Intravenous fluid therapy in sepsis
Sepsis is the dysregulated immune response to severe infection that is common and lethal among critically ill patients. Fluid administration is a common treatment for hypotension and shock in early sepsis. Fluid therapy can also cause edema and organ dysfunction. Research on the best treatment strategies for sepsis has provided insights on the optimal timing, dose, and type of fluid to treat patients with sepsis. Initial research on early goal-directed therapy for sepsis included an initial bolus of 30 ml/kg of fluid, but more recent research has supported use of smaller volumes. After initial fluid resuscitation, minimizi...
Source: Current Awareness Service for Health (CASH) - September 15, 2022 Category: Consumer Health News Source Type: news

Surviving Sepsis Campaign Guidelines 2021: highlights for the practicing clinician
The 2021 Surviving Sepsis Campaign Guidelines provided evidence-based recommendations for adult patients with sepsis and septic shock. This iteration of the guidelines placed increased emphasis on a diverse, global perspective, as well as on the long-term sequelae of sepsis experienced by patients and their families. The guidelines encompassed the following sections: 1) screening and early treatment; 2) infection; 3) hemodynamic management; 4) ventilation; 5) additional therapies; and 6) goals of care and long-term outcomes. In this review, we provide a summary of key recommendations of interest to the practicing clinician...
Source: Current Awareness Service for Health (CASH) - September 15, 2022 Category: Consumer Health News Source Type: news

SOFA Score in relation to Sepsis: Clinical Implications in Diagnosis, Treatment, and Prognostic Assessment
Purpose: To analyze the clinical significance of the sequential organ failure assessment (SOFA) score in the diagnosis, treatment, and prognostic assessment of sepsis. Methods: 140 patients with sepsis from January 2020 to January 2021 were selected as the observation group, and 40 healthy people were selected as the control group. The observation group was divided into mild group, severe group, and septic shock group by single blind grouping according to the condition of the disease, and they were also divided into survival group and death group according to the prognosis. Collect the fasting venous blood of the subjects...
Source: Current Awareness Service for Health (CASH) - September 12, 2022 Category: Consumer Health News Source Type: news

Renin as a Marker of Tissue Perfusion, Septic Shock and Mortality in Septic Patients: A Prospective Observational Study
Objectives: To characterize renin in critically ill patients. Renin is fundamental to circulatory homeostasis and could be a useful marker of tissue-perfusion. However, diurnal variation, continuous renal replacement therapy and drug-interference could confound its use in critical care practice. Design: Prospective observational study. Setting: Single-center, mixed medical-surgical ICU in Europe. Patients: Patients over 18 years old with a baseline estimated glomerular filtration rate greater than 30 mL/min/1.73 m and anticipated ICU stay greater than 24 hours. Informed consent was obtained from the patient or next-of-k...
Source: Current Awareness Service for Health (CASH) - September 9, 2022 Category: Consumer Health News Source Type: news

A nationwide study on characteristics and outcome of cancer patients with sepsis requiring intensive care.
Background: Sepsis is the leading cause of admission to the intensive care unit (ICU) for cancer patients and survival rates have historically been low. The aims of this nationwide cohort study were to describe the characteristics and outcomes of cancer patients admitted to the ICU with sepsis compared with other sepsis patients requiring ICU admission. Material and methods: This was a retrospective, observational study. All adult admissions to Icelandic ICUs during years 2006, 2008, 2010, 2012, 2014 and 2016 were screened for severe sepsis or septic shock by ACCP/SCCM criteria. Clinical characteristics and outcomes of se...
Source: Current Awareness Service for Health (CASH) - September 9, 2022 Category: Consumer Health News Source Type: news

Right dose, right now: bedside, real-time, data-driven, and personalised antibiotic dosing in critically ill patients with sepsis or septic shock-a two-centre randomised clinical trial
This study evaluates the feasibility, safety and efficacy of its clinical implementation. Methods: In this two-centre randomised clinical trial, critically ill patients with sepsis or septic shock were randomised to AutoKinetics dosing or standard dosing for four antibiotics: vancomycin, ciprofloxacin, meropenem, and ceftriaxone. Adult patients with a confirmed or suspected infection and either lactate> 2 mmol/L or vasopressor requirement were eligible for inclusion. The primary outcome was pharmacokinetic target attainment in the first 24 h after randomisation. Clinical endpoints included mortality, ICU length of stay an...
Source: Current Awareness Service for Health (CASH) - September 8, 2022 Category: Consumer Health News Source Type: news

Multiple datasets to explore the molecular mechanism of sepsis
Conclusion: In this study, a series of algorithms were used to identify five key genes that are associated with septic shock, which may become potential candidate targets for septic shock diagnosis and treatment. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 5, 2022 Category: Consumer Health News Source Type: news

Evolution of platelet activation parameters during septic shock in intensive care unit
During severe sepsis, platelet activation may induce disseminate microvascular thrombosis, which play a key role in critical organ failure. Crucially, most of the studies in this field have explored platelet-leukocyte interactions in animal models, or explored platelets under the spectrum of thrombocytopenia or disseminated intravascular coagulation and have not taken into account the complex interplay that might exist between platelets and leukocytes during human septic shock nor the kinetics of platelet activation. Here, we assessed platelet activation parameters at the admission of patients with sepsis to the intensive ...
Source: Current Awareness Service for Health (CASH) - September 5, 2022 Category: Consumer Health News Source Type: news

Surviving Sepsis Campaign Guidelines 2021: highlights for the practicing clinician
The 2021 Surviving Sepsis Campaign Guidelines provided evidence-based recommendations for adult patients with sepsis and septic shock. This iteration of the guidelines placed increased emphasis on a diverse, global perspective, as well as on the long-term sequelae of sepsis experienced by patients and their families. The guidelines encompassed the following sections: 1) screening and early treatment; 2) infection; 3) hemodynamic management; 4) ventilation; 5) additional therapies; and 6) goals of care and long-term outcomes. In this review, we provide a summary of key recommendations of interest to the practicing clinician...
Source: Current Awareness Service for Health (CASH) - September 5, 2022 Category: Consumer Health News Source Type: news

Coupled plasma filtration adsorption for the treatment of sepsis or septic shock: a systematic review and meta-analysis
Conclusions: The treatment of CPFA failed to decrease all-cause mortality of sepsis or septic shock patients. Further large-scale randomized controlled trials (RCTs) evaluating the ability of this therapy to improve clinical outcomes are still required to confirm these results. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 5, 2022 Category: Consumer Health News Source Type: news

A pilot study on the melatonin treatment in patients with early septic shock: results of a single-center randomized controlled trial.
Conclusions: Our pilot study supported the potential benefits of melatonin in treating septic shock. Further clinical evidence is required for expanding and confirming these findings. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 15, 2022 Category: Consumer Health News Source Type: news

A 2-year retrospective analysis of the prognostic value of MqSOFA compared to lactate, NEWS and qSOFA in patients with sepsis
Purpose: Sepsis is a life-threating organ dysfunction caused by a dysregulated host response to infection. Being a time-dependent condition, the present study aims to compare a recently established score, i.e., modified quick SOFA (MqSOFA), with other existing tools commonly applied to predict in-hospital mortality. Methods: All cases of sepsis and septic shock consecutively observed at St. Anna University Hospital of Ferrara, Italy, from January 2017 to December 2018 were included in this study. Each patient was evaluated with MqSOFA, lactate assay, NEWS and qSOFA. Accurate statistical and logistic regression analyses wer...
Source: Current Awareness Service for Health (CASH) - August 15, 2022 Category: Consumer Health News Source Type: news

What Is the Narrative You Hear When Faced With Uncertainty?
(MedPage Today) -- The first week of my big attending job, I saw a patient with fever, sore throat, no cough, and tonsillar exudates. Well-trained to manage septic shock, but having no idea how to practice in a primary care clinic, I crafted a... (Source: MedPage Today Public Health)
Source: MedPage Today Public Health - July 27, 2022 Category: American Health Source Type: news

Evaluating the impact of severe sepsis 3-hour bundle compliance on 28-day in-hospital mortality: A propensity adjusted, nested case-control study
Conclusions: Three-hour bundle compliance did not impact 28-day in-hospital mortality in patients with severe sepsis. Further research is needed to understand the impact of 3-hour bundle compliance on mortality in severe sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 25, 2022 Category: Consumer Health News Source Type: news

Benefits of esmolol in adults with sepsis and septic shock: An updated meta-analysis of randomized controlled trials
Conclusions: Esmolol treatment may be safe and effective in decreasing 28-day mortality, controlling heart rate, and providing cardioprotective function, but has no effect on lung injury in patients with sepsis or septic shock after early fluid resuscitation. Improvement in cardiac function may be related to changes in serum inflammatory mediators. No significant adverse effects on tissue perfusion and oxygen utilization were observed. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 15, 2022 Category: Consumer Health News Source Type: news