonary complications. Appropriate diagnosis and early initiation of adequate antimicrobial treatment for severe pneumonia are crucial in improving survival among critically ill patients. Identifying the underlying causative pathogen is also critical for antimicrobial stewardship. However, establishing an etiological diagnosis is challenging in most patients, especially in those with chronic underlying disease; those who received previous antibiotic treatment; and those treated with mechanical ventilation...
December 6, 2021: BMJ: British Medical Journal
https://read.qxmd.com/read/33999276/fluid-induced-harm-in-the-hospital-look-beyond-volume-and-start-considering-sodium-from-physiology-towards-recommendations-for-daily-practice-in-hospitalized-adults
#8
REVIEW
Niels Van Regenmortel, Lynn Moers, Thomas Langer, Ella Roelant, Tim De Weerdt, Pietro Caironi, Manu L N G Malbrain, Paul Elbers, Tim Van den Wyngaert, Philippe G Jorens
PURPOSE: Iatrogenic fluid overload is a potential side effect of intravenous fluid therapy in the hospital. Little attention has been paid to sodium administration as a separate cause of harm. With this narrative review, we aim to substantiate the hypothesis that a considerable amount of fluid-induced harm is caused not only by fluid volume, but also by the sodium that is administered to hospitalized patients. METHODS: We show how a regular dietary sodium intake is easily surpassed by the substantial amounts of sodium that are administered during typical hospital stays...
May 17, 2021: Annals of Intensive Care
https://read.qxmd.com/read/33852500/clinical-use-of-peripheral-perfusion-parameters-in-septic-shock
#9
REVIEW
Jan Bakker
PURPOSE OF REVIEW: Current goals of resuscitation in septic shock are mainly a fixed volume of fluids and vasopressors to correct hypotension and improve tissue perfusion indicated by decreasing lactate levels. RECENT FINDINGS: Abnormal peripheral perfusion by objective and subjective parameters are associated with increased mortality in various phases of the treatment of critically ill patients including patients with septic shock. Ongoing resuscitation in septic shock patients with normal peripheral perfusion is not associated with improved outcome, rather with increased mortality...
June 1, 2021: Current Opinion in Critical Care
https://read.qxmd.com/read/30626586/sepsis-associated-acute-kidney-injury
#10
REVIEW
Jason T Poston, Jay L Koyner
Sepsis is defined as organ dysfunction resulting from the host's deleterious response to infection. One of the most common organs affected is the kidneys, resulting in sepsis associated acute kidney injury (SA-AKI) that contributes to the morbidity and mortality of sepsis. A growing body of knowledge has illuminated the clinical risk factors, pathobiology, response to treatment, and elements of renal recovery that have advanced our ability to prevent, detect, and treat SA-AKI. Despite these advances, SA-AKI remains an important concern and clinical burden, and further study is needed to reduce the acute and chronic consequences...
January 9, 2019: BMJ: British Medical Journal
https://read.qxmd.com/read/30374729/hemodynamic-support-in-the-early-phase-of-septic-shock-a-review-of-challenges-and-unanswered-questions
#11
REVIEW
Olivier Lesur, Eugénie Delile, Pierre Asfar, Peter Radermacher
BACKGROUND: Improving sepsis support is one of the three pillars of a 2017 resolution according to the World Health Organization (WHO). Septic shock is indeed a burden issue in the intensive care units. Hemodynamic stabilization is a cornerstone element in the bundle of supportive treatments recommended in the Surviving Sepsis Campaign (SSC) consecutive biannual reports. MAIN BODY: The "Pandera's box" of septic shock hemodynamics is an eternal debate, however, with permanent contentious issues...
October 29, 2018: Annals of Intensive Care
https://read.qxmd.com/read/30028362/effect-of-thiamine-administration-on-lactate-clearance-and-mortality-in-patients-with-septic-shock
#12
JOURNAL ARTICLE
Jordan A Woolum, Erin L Abner, Andrew Kelly, Melissa L Thompson Bastin, Peter E Morris, Alexander H Flannery
OBJECTIVES: Mounting evidence has shown that critically ill patients are commonly thiamine deficient. We sought to test the hypothesis that critically ill patients with septic shock exposed to thiamine would demonstrate improved lactate clearance and more favorable clinical outcomes compared with those not receiving thiamine. DESIGN: Retrospective, single-center, matched cohort study. SETTING: Tertiary care academic medical center. PATIENTS: Adult patients admitted with an International Classification of Diseases, 9th Edition, or International Classification of Diseases, 10th Edition, diagnosis code of septic shock to either the medicine or surgery ICU...
November 2018: Critical Care Medicine
https://read.qxmd.com/read/29980217/definitions-and-pathophysiology-of-vasoplegic-shock
#13
REVIEW
Simon Lambden, Ben C Creagh-Brown, Julie Hunt, Charlotte Summers, Lui G Forni
Vasoplegia is the syndrome of pathological low systemic vascular resistance, the dominant clinical feature of which is reduced blood pressure in the presence of a normal or raised cardiac output. The vasoplegic syndrome is encountered in many clinical scenarios, including septic shock, post-cardiac bypass and after surgery, burns and trauma, but despite this, uniform clinical definitions are lacking, which renders translational research in this area challenging. We discuss the role of vasoplegia in these contexts and the criteria that are used to describe it are discussed...
July 6, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/29789983/principles-of-fluid-management-and-stewardship-in-septic-shock-it-is-time-to-consider-the-four-d-s-and-the-four-phases-of-fluid-therapy
#14
REVIEW
Manu L N G Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W Rice, Monty Mythen, Xavier Monnet
In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition...
May 22, 2018: Annals of Intensive Care
https://read.qxmd.com/read/29767636/the-surviving-sepsis-campaign-bundle-2018-update
#15
JOURNAL ARTICLE
Mitchell M Levy, Laura E Evans, Andrew Rhodes
No abstract text is available yet for this article.
June 2018: Critical Care Medicine
https://read.qxmd.com/read/29704160/there-is-more-to-septic-shock-than-arterial-hypotension-and-elevated-lactate-levels-another-appeal-to-rethink-current-resuscitation-strategies
#16
REVIEW
Martin W Dünser, Arnaldo Dubin
No abstract text is available yet for this article.
April 27, 2018: Annals of Intensive Care
https://read.qxmd.com/read/28729906/update-on-pediatric-sepsis-a-review
#17
REVIEW
Tatsuya Kawasaki
BACKGROUND: Sepsis is one of the leading causes of mortality among children worldwide. Unfortunately, however, reliable evidence was insufficient in pediatric sepsis and many aspects in clinical practice actually depend on expert consensus and some evidence in adult sepsis. More recent findings have given us deep insights into pediatric sepsis since the publication of the Surviving Sepsis Campaign guidelines 2012. MAIN TEXT: New knowledge was added regarding the hemodynamic management and the timely use of antimicrobials...
2017: Journal of Intensive Care
https://read.qxmd.com/read/28050897/fluid-resuscitation-in-human-sepsis-time-to-rewrite-history
#18
REVIEW
Liam Byrne, Frank Van Haren
Fluid resuscitation continues to be recommended as the first-line resuscitative therapy for all patients with severe sepsis and septic shock. The current acceptance of the therapy is based in part on long history and familiarity with its use in the resuscitation of other forms of shock, as well as on an incomplete and incorrect understanding of the pathophysiology of sepsis. Recently, the safety of intravenous fluids in patients with sepsis has been called into question with both prospective and observational data suggesting improved outcomes with less fluid or no fluid...
December 2017: Annals of Intensive Care
https://read.qxmd.com/read/27974285/increased-incidence-of-clinical-hypotension-with-etomidate-compared-to-ketamine-for-intubation-in-septic-patients-a-propensity-matched-analysis
#19
JOURNAL ARTICLE
Megan A Van Berkel, Matthew C Exline, Kari M Cape, Lindsay P Ryder, Gary Phillips, Naeem A Ali, Bruce A Doepker
PURPOSE: This study compared the incidence of clinical hypotension between ketamine and etomidate within a 24 hour period following endotracheal intubation. MATERIALS AND METHODS: This single-center, retrospective propensity-matched cohort study included septic patients admitted to our medical intensive care unit who received either etomidate or ketamine for intubation. Clinical hypotension was defined as any one of the following: mean arterial pressure (MAP) decrease >40% compared to baseline and MAP <70 mmHg, MAP <60 mmHg, initiation of a vasopressor, or increase to >30% of the initial vasopressor dose...
April 2017: Journal of Critical Care
https://read.qxmd.com/read/27011791/sepsis-induced-myocardial-dysfunction-pathophysiology-and-management
#20
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
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