The Restrictive IV Fluid Trial in Severe Sepsis and Septic Shock (RIFTS): A Randomized Pilot Study
RCT (n=109) demonstrates a restrictive resuscitation strategy can successfully reduce the amount of IV fluid administered to patients with severe sepsis and septic shock compared with usual care. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - May 15, 2019 Category: Consumer Health News Source Type: news

Diagnosis Sepsis: Is Newer Better?
In hospitalized patients who deteriorated from suspected infection, Sepsis-3 septic shock criteria predicted in-hospital mortality better than systemic inflammatory response syndrome-based criteria. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Open abdominal management for perforative peritonitis with septic shock: a retrospective analysis on usefulness of a standardized treatment protocol
Damage control surgery (DCS) with open abdominal management (OAM) has been increasingly expanded to include critically ill non-trauma patients. However, there is limited data regarding the usefulness of this protocol for the treatment of severe perforative peritonitis (PP), especially with septic shock (SS). Here, we retrospectively evaluated the usefulness of our OAM protocol for PP with SS. A standardized protocol for OAM may improve the outcomes of patients with SS due to PP. This damage control approach can be applied for the treatment of severe abdominal sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Association of septic shock definitions and standardized mortality ratio in a contemporary cohort of critically ill patients
The newly proposed septic shock definition has provoked a substantial controversy in the emergency and critical care communities. We aim to compare new (SEPSIS-III) versus old (SEPSIS-II) definitions for septic shock in a contemporary cohort of critically ill patients. Compared to SEPSIS-II, SEPSIS-III definition of septic shock identifies patients further along disease trajectory with higher likelihood of poor outcome. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Hemodynamic response to β-blockers in severe sepsis and septic shock: A review of current literature
The administration of β-blockers in patients with sepsis is a trending topic in intensive care medicine since the landmark study by Morelli and colleagues, showing a striking decrease in 28-day mortality compared to standard care. While the available evidence suggests that the use of β-blockers in septic shock is safe, the effects on hemodynamics are controversial. In this paper, we review the effect of β-blockade in septic shock on hemodynamics from animal models to critically ill patients. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Comparison of the accuracy of three early warning scores with SOFA score for predicting mortality in adult sepsis and septic shock patients admitted to intensive care unit.
The purpose of this study was to compare the accuracy of the Modified Early Warning Score (MEWS), National Early Warning Score (NEWS) and Search Out Severity (SOS), with the quick Sequential Organ Failure Assessment (qSOFA) and SOFA scores, to predict outcomes in sepsis patients. The SOS presents nearly as good as the SOFA score, to predict mortality among sepsis patients admitted to the ICU. The early warning score is another, alternative tool to use for risk stratification and sepsis screening for ICU sepsis patients. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Cost-effectiveness of rapid diagnostic assays that perform directly on blood samples for the diagnosis of septic shock
Molecular diagnostic assays that test directly whole blood provide the ability to decrease inappropriate antimicrobial therapy and improve survival in patients with septic shock. We developed a decision analysis model to evaluate the cost-effectiveness of the addition of molecular assays to blood cultures in adults admitted to medical ICUs with septic shock. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

The Safety of Vasopressin Receptor Agonists in Septic Shock The Safety of Vasopressin Receptor Agonists in Septic Shock
What do we currently know about the effects and safety of vasopressin receptor agonists in septic shock patients?Critical Care (Source: Medscape Critical Care Headlines)
Source: Medscape Critical Care Headlines - April 23, 2019 Category: Intensive Care Tags: Critical Care Journal Article Source Type: news

Women went into septic shock after surgeons snagged her intestine during 'routine' surgery
Bonnie Judge, 35, of Utah, went under the knife in September last year to clear a blockage in her bowel ahead of having her appendix removed. Her inflamed colon caused the 'nick'. (Source: the Mail online | Health)
Source: the Mail online | Health - April 16, 2019 Category: Consumer Health News Source Type: news

Sepsis and septic shock: current approaches to management
Sepsis, defined as life-threatening organ dysfunction due to a dysregulated host response to infection, is recognised by the World Health Organization as a global health priority. Each year, 5000 of the 18 000 adults with sepsis treated in Australian intensive care units die, with survivors suffering long-term physical, cognitive and psychological dysfunction, which is poorly recognised and frequently untreated. There are currently no effective pharmacological treatments for sepsis, making early recognition, resuscitation and immediate treatment with appropriate antibiotics the key to reducing the burden of resulting disea...
Source: Current Awareness Service for Health (CASH) - March 28, 2019 Category: Consumer Health News Source Type: news

Analysis of a new best-practice advisory on time to initiation of antibiotics in surgical intensive care unit patients with septic shock
Early administration of antibiotics in septic shock is associated with decreased mortality. Promptly identifying sepsis and eliciting a response are necessary to reduce time to antibiotic administration. A new best-practice advisory has been effective at eliciting a rapid response and reducing the time-to-antibiotics in surgical intensive care unit patients with septic shock. Team notification and pharmacist response are associated with decreased time-to-antibiotics. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - March 28, 2019 Category: Consumer Health News Source Type: news

Adherence to fluid resuscitation guidelines and outcomes in patients with septic shock: Reassessing the " one-size-fits-all " approach
The Surviving Sepsis Campaign and Centers for Medicare and Medicaid Services (CMS) Severe Sepsis and Septic Shock Management Bundle (SEP-1) recommend rapid crystalloid infusion ( ≥30 mL/kg) for patients with sepsis-induced hypoperfusion or septic shock. We aimed to assess compliance with this recommendation, factors associated with non-compliance, and how compliance relates to mortality. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - March 28, 2019 Category: Consumer Health News Source Type: news

Woman who lost limbs after dog bite says sepsis foundation will save lives
An Ottawa woman who lost both her legs and one of her arms after a dog bite sent her into septic shock says a new foundation designed to spread awareness about sepsis and connect survivors will save lives. (Source: CBC | Health)
Source: CBC | Health - March 25, 2019 Category: Consumer Health News Tags: News/Canada/Ottawa Source Type: news

Left ventricular systolic function evaluated by strain echocardiography and relationship with mortality in patients with severe sepsis or septic shock: a systematic review and meta-analysis
Sepsis-induced myocardial dysfunction is associated with poor outcomes, but traditional measurements of systolic function such as left ventricular ejection fraction (LVEF) do not directly correlate with prognosis. Global longitudinal strain (GLS) utilizing speckle-tracking echocardiography (STE) could be a better marker of intrinsic left ventricular (LV) function, reflecting myocardial deformation rather than displacement and volume changes. The authors sought to investigate the prognostic value of GLS in patients with sepsis and/or septic shock. Worse GLS (less negative) values are associated with higher mortality in pati...
Source: Current Awareness Service for Health (CASH) - February 22, 2019 Category: Consumer Health News Source Type: news

Intra-abdominal sepsis: new definitions and current clinical standards
The abdomen is the second most common source of sepsis and is associated with unacceptably high morbidity and mortality. Recently, the essential definitions of sepsis and septic shock were updated (Third International Consensus Definitions for Sepsis and Septic Shock, Sepsis-3) and modified. The purpose of this review is to provide an overview of the changes introduced by Sepsis-3 and the current state of the art regarding the treatment of abdominal sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - February 22, 2019 Category: Consumer Health News Source Type: news

Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock: A Systematic Review and Meta-analysis
The authors performed a systematic review and meta-analysis of studies of children with severe sepsis and septic shock to elucidate the patterns of CFRs in developing and developed countries over time. They also described factors associated with CFRs. Despite the declining trend of pediatric severe sepsis and septic shock CFRs, the disparity between developing and developed countries persists. Further characterizations of vulnerable populations and collaborations between developed and developing countries are warranted to reduce the burden of pediatric sepsis globally. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - February 22, 2019 Category: Consumer Health News Source Type: news

Alternate Resuscitation Target Does Not Cut Sepsis Mortality Alternate Resuscitation Target Does Not Cut Sepsis Mortality
A peripheral perfusion resuscitation strategy was not superior to the standard lactate-level testing currently used in patients with early septic shock in the five-country ANDROMEDA-SHOCK trial.Medscape Medical News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - February 19, 2019 Category: Consumer Health News Tags: Critical Care News Source Type: news

A Nationwide Comparison Between Sepsis-2 and Sepsis-3 Definition in Japan
Currently, it remains controversial whether the Sepsis-3 definition provides the most appropriate criteria for clinical use. The purpose of this study was to compare between the Sepsis-2 and Sepsis-3 definitions using Japan's nationwide registry. The ICU mortality of the " Sepsis-2 shock-only " group was significantly low. Besides septic shock diagnosed by the Sepsis-3 definition selects patients with more severe cases of sepsis among the " Sepsis-2 shock " group. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - February 14, 2019 Category: Consumer Health News Source Type: news

Effect of Troponin I Elevation on Duration of Mechanical Ventilation and Length of Intensive Care Unit Stay in Patients With Sepsis
Sepsis is a leading cause of mortality and morbidity. Recent studies suggest that troponin elevation is associated with increased mortality in sepsis patients. The purpose of this study is to determine the effect of troponin elevation on mechanical ventilation duration and intensive care unit (ICU) length of stay in patients with sepsis. Additionally, we investigated the association between troponin elevation and septic shock. Troponin elevation was associated with longer duration of mechanical ventilation in patients admitted to ICU with sepsis. Troponin elevation was associated with higher risk for development of septic ...
Source: Current Awareness Service for Health (CASH) - February 14, 2019 Category: Consumer Health News Source Type: news

Sepsis National Hospital Inpatient Quality Measure (SEP-1): Multistakeholder Work Group Recommendations for Appropriate Antibiotics for the Treatment of Sepsis
The Center for Medicare and Medicaid Services adopted the Early Management Bundle, Severe Sepsis/Septic Shock (SEP-1) performance measure to the Hospital Inpatient Quality Reporting Program in July 2015 to help address the high mortality and high cost associated with sepsis. The SEP-1 performance measure requires, among other critical interventions, timely administration of antibiotics to patients with sepsis or septic shock. The multistakeholder workgroup recognizes the need for SEP-1 but strongly believes that multiple antibiotics listed in the antibiotic tables for SEP-1 are not appropriate and the use of these antibiot...
Source: Current Awareness Service for Health (CASH) - February 14, 2019 Category: Consumer Health News Source Type: news

Infectious Diseases Team for the Early Management of Severe Sepsis and Septic Shock in the Emergency Department
The impact on patient survival of an infectious disease (ID) team dedicated to the early management of severe sepsis/septic shock (SS/SS) in Emergency Department (ED) has yet to be assessed. Implementation of an ID team for the early management of SS/SS in the ED improved the adherence to SSC recommendations and patient survival. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - February 14, 2019 Category: Consumer Health News Source Type: news

Using lean methodology to optimize time to antibiotic administration in patients with sepsis
Results of a study to apply lean methodology to an inpatient pharmacy workflow to optimize timely administration of Centers for Medicare and Medicaid Services (CMS)-approved antibiotics for patients with severe sepsis or septic shock are presented. Lean methodology was successfully used to reduce time to antibiotic administration, which led to improved compliance with the newly implemented sepsis CMS core measure. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - February 14, 2019 Category: Consumer Health News Source Type: news

Parents express deep sorrow at sentencing hearing after being convicted in their toddler's death
"I can never get over the fact that John doesn't get to be a man," says a Calgary father as he and his wife faced a sentencing hearing after being convicted in the death of their toddler, who was taken to hospital in septic shock, with four gangrenous toes. (Source: CBC | Health)
Source: CBC | Health - February 8, 2019 Category: Consumer Health News Tags: News/Canada/Calgary Source Type: news

'I feel the presence of his loss': Calgary parents guilty in death of toddler address court
"I can never get over the fact that John doesn't get to be a man," says a Calgary father as he and his wife faced a sentencing hearing. They were convicted in the death of their toddler, who was taken to hospital in septic shock, with four gangrenous toes. (Source: CBC | Health)
Source: CBC | Health - February 8, 2019 Category: Consumer Health News Tags: News/Canada/Calgary Source Type: news

More Septic Shock Control With Early Norepinephrine vs Standard Care (CME/CE)
(MedPage Today) -- Achieved by 6 hours after Thai adults with sepsis and hypotension received early norepinephrine (Source: MedPage Today Infectious Disease)
Source: MedPage Today Infectious Disease - February 7, 2019 Category: Infectious Diseases Source Type: news

Early Norepinephrine Stabilizes Septic Shock Patients Faster
(MedPage Today) -- Randomized trial shows clear benefit, no sign of harm (Source: MedPage Today Infectious Disease)
Source: MedPage Today Infectious Disease - February 2, 2019 Category: Infectious Diseases Source Type: news

Not-for-profit to offer 20 generic drugs in 2019 to alleviate shortages
A new not-for-profit supplier of generic drugs formed by a consortium of hospitals systems said it expects this year to be able to provide about 20 products to alleviate shortages of medicines used during surgeries and to treat life-threatening conditions, such as septic shock. (Source: Reuters: Health)
Source: Reuters: Health - January 24, 2019 Category: Consumer Health News Tags: healthNews Source Type: news

Can a Polymer Help Reduce Deaths from Sepsis?
Sepsis is one of the leading causes of death in hospitals, and incidences are on the rise, according to the National Institute of General Medical Sciences (NIGMS). Two independent cohort studies published in JAMA found that sepsis contributed to 1 in every 2 to 3 deaths.1 Harshu Musunuri wants to help prevent such deaths. Majoring in Chemical Engineering at Stanford, the 18-year-old student is developing a synthetic (polymer) material that could act as both a diagnostic and a therapeutic agent for the bacterial toxins involved in the infections associated with sepsis. She has just won the first Pion...
Source: MDDI - January 19, 2019 Category: Medical Devices Authors: Daphne Allen Tags: R & D Source Type: news

Doppler-defined pulmonary hypertension in sepsis and septic shock
The authors of this study state that the association of pulmonary hypertension (PH) in patients with sepsis is lesser understood. In patients with sepsis and septic shock, PH is common and is noted to be associated with higher short and long-term mortality. Further studies are needed to understand the mechanisms by which PH is associated with outcomes. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 17, 2019 Category: Consumer Health News Source Type: news

Sepsis: Early Recognition and Optimized Treatment
The authors of this article state that sepsis is a life-threatening condition caused by infection and represents a substantial global health burden. Recent epidemiological studies showed that sepsis mortality rates have decreased, but that the incidence has continued to increase. Although a mortality benefit from early-goal directed therapy (EGDT) in patients with severe sepsis or septic shock was reported in 2001, three subsequent multicenter randomized studies showed no benefits of EGDT versus usual care. Nonetheless, the early administration of antibiotics and intravenous fluids is considered crucial for the treatment o...
Source: Current Awareness Service for Health (CASH) - January 17, 2019 Category: Consumer Health News Source Type: news

A Retrospective Review of the Sepsis Definition after Publication of Sepsis-3
The authors of this review article state that two and a half years after the introduction of Sepsis-3, clinicians continue not to document Sequential Organ Failure Assessment (SOFA) scores. The purpose of the review is to determine if the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) were being utilized in defining sepsis in the clinical setting. There continue to be variations in what standard is accepted by both commercial payers and the Centers for Medicare and Medicaid (CMS) in diagnosing sepsis. Due to Sepsis-3 criteria not being accepted by CMS or the Infectious Disease Society of A...
Source: Current Awareness Service for Health (CASH) - January 17, 2019 Category: Consumer Health News Source Type: news

Circulating adrenomedullin estimates survival and reversibility of organ failure in sepsis: the prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock-1 (AdrenOSS-1) study
The authors of this journal article state that adrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, they assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled ...
Source: Current Awareness Service for Health (CASH) - January 17, 2019 Category: Consumer Health News Source Type: news

Liberal versus conservative fluid therapy in adults and children with sepsis or septic shock
This Review says that based on data from 3 paediatric RCTs (n=3402), liberal fluid therapy might increase mortality among children with sepsis or septic shock in hospital and at four ‐week follow‐up. Trials including adults, and patients with a broader spectrum of pathogens are needed. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 16, 2019 Category: Consumer Health News Source Type: news

Effectiveness and safety of procalcitonin evaluation for reducing mortality in adults with sepsis, severe sepsis or septic shock
This Cochrane Review was Substantively amended in January 2019. However, there was no change to the conclusion, that Up-to-date evidence of very low to moderate quality, with insufficient sample power per outcome, does not clearly support the use of procalcitonin-guided antimicrobial therapy to minimize mortality, mechanical ventilation, clinical severity, reinfection or duration of antimicrobial therapy of patients with septic conditions. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 11, 2019 Category: Consumer Health News Source Type: news

Sepsis | Medscape Sepsis | Medscape
Review clinical reference information, guidelines, and medical news on sepsis, including identification of sepsis blood infection and septic shock. Review guidelines on SIRS sepsis, Candida sepsis, MRSA sepsis, and pneumococcal sepsis. (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - January 4, 2019 Category: Consumer Health News Tags: Resource Center Source Type: news

Hydrocortisone, Ascorbic Acid and Thiamine (HAT Therapy) for the Treatment of Sepsis. Focus on Ascorbic Acid
The authors of this journal article state that sepsis is a devastating disease that carries an enormous toll in terms of human suffering and lives lost. They say that over 100 novel pharmacologic agents that targeted specific molecules or pathways have failed to improve the outcome of sepsis. Preliminary data suggests that the combination of Hydrocortisone, Ascorbic Acid and Thiamine (HAT therapy) may reduce organ failure and mortality in patients with sepsis and septic shock. HAT therapy is based on the concept that a combination of readily available, safe and cheap agents, which target multiple components of the host's r...
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Prompt admission to intensive care is associated with improved survival in patients with severe sepsis and/or septic shock
This research article aims to investigate the association between time from hospital admission to intensive care unit (ICU) admission (door to ICU time) and hospital mortality in patients with sepsis. A shorter time from hospital door to ICU admission was shown to be independently associated with reduced hospital mortality in patients with severe sepsis and/or septic shock. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Emerging Adjunctive Approach for the Treatment of Sepsis: Vitamin C and Thiamine.
The authors of this journal article say that evidence is emerging that parenteral administration of high-dose vitamin C and thiamine may be a beneficial adjuvant therapy of severe sepsis and septic shock. Despite modern practices in critical care medicine, sepsis and severe sepsis remain a leading cause of morbidity and mortality in the critical care unit. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

The use of procalcitonin in the determination of severity of sepsis, patient outcomes and infection characteristics
The primary objective of this study was to determine the correlation between procalcitonin values and illness severity by evaluating the degree of end organ dysfunction using the Sequential Organ Failure Assessment score, length of stay and the severity of sepsis (sepsis alone vs. septic shock), The hypothesis that procalcitonin values would be higher in sicker patients was formulated before data collection began. Secondary outcomes studied in relation to procalcitonin levels included infection characteristics such as the site of infection, microbial agent and dialysis dependent CKD. Procalcitonin has a higher specificity ...
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock
This review concludes that there is no adequate, direct evidence as to whether de-escalation of antimicrobial agents is effective and safe for adults with sepsis, severe sepsis or septic shock. The authors say this uncertainty warrants further research via RCTs and the authors are awaiting the results of an ongoing RCT testing the de-escalation of empirical antimicrobial therapy for severe sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Liberal versus conservative fluid therapy in adults and children with sepsis or septic shock
This review concludes low ‐ to high‐quality evidence shows that liberal fluid therapy may increase the death rate for children with sepsis or septic shock. Except for this finding, the authors are uncertain about the effects of liberal versus conservative fluid therapy on the risk of adverse events. They are also uncerta in about the effects of these two interventions for adults with sepsis or septic shock due to lack of data. Future trials focusing on adult sepsis or septic shock in other settings, with a wider range of pathogens, are expected. The authors say that once published and assessed, the three'ongoing'studie...
Source: Current Awareness Service for Health (CASH) - December 19, 2018 Category: Consumer Health News Source Type: news

Mayo Clinic Q and A: Understanding sepsis and septic shock
DEAR MAYO CLINIC:?Who?s most at risk for developing sepsis, and what are the symptoms to watch for? What?s the difference between sepsis and septic shock? ANSWER:?Sepsis?is a serious complication of an infection. It often triggers various symptoms, including high fever, elevated heart rate and fast breathing. If sepsis goes unchecked, it can progress to septic [...] (Source: News from Mayo Clinic)
Source: News from Mayo Clinic - December 7, 2018 Category: Databases & Libraries Source Type: news

Diagnostics Are Helping Counter Antimicrobial Resistance, But More Work Is Needed
Antimicrobial resistance (AMR) threats to patient health are becoming more widely recognized and diagnostics manufacturers are making significant progress in combatting the overuse of antibiotics. There is still a lot of work to be done, however. A recent health scare for Rick Bright, Ph.D., director of the Biomedical Advanced Research and Development Authority (BARDA), HHS, the very agency working to combat emerging infectious diseases (EID) and other threats, highlights the lingering risks.  During the 10th Public Meeting of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB...
Source: MDDI - November 21, 2018 Category: Medical Devices Authors: Daphne Allen Tags: IVD Source Type: news

Current Management of Gram-Negative Septic Shock Current Management of Gram-Negative Septic Shock
Septic shock is a potentially life-threatening condition, and its management can be challenging. How are Gram-negative infections best treated?Current Opinion in Infectious Diseases (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - November 19, 2018 Category: Consumer Health News Tags: Infectious Diseases Journal Article Source Type: news

Ascorbic acid, corticosteroids, and thiamine in sepsis: a review of the biologic rationale and the present state of clinical evaluation
This review states that the combination of thiamine, ascorbic acid, and hydrocortisone has recently emerged as a potential adjunctive therapy to antibiotics, infectious source control, and supportive care for patients with sepsis and septic shock. In the present manuscript, the authors provide a comprehensive review of the pathophysiologic basis and supporting research for each element of the thiamine, ascorbic acid, and hydrocortisone drug combination in sepsis. In addition, they describe potential areas of synergy between these therapies and discuss the strengths/weaknesses of the two studies to date which have evaluated...
Source: Current Awareness Service for Health (CASH) - November 16, 2018 Category: Consumer Health News Source Type: news

Transcriptomic Signatures in Sepsis and a Differential Response to Steroids: From the VANISH Randomized Trial
This research article states that there remains uncertainty about the role of corticosteroids in sepsis with clear beneficial effects on shock duration but conflicting survival effects. Two transcriptomic sepsis response signatures (SRS) have been identified. SRS1 is relatively immunosuppressed whilst SRS2 is relatively immunocompetent. The Transcriptomic profile at onset of septic shock was associated with response to corticosteroids. The study concludes that those with the immuno-competent SRS2 endotype had significantly higher mortality when given corticosteroids compared to placebo. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - November 16, 2018 Category: Consumer Health News Source Type: news

Timing of Renal-Replacement Therapy in Patients with Acute Kidney Injury and Sepsis
This research article states that acute kidney injury is the most frequent complication in patients with septic shock and is an independent risk factor for death. The authors say that although renal-replacement therapy is the standard of care for severe acute kidney injury, the ideal time for initiation remains controversial. The study found that among patients with septic shock who had severe acute kidney injury, there was no significant difference in overall mortality at 90 days between patients who were assigned to an early strategy for the initiation of renal-replacement therapy and those who were assigned to a delayed...
Source: Current Awareness Service for Health (CASH) - November 16, 2018 Category: Consumer Health News Source Type: news

Antibiotics for Sepsis-Finding the Equilibrium
This journal article describes sepsis is medicine's last remaining preserve for unrestrained antibiotic prescribing. The Surviving Sepsis Campaign guidelines recommend empirical broad-spectrum therapy within one hour of triage for both sepsis and septic shock.1 This recommendation, and mandates that compel it, encourage clinicians to adopt an approach of “treat first, ask questions later” for patients with any possibility of serious infection. The authors state that this approach fails to account for the difficulties clinicians face with diagnosing infection, especially when patients initially present to care, ...
Source: Current Awareness Service for Health (CASH) - November 15, 2018 Category: Consumer Health News Source Type: news

Oregon researchers discover novel anti-inflammatory bacterial protein
(University of Oregon) Researchers at the University of Oregon have identified a novel protein secreted by a common gut bacterium in zebrafish that reduces inflammation in the gut and delays death by septic shock. (Source: EurekAlert! - Biology)
Source: EurekAlert! - Biology - November 6, 2018 Category: Biology Source Type: news

Derivation of a screen to identify severe sepsis and septic shock in the Emergency Department-BOMBARD vs. SIRS and qSOFA
This study looks to predict severe sepsis/septic shock in ED patients. The authors conducted a retrospective case-control study of patients ≥18 admitted to two urban hospitals with a combined ED census of 162,000. Study cases included patients with severe sepsis/septic shock admitted via the ED. Controls comprised admissions without severe sepsis/septic shock. Using multivariate logistic regression, a prediction rule was const ructed - BOMBARD. The model's AUROC was internally validated using 1000 bootstrap samples. BOMBARD was more accurate than SIRS and qSOFA at predicting severe sepsis/septic shock and sepsis mortali...
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news