Trajectories and Risk Factors for Altered Physical and Psychosocial Health-Related Quality of Life After Pediatric Community-Acquired Septic Shock*

Objectives: To evaluate the physical and psychosocial domains of health-related quality of life among children during the first year following community-acquired septic shock, and explore factors associated with poor physical and psychosocial health-related quality of life outcomes. Design: Secondary analysis of the Life After Pediatric Sepsis Evaluation. Setting: Twelve academic PICUs in the United States. Patients: Children greater than or equal to 1 month and less than 18 years old who were perceived to be without severe developmental disability by their family caregiver at baseline and who survived hospitalization for community-acquired septic shock. Interventions: Family caregivers completed the Pediatric Quality of Life Inventory for children 2–18 years old or the Pediatric Quality of Life Inventory Infant Scales for children less than 2 years old at baseline (reflecting preadmission status), day 7, and months 1, 3, 6, and 12 following PICU admission. Higher Pediatric Quality of Life Inventory Physical and Psychosocial Health Summary Scores indicate better health-related quality of life. Measurements and Main Results: Of 204 children, 58 (28.2%) had a complex chronic comorbid condition. Children with complex chronic comorbid conditions had lower baseline physical health-related quality of life (62.7 ± 22.6 vs 84.1 ± 19.7; p
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Feature Articles Source Type: research

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Septic sacroiliitis is a rare and difficult to diagnose infection of the sacroiliac joints [1-3]. Septic sacroiliitis represents 1 –2% of all cases of septic arthritis and the incidence is exceedingly low with only 1–2 cases per year being diagnosed [4,5]. Symptoms of septic sacroiliitis include fever, lower back pain, referred hip pain, and weight-bearing difficulty [6]. Risk factors include trauma, pregnancy, intravenous (IV) drug use, endocarditis, and immunosuppression [7]. Complications resulting from septic sacroiliitis include septic shock, psoas muscle abscess, iliopsoas abscess, long-term joint deformi...
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
Abstract Guidelines published in 2016 provide a revised definition of sepsis: life-threatening organ dysfunction caused by a dysregulated host response to infection. The guidelines define septic shock as sepsis with circulatory, cellular, and metabolic dysfunction that is associated with a higher risk of mortality. The measurement of serum lactate has been incorporated into the latest septic shock definition. The guidelines recommend the Sequential Organ Failure Assessment (original and quick versions) as an important tool for early diagnosis. Respiratory, gastrointestinal, genitourinary, and skin and soft tissue ...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
Margaret M. Parker, MD, MCCM, and Jerry J. Zimmerman, MD, PhD, FCCM talk about the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock.
Source: SCCM PodCast - iCritical Care - Category: Intensive Care Authors: Tags: Medicine Source Type: podcasts
Objectives: A companion article reports the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock. In this article, the investigators examine critical illness factors associated with these adverse outcomes. Design: Prospective, cohort-outcome study, conducted 2013–2017. Setting: Twelve United States academic PICUs. Patients: Critically ill children, 1 month to 18 years, with community-acquired septic shock requiring vasoactive-inotropic support. Interventions: Illness severity, organ dysfunction, and resource utilization data...
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Late Breaker Articles Source Type: research
Sepsis in older children is often associated with the presence of developmental abnormalities and cerebral palsy. While relatively uncommon, surgical abdomen in these patients is associated with a high rate of mortality. Few reports have been described of sepsis caused by isolated cecal necrosis.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Clinical Communications: Pediatric Source Type: research
Acute respiratory distress syndrome (ARDS) is a disease associated with both short- and long-term complications. Acute complications include refractory respiratory failure requiring prolonged dependence on mechanical ventilation and the subsequent need for tracheostomy and gastrostomy tubes, protracted immobilization, and lengthy stays in the intensive care unit resulting in delirium, critical illness myopathy, and polyneuropathy, as well as secondary nosocomial infections. Chronic adverse outcomes of ARDS include irreversible changes such as fibrosis, tracheal stenosis from prolonged tracheostomy tube placement, pulmonary...
Source: Critical Care Nursing Quarterly - Category: Nursing Tags: Original Articles Source Type: research
AbstractTraumatic brain injury (TBI) is one of the leading public health problems in the USA and worldwide. It is the number one cause of death and disability in children and adults between ages 1 –44. Despite efforts to prevent TBIs, the incidence continues to rise. Secondary brain injury occurs in the first hours and days after the initial impact and is the most effective target for intervention. Inflammatory processes and oxidative stress play an important role in the pathomechanism of T BI and are exacerbated by impaired endogenous defense mechanisms, including depletion of antioxidants. As a reducing agent, free...
Source: Neurocritical Care - Category: Neurology Source Type: research
ConclusionICU survivors referred to rehabilitation centers after SPG-related amputations had impaired HRQOL. At the time of HRQOL assessment, they considered themselves in good health and preferred to be treated again despite disability. Appraisal of long-term functional outcome should not be used to guide end-of-life decision-making in this situation.
Source: Journal of Critical Care - Category: Gastroenterology Source Type: research
CONCLUSIONS: At PUMCH, the new collaborative salvage protocol with proactive use of NPWT with simultaneous life- support methods resulted in greater therapeutic effects than traditional salvage treatment could offer. PMID: 30212366 [PubMed - in process]
Source: Wounds - Category: General Medicine Tags: Wounds Source Type: research
CONCLUSION: Early physical rehabilitation may improve functional recovery at hospital discharge, especially in patients with high initial severity scores. PMID: 30091317 [PubMed - in process]
Source: Yonsei Medical Journal - Category: Universities & Medical Training Authors: Tags: Yonsei Med J Source Type: research
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