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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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We report the first case of infective endocarditis caused by Granulicatella sp. in a kidney transplant recipient. A 67-year-old male kidney transplant recipient was admitted to the hospital for investigation of fever, abdominal pain, and diarrhea. On physical examination, he was dehydrated. Laboratory tests identified impaired renal function (creatinine level of 15.5 mg/dl; reference, 3.0 mg/dl), metabolic acidosis, and electrolyte disturbances. Cryptosporidium sp. was identified as the cause of the diarrhea, and the infection was treated with nitazoxanide. On admission, cultures of blood, urine, and stool samples were neg...
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
This was the first large multi-center study in a public health system evaluating the effect of EMS transport on the management and outcome of patients who were diagnosed with severe sepsis or septic shock in the ED. As expected, triage to emergency physician time, triage to admission time, triage to declaration time, and triage to bundle compliance time were all shorter for patients who arrived by EMS.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
Sepsis is a common illness and is recognized in the recent World Health Organization resolution as a global health priority.1 In February 2016, the definitions of sepsis were updated with the emphasis on organ dysfunction being triggered by a dysregulated host response to infection. Septic shock was redefined as a subset of sepsis carrying a worse prognosis. Explicit clinical criteria were published for identifying sepsis, septic shock, and infected patients at risk of bad outcomes.2 –4
Source: Critical Care Clinics - Category: Intensive Care Authors: Tags: Preface Source Type: research
No abstract available
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Viewpoints Source Type: research
No abstract available
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Viewpoints Source Type: research
Conclusions: Conclusions:Activation of the apelinergic system by exogenous ELA or Apelin-13 infusion improves cardiovascular function and survival after cecal ligation puncture–induced sepsis. However, ELA proved better than Apelin-13 by improving fluid homeostasis, cardiovascular hemodynamics recovery, and limiting kidney dysfunction in a vasopressinergic-dependent manner.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Online Laboratory Investigations Source Type: research
No abstract available
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research
Conclusions: This rare event stresses our inability to correctly predict the risk of a patient developing cardiotoxicity and also highlights the need to improve the knowledge of underlying pathophysiological mechanisms; in fact, it suggests a possible genetic predisposition to develop cardiotoxicity due to a relatively limited dosage.Cardiology 2018;139:7-10
Source: Cardiology - Category: Cardiology Source Type: research
Conclusions: The P(v-a)CO2/C(a-v)O2 ratio is an independent predictor of ICU mortality in septic shock patients with high ScvO2 after resuscitation. It is worthy of consideration to recruit microcirculation to correct the high ratio in high ScvO2 case.
Source: Shock - Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research
Conclusions: Atorvastatin-induced changes in inflammatory biomarkers did not confer mortality benefit in septic shock (ClinicalTrials.govNCT02681653).
Source: Indian Journal of Critical Care Medicine - Category: Intensive Care Authors: Source Type: research
More News: Children | Emergency Medicine | Pediatrics | Septic Shock