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Fluid Bolus Over 15–20 Versus 5–10 Minutes Each in the First Hour of Resuscitation in Children With Septic Shock: A Randomized Controlled Trial*

Objectives: To compare the effect of administration of 40–60 mL/kg of fluids as fluid boluses in aliquots of 20 mL/kg each over 15–20 minutes with that over 5–10 minutes each on the composite outcome of need for mechanical ventilation and/or impaired oxygenation—increase in oxygenation index by 5 from baseline in the initial 6 and 24 hours in children with septic shock. Design: Randomized controlled trial. Setting: Pediatric emergency and ICU of a tertiary care institute. Patients: Children (
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

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Authors: Wang DW, Yin YM, Yao YM Abstract The vagus nerve can sense peripheral inflammation and transmit action potentials from the periphery to the brainstem. Vagal afferent signaling is integrated in the brainstem, and efferent vagus nerves carry outbound signals that terminate in spleen and other organs. Stimulation of efferent vagus nerve leads to the release of acetylcholine in these organs. In turn, acetylcholine interacts with members of the nicotinic acetylcholine receptor (nAChR) family, particularly with the alpha7 nicotinic acetylcholine receptor (α7nAChR), which is expressed by macrophages and oth...
Source: International Reviews of Immunology - Category: Allergy & Immunology Tags: Int Rev Immunol Source Type: research
We appreciate the comments from Dr. Jha. According to the study protocol, all patients received a cardiac output monitor aiming to optimize fluid status and cardiac index. Therefore, as our data show, with norepinephrine or vasopressin, we did not observe either a reduction in the cardiac index or a worsening of tissue perfusion and oxygenation parameters as lactate and central venous oxygen saturation.1 Furthermore, the incidence of low cardiac output and cardiogenic shock in the norepinephrine and vasopressin groups was not different. We attribute this to the fact that we assessed the fluid status and used inotropes regu...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Conditions:   Septic Shock;   Sepsis;   Pathologic Processes;   Shock;   Infection;   Systemic Inflammatory Response Syndrome;   Inflammation Interventions:   Biological: Allogeneic Bone Marrow-Derived Human Mesenchymal Stem Cells;   Other: Placebo Sponsors:   Ottawa Hospital Research Institute;   Canadian Institutes of Health Research (CIHR);   Ontario Institute for Regenerative Medicine (OIRM);   Stem Cell Network Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionsA case of internal hernia formation is quite rare; accurate preoperative diagnosis and timely surgery are essential because it can cause strangulation of the ileus. However, the incidence of this internal herniation is low and preoperative diagnosis is difficult. An accurate preoperative diagnosis of internal hernia is still a challenge.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Abstract Capnocytophaga canimorsus is a Gram-negative bacterium present in the oral cavities of cats and dogs. It is known for its capability to cause life-threatening sepsis following a dog bite, especially in immunocompromised patients. We report the case of a 67-year-old man who suffered from septic shock and multiorgan failure presumably following contamination of a pre-existing minor skin lesion by canine saliva. The purpose of this report is to raise awareness of Capnocytophaga canimorsus among physicians when faced with a patient presenting with fulminant septic shock and Gram-negat...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
Conclusion: This study identified several risk factors associated with blood stream infections caused by Candida over 10-years period. Continuous surveillance programs to monitor such types of infection are of great value to antimicrobial stewardship programs.
Source: The Journal of Infection in Developing Countries - Category: Infectious Diseases Source Type: research
Condition:   Septic Shock Interventions:   Drug: Plasma;   Drug: Balanced crystalloids Sponsor:   The University of Texas Health Science Center, Houston Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Septic shock-induced disseminated intravascular coagulation is responsible for increased occurrence of multiple organ dysfunction and mortality. Immunothrombosis-induced coagulopathy may contribute to hypercoa...
Source: Annals of Intensive Care - Category: Intensive Care Authors: Tags: Research Source Type: research
This research article concluded that implementing a multifaceted intervention including sepsis e-alert with SRT was associated with earlier identification of sepsis, increase in compliance with sepsis resuscitation bundle and reduction in the need for mechanical ventilation and reduction in hospital mortality and length of stay.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
Source: Notes from Dr. RW - Category: Internal Medicine Tags: critical care Source Type: blogs
More News: Children | Emergency Medicine | Pediatrics | Septic Shock