Antibiotic therapy in sepsis: No next time for a second chance! "
What is known and objective: Sepsis is a life ‐threatening organ dysfunction associated with a high rate of morbidity and mortality. Appropriate antibiotic therapy remains the cornerstone of sepsis and septic shock management. Comment: Although the early initiation of antimicrobial agents in the treatment of sepsis is widely acknowledged, the selection and adjustment to optimal dosage can be equally important. Since significant pathophysiological changes in the critically ill patients lead to altered pharmacokinetics of antibiotics, early consideration of pharmacokinetic/pharmacodynamic (PK/PD) properties is necessary fo...
Source: Current Awareness Service for Health (CASH) - August 11, 2021 Category: Consumer Health News Source Type: news
Association of ischemia modified albumin with mortality in qSOFA positive sepsis patients by sepsis-3 in the emergency department
This study aimed to investigate whether IMA was associated with short-term mortality in quick sequential organ failure assessment (qSOFA)-positive sepsis or septic shock patients screened by the sepsis management program.; Method: From September 2019 to April 2020, patients who arrived at the emergency departments with qSOFA-positive sepsis or septic shock were included in this retrospective observational study.; Results: Among 124 patients analyzed, IMA was higher in the non-surviving group than in the surviving group (92.6 ± 8.1 vs. 86.8 ± 6.2 U/mL, p (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 9, 2021 Category: Consumer Health News Source Type: news
Emerging mechanisms of immunocoagulation in sepsis and septic shock
Sepsis and septic shock driven by microbial infections are still among the most challenging health problems, causing 11 million deaths worldwide every year. How does the host ' s response to pathogen infections effectively restore homeostasis instead of precipitating pathogenic and potentially fatal feedforward reactions? Recently, there have been significant new advances in our understanding of the interface between mammalian immunity and coagulation ( ' immunocoagulation ' ) and its impact on sepsis. In particular, the release and activation of F3 (the main initiator of coagulation) from and on myeloid or epithelial cell...
Source: Current Awareness Service for Health (CASH) - July 9, 2021 Category: Consumer Health News Source Type: news
Lower socioeconomic factors are associated with higher mortality in patients with septic shock
Background: Previous studies have explored the relationship between socioeconomic status and sepsis outcomes OBJECTIVES: The purpose of this investigation is to determine if race, ethnicity, economic stability, neighborhood environment, and access to health care are predictive of mortality in patients with septic shock.; Methods: Retrospective study of septic shock patients admitted to two medical centers.; Results: Caucasian patients had higher proportion of outpatient physician visits in the year prior to admission and were less likely to be Medicare or Medicaid beneficiaries. Thirty-day mortality was lower for the Cauca...
Source: Current Awareness Service for Health (CASH) - July 9, 2021 Category: Consumer Health News Source Type: news
Thiamine combined with vitamin C in sepsis or septic shock: a systematic review and meta-analysis
Conclusions: Despite widespread enthusiasm for thiamine combined with vitamin C for sepsis and septic shock, we only found an association with reduced SOFA score and time of vasopressor use. There was no association with in-hospital mortality. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 9, 2021 Category: Consumer Health News Source Type: news
Treatment of suspected sepsis and septic shock in children with chronic disease seen in the pediatric emergency department
Conclusions: Study findings suggest pediatric patients with chronic disease with suspected sepsis or septic shock in the PED have a slower time to IVF administration but equivocal use of sepsis recognition tools compared to patients without chronic disease. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 9, 2021 Category: Consumer Health News Source Type: news
Evaluation of hospital nurse-to-patient staffing ratios and sepsis bundles on patient outcomes...Association for Professionals in Infection Control and Epidemiology, Annual Conference (Virtual), 28-30 June, 2021
• New York state was one of the first to require implementation of sepsis bundles. • Patient-to-nurse staffing ratios vary considerably across hospitals in New York. • Sepsis outcomes vary despite bundle requirements because of nurse staffing. • Requiring minimum nurse staffing along with se psis bundles may improve outcomes. Despite nurses ' responsibilities in recognition and treatment of sepsis, little evidence documents whether patient-to-nurse staffing ratios are associated with clinical outcomes for patients with sepsis. Using linked data sources from 2017 including MEDPAR patient claims, Hospital Compare, Am...
Source: Current Awareness Service for Health (CASH) - July 9, 2021 Category: Consumer Health News Source Type: news
Time to antibiotic administration: Sepsis alerts called in emergency department versus in the field via emergency medical services
Introduction: The Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) identifies patients with " severe sepsis " and mandates antibiotics within a specific time window. Rapid time to administration of antibiotics may improve patient outcomes. The goal of this investigation was to compare time to antibiotic administration when sepsis alerts are called in the emergency department (ED) with those called in the field by emergency medical services (EMS).; Methods: This was a multi-center, retrospective review of patients designated as sepsis alerts in ED or via EMS in the field, presenting to four community emergency...
Source: Current Awareness Service for Health (CASH) - July 9, 2021 Category: Consumer Health News Source Type: news
The influence of nurse allocated triage category on the care of patients with sepsis in the emergency department: A retrospective review
' Gold standard ' sepsis care encompasses the recognition and treatment of sepsis within one hour of emergency department (ED) presentation. Early treatment of patients with sepsis reduces mortality. The aim of this study was to examine the effect that the nurse allocated Australasian Triage Scale (ATS) Category allocation had on ED patient treatment for severe sepsis and septic shock. A two-year retrospective observational cohort study from a single major metropolitan ED, including all patients with severe sepsis or septic shock. Sixty patients were included in this study. Sepsis was recognised at triage for the majority ...
Source: Current Awareness Service for Health (CASH) - July 9, 2021 Category: Consumer Health News Source Type: news
Recognition in Emergency Department of Septic Patients at Higher Risk of Death: Beware of Patients without Fever
Conclusions : Physicians should bear in mind that fever is not a criterium for defining sepsis; according to our results, absence of fever upon presentation might be indicative of greater severity and diagnosis of sepsis should not be delayed. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 9, 2021 Category: Consumer Health News Source Type: news
Biomaterial vaccines ward off broad range of bacterial infections and septic shock
(Wyss Institute for Biologically Inspired Engineering at Harvard) Researchers at Harvard's Wyss Institute and John A. Paulson School for Engineering and Applied Sciences (SEAS) have developed a biomaterial-based infection vaccine (ciVAX) approach as a solution that could be broadly applied to challenges in infection medicine. (Source: EurekAlert! - Infectious and Emerging Diseases)
Source: EurekAlert! - Infectious and Emerging Diseases - July 8, 2021 Category: Infectious Diseases Source Type: news
Effect of Ultrashort-Acting β-Blockers on Mortality in Patients With Sepsis With Persistent Tachycardia Despite Initial Resuscitation: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Review of 7 RCTs (n=613) reported significantly lower 28-day mortality with ultra-short acting β-blockers esmolol and landiolol vs placebo/no-intervention in patients with sepsis& septic shock (RR 0.68, 95% CI 0.54-0.85). Absolute risk reduction was 18.2% and NNT was 5.5. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 16, 2021 Category: Consumer Health News Source Type: news
Quantitative and Qualitative Assessments of Cholesterol Association With Bacterial Infection Type in Sepsis and Septic Shock
Background: Reduced cholesterol levels are associated with increased organ failure and mortality in sepsis. Cholesterol levels may vary by infection type (gram negative vs positive), possibly reflecting differences in cholesterol-mediated bacterial clearance. Methods: This was a secondary analysis of a combined data set of 2 prospective cohort studies of adult patients meeting Sepsis-3 criteria. Infection types were classified as gram negative, gram positive, or culture negative. We investigated quantitative (levels) and qualitative (dysfunctional high-density lipoprotein [HDL]) cholesterol differences. We used multivariab...
Source: Current Awareness Service for Health (CASH) - June 9, 2021 Category: Consumer Health News Source Type: news
Impact of the timeliness of antibiotic therapy on the outcome of patients with sepsis and septic shock
Conclusions: While two-thirds of sepsis studies reported an association between early administration of antibiotic therapy and patient outcome, the time-to-antibitiocs metrics varied significantly across studies and no robust time thresholds emerged. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 9, 2021 Category: Consumer Health News Source Type: news
Maternal Sepsis: presentation, course, treatment and outcomes
The current adult definition of sepsis and septic shock, as developed in 1992, does not adequately define sepsis in the pregnant and peripartum women due to the alteration of sepsis presentation in the maternal population. The purpose of this study was to determine potential causative factors for sepsis with the aim of prevention and reducing morbidity and mortality. Study Design and Methods: A descriptive observational design via a retrospective medical record review was used with a convenience sample of 22 women who were identified after admission as having sepsis. The setting was the labor and delivery unit of a large u...
Source: Current Awareness Service for Health (CASH) - June 9, 2021 Category: Consumer Health News Source Type: news
