Fluid Resuscitation in Pediatric Septic Shock: The Case Against Haste*

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Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Editorials Source Type: research

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Authors: García Harana C, Fernández Canedo I, de Troya Martín M PMID: 29789143 [PubMed - as supplied by publisher]
Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research
Urinary tract infections (UTI) are amongst the most common infectious diseases found in the emergency department (ED), and usually result in a mild, low severity illness. Nevertheless, these conditions may rapidly develop in a minority of patients into a life-threatening condition, such as septic shock or multiple organ failure. Due to this potential risk, many patients are initially hospitalized, leading to a potential over treatment of low severity patients and increased healthcare costs [1,2].
Source: Journal of Infection - Category: Infectious Diseases Authors: Source Type: research
Authors: Ramos MFP, Monteiro de Barros ADCM, Razvickas CV, Borges FT, Schor N Abstract Xanthine oxidase activation occurs in sepsis and results in the generation of uric acid (UrAc) and reactive oxygen species (ROS). We aimed to evaluate the effect of xanthine oxidase inhibitors (XOis) in rats stimulated with lipopolysaccharide (LPS). LPS (10 mg/kg) was administered intraperitoneally (i.p.) immediately after allopurinol (Alo, 2 mg/kg) or febuxostat (Feb, 1 mg/kg) every 24 h for 3 days. To increase UrAc levels, oxonic acid (Oxo) was administered by gavage (750 mg/kg per day)...
Source: International Journal of Immunopathology and Pharmacology - Category: Allergy & Immunology Tags: Int J Immunopathol Pharmacol Source Type: research
(University of Chicago Medical Center) The controversial Severe Sepsis and Septic Shock Early Management Bundle study adds weight to the belief that early lactate measurements can make a big difference. This follow-up study found a two percent increase in mortality for each hour of delay in patients with an abnormal lactate value.
Source: EurekAlert! - Infectious and Emerging Diseases - Category: Infectious Diseases Source Type: news
Conclusion: Patients with refractory septic shock should be transferred precociously to a referral ECMO center. However, therapy should be used with caution in patients with vasoplegic pattern shock orS. pneumoniae sepsis.What is Known:•Children with refractory septic shock have significant mortality rates, and although ECMO is recommended, overall survival is low.•There are no studies regarding characteristics of infections as predictors of pediatric survival in ECMO.What is New:•Septic children should be transferred precociously to referral ECMO centers during the first hours if patients do not respond to ...
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
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 ti...
Source: Annals of Intensive Care - Category: Intensive Care Authors: Tags: Review Source Type: research
Sepsis remains the most common cause of emergent hospital admission and readmission in the United States [1]. However, septic shock mortality has decreased significantly over the last two decades [2,3]. Intensivists all over the world are quickly realizing that short term organ dysfunction is as important as overall mortality in these patients. These ‘patient centered’ outcomes such as the need for renal replacement therapy and days spent on mechanical ventilation speak to the quality of life and consequent pivotal decision making asks for family members.
Source: Journal of Critical Care - Category: Intensive Care Authors: Source Type: research
ConclusionsThe survey provided valuable information on the choice of primary outcome, target population and physician equipoise. The retrospective study provided estimates of patient numbers, the minimal clinically important difference, evidence for community equipoise and physician practice patterns. Strong consideration should be given to performing both types of studies prior to conducting RCTs in paediatric critical-care environments.
Source: Trials - Category: Research Source Type: clinical trials
Vasopressin (AVP) is commonly added to norepinephrine (NE) to reverse shock in patients with sepsis. However, there are no data to support the appropriate strategy of vasopressor tapering in patients on concom...
Source: Critical Care - Category: Intensive Care Authors: Tags: Research Source Type: research
Authors: Yu YJ, Su AH, Yang HB, Chen JX Abstract OBJECTIVE: To investigate the protective effect of intermedin1-53 (IMD1-53) on cardiac function in rats with septic shock and its underlying mechanism. MATERIALS AND METHODS: Twenty-four male Sprague-Dawley (SD) rats were randomly assigned into three groups, namely the control group (NC group), septic shock group (ET group) and IMD1-53 treatment group (IMD group), with 8 rats in each group. Levels of hemodynamic indicators, blood glucose, lactate acid, CK-MB (creatine kinase-MB) and cTnI (cardiac troponin I) in rats were determined. Cardiac tissues of rats were c...
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
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