Serum Lactate Levels as a Prognostic Predictor of Septic Shock in Emergency Department Patients with Systemic Inflammatory Response Syndrome (SIRS) at Songklanagarind Hospital.
Conclusion: For patients presenting to the emergency department with clinical symptoms of SIRS, a single serum venous lactate level measurement of greater than 36 mg/dL provides valuable prognostic predictor information concerning the high-risk group likely to progress to septic shock, more serious disease severity, and death. PMID: 29947498 [PubMed - in process]
Authors: Na SH, Shin CS, Kim GH, Kim JH, Lee JS Abstract Background: The long-term outcomes of patients discharged from the hospital after successful care in intensive care unit (ICU) are not briskly evaluated in Korea. The aim of this study was to assess long-term mortality of patients treated in the ICU and discharged alive from the hospital and to identify predictive factors of mortality. Methods: In 3679 adult patients discharged alive from the hospital after ICU care between 2006 and 2011, 1-year mortality rate (primary outcome measure) was investigated. Various factors were entered into multivariate analy...
Conclusions. DCS with temporary abdominal closure by negative pressure wound therapy combined with instillation in patients with diffuse peritonitis from complicated diverticulitis could represent a feasible surgical option both in hemodynamically stable and no stable patients, showing encouraging results including a low stoma rate and an acceptable morbidity rate. PMID: 31221028 [PubMed - as supplied by publisher]
Conclusions: The mFI-5 is an independent predictor of postoperative morbidity and mortality in elderly patients undergoing surgery for hip fractures. This clinical tool can be used by hospitals and surgeons to identify high-risk patients, accurately council patients and families with transparency, and guide perioperative care to optimize patient outcomes. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Natriuretic peptide [NP; B ‐type NP (BNP), N‐terminal proBNP (NT‐proBNP), and midregional proANP (MR‐proANP)] concentrations are quantitative plasma biomarkers for the presence and severity of haemodynamic cardiac stress and heart failure (HF). End‐diastolic wall stress, intracardiac filling pressures, and intracard iac volumes seem to be the dominant triggers. This paper details the most important indications for NPs and highlights 11 key principles underlying their clinical use shown below. NPs should always be used in conjunction with all other clinical information. NPs are reasonable surrogates for intracar d...
This study aims to investigate arterial stiffness in early sepsis and its association with clinical outcomes. Patients with severe sepsis and septic shock admitted to intensive care have higher arterial stiffness than in the general population. No convincing association was found between pulse wave velocity at admission and the progression of multiple organ or cardiovascular failure, although the group with pulse wave velocity> 24.7 m/s had shorter survival time.
Sepsis is characterized by a complex immune response. This meta-analysis evaluated the clinical effectiveness of intravenous IgM-enriched immunoglobulin (IVIgGM) in patients with sepsis and septic shock. Administration of IVIgGM to adult septic patients may be associated with reduced mortality. Treatment effects tended to be smaller or less consistent when including only those studies deemed adequate for each indicator. The available evidence is not clearly sufficient to support the widespread use of IVIgGM in the treatment of sepsis.
Multidrug-resistant gram-negative bacilli (MDR-GNB) have emerged globally as a serious threat and with a high case fatality rate (CFR). Neonates suspected of sepsis with septic shock need broad-spectrum empirical antimicrobial therapy until the second successive negative culture, especially in high MDR areas.
ConclusionsCompared to PTSS-10 and PCL-5, PTSS-14 appeared more appropriate for post-ICU PTSD screening when validated against a DSM-5 diagnostic interview.
ConclusionsIn a population of early septic shock patients, increases in PcvaCO2 and PcvaCO2/CavO2 reflected different alterations at the microcirculatory level. While PcvaCO2 was related to global flow, the PcvaCO2/CavO2 ratio was associated to impaired local oxygen utilization and diminished microvascular reactivity.
Publication date: Available online 17 June 2019Source: Journal of Critical CareAuthor(s): Hongjung Kim, Sung Phil Chung, Sung-Hyuk Choi, Gu Hyun Kang, Tae Gun Shin, Kyuseok Kim, Yoo Seok Park, Kap Su Han, Han Sung Choi, Gil Joon Suh, Won Young Kim, Tae Ho Lim, Byuk Sung Ko, for the Korean Shock Society (KoSS) InvestigatorsAbstractPurposeCurrent guidelines recommend that rapid source control should be adopted in patients not>6–12 h after sepsis is diagnosed. However, evidence level of this guideline is not specified, and there is no previous study on patients with septic shock visiting the emergency department (E...