Latest & greatest articles for sepsis

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Top results for sepsis

541. Chlorhexidine maternal-vaginal and neonate body wipes in sepsis and vertical transmission of pathogenic bacteria in South Africa: a randomised, controlled trial. (Abstract)

Chlorhexidine maternal-vaginal and neonate body wipes in sepsis and vertical transmission of pathogenic bacteria in South Africa: a randomised, controlled trial. About 500,000 sepsis-related deaths per year arise in the first 3 days of life. On the basis of results from non-randomised studies, use of vaginal chlorhexidine wipes during labour has been proposed as an intervention for the prevention of early-onset neonatal sepsis in developing countries. We therefore assessed the efficacy (...) of chlorhexidine in early-onset neonatal sepsis and vertical transmission of group B streptococcus.In a trial in Soweto, South Africa, 8011 women (aged 12-51 years) were randomly assigned in a 1:1 ratio to chlorhexidine vaginal wipes or external genitalia water wipes during active labour, and their 8129 newborn babies were assigned to full-body (intervention group) or foot (control group) washes with chlorhexidine at birth, respectively. In a subset of mothers (n=5144), we gathered maternal lower vaginal swabs

2009 Lancet Controlled trial quality: predicted high

542. Corticosteroids in the treatment of severe sepsis and septic shock in adults: a systematic review. Full Text available with Trip Pro

Corticosteroids in the treatment of severe sepsis and septic shock in adults: a systematic review. The benefit of corticosteroids in severe sepsis and septic shock remains controversial.We examined the benefits and risks of corticosteroid treatment in severe sepsis and septic shock and the influence of dose and duration.We searched the CENTRAL, MEDLINE, EMBASE, and LILACS (through March 2009) databases as well as reference lists of articles and proceedings of major meetings, and we contacted (...) trial authors.Randomized and quasi-randomized trials of corticosteroids vs placebo or supportive treatment in adult patients with severe sepsis/septic shock per the American College of Chest Physicians/Society of Critical Care Medicine consensus definition were included.All reviewers agreed on trial eligibility. One reviewer extracted data, which were checked by the other reviewers and by the trials' authors whenever possible. Some unpublished data were obtained from the trials' authors. The primary

2009 JAMA

543. Diseases 2.0: Sepsis

Diseases 2.0: Sepsis Diseases 2.0: Sepsis – Clinical Correlations Search Diseases 2.0: Sepsis February 5, 2009 5 min read Diseases 2.0 – Bringing you the latest updates on disease pathophysiology and treatment Commentary by Andrew McKinstry MD PGY-1 Faculty Peer Reviewed For anyone who has stepped into an ICU, the septic patient is a familiar sight. Despite advances in research and management, including goal directed therapy and recombinant human activated protein C (Xigris), sepsis continues (...) to be a major cause of mortality in the critical care setting, with an estimated 215,000 deaths annually, and costing roughly 16.7 billion dollars per year. Despite these staggering human and monetary costs, the nature of and mechanisms involved in sepsis remain either unknown or hotly contested. The continuing research into this problem is on the verge of producing a number of promising insights and interventions, from insights into the nature of the syndrome to new pharmaceutical solutions and systems

2009 Clinical Correlations

544. Granulocyte-macrophage colony stimulating factor administered as prophylaxis for reduction of sepsis in extremely preterm, small for gestational age neonates (the PROGRAMS trial): a single-blind, multicentre, randomised controlled trial. (Abstract)

Granulocyte-macrophage colony stimulating factor administered as prophylaxis for reduction of sepsis in extremely preterm, small for gestational age neonates (the PROGRAMS trial): a single-blind, multicentre, randomised controlled trial. Systemic sepsis is a major cause of death in preterm neonates. There are compelling theoretical reasons why treatment with haemopoietic colony-stimulating factors might reduce sepsis and improve outcomes, and as a consequence these agents have entered into use (...) in neonatal medicine without adequate evidence. We assessed whether granulocyte-macrophage colony stimulating factor (GM-CSF) administered as prophylaxis to preterm neonates at high risk of neutropenia would reduce sepsis, mortality, and morbidity.We undertook a single-blind, multicentre, randomised controlled trial in 26 centres between June, 2000, and June, 2006. 280 neonates of below or equal to 31 weeks' gestation and below the 10th centile for birthweight were randomised within 72 h of birth

2009 Lancet Controlled trial quality: predicted high

545. Use of polyclonal immunoglobulins as adjunctive therapy for sepsis or septic shock

Use of polyclonal immunoglobulins as adjunctive therapy for sepsis or septic shock PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2008 PedsCCM Evidence-Based Journal Club

546. The effect of a quantitative resuscitation strategy on mortality in patients with sepsis: a meta-analysis Full Text available with Trip Pro

The effect of a quantitative resuscitation strategy on mortality in patients with sepsis: a meta-analysis Quantitative resuscitation consists of structured cardiovascular intervention targeting predefined hemodynamic end points. We sought to measure the treatment effect of quantitative resuscitation on mortality from sepsis.We conducted a systematic review of the Cochrane Library, MEDLINE, EMBASE, CINAHL, conference proceedings, clinical practice guidelines, and other sources using (...) a comprehensive strategy.We identified randomized control trials comparing quantitative resuscitation with standard resuscitation in adult patients who were diagnosed with sepsis using standard criteria. The primary outcome variable was mortality.Three authors independently extracted data and assessed study quality using standardized instruments; consensus was reached by conference. Preplanned subgroup analysis required studies to be categorized based on early (at the time of diagnosis) vs. late resuscitation

2008 EvidenceUpdates

547. Thymosin alpha(1)- and Ulinastatin-Based Immunomodulatory Strategy for Sepsis Arising from Intra-Abdominal Infection Due to Carbapenem-Resistant Bacteria Full Text available with Trip Pro

Thymosin alpha(1)- and Ulinastatin-Based Immunomodulatory Strategy for Sepsis Arising from Intra-Abdominal Infection Due to Carbapenem-Resistant Bacteria The aim of this study was to evaluate the potential efficacy of therapy with thymosin alpha(1) and ulinastatin for patients with sepsis due to carbapenem-resistant bacteria.Prospective, randomized, parallel controlled clinical study.A total of 120 patients received a diagnosis of sepsis caused by infection with carbapenem-resistant bacteria

2008 EvidenceUpdates Controlled trial quality: uncertain

548. Intensive Insulin Therapy and Pentastarch Resuscitation in Severe Sepsis

Intensive Insulin Therapy and Pentastarch Resuscitation in Severe Sepsis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2008 PedsCCM Evidence-Based Journal Club

549. Outcome of severe sepsis in pediatric oncology patients

Outcome of severe sepsis in pediatric oncology patients PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2008 PedsCCM Evidence-Based Journal Club

550. Score-based immunoglobulin G therapy of patients with sepsis: The SBITS study

Score-based immunoglobulin G therapy of patients with sepsis: The SBITS study PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2008 PedsCCM Evidence-Based Journal Club

551. Combination of biphasic transmittance waveform with blood procalcitonin levels for diagnosis of sepsis in acutely ill patients (Abstract)

Combination of biphasic transmittance waveform with blood procalcitonin levels for diagnosis of sepsis in acutely ill patients To assess the diagnostic utility of combining measurement of blood procalcitonin (PCT) concentrations with the presence of a biphasic transmittance waveform (BPW) from the activated partial thromboplastin time (aPTT) to identify sepsis in critically ill patients.Prospective observational study.Thirty-one-bed university hospital department of medico-surgical intensive (...) care.Two hundred consecutive adult patients admitted to the department during a 3-month period.aPTT waveform analysis was performed on admission and daily throughout the intensive care unit (ICU) stay. Receiver operating characteristic curves were created to determine the best threshold values of BPW and PCT for prediction of sepsis. Of the 200 patients, 63 (32%) had sepsis during the ICU stay; 29 (15%) patients were diagnosed with sepsis at admission. Using a threshold value of BPW slope_1 = -0.075%T

2008 EvidenceUpdates

552. Improvement in process of care and outcome after a multicenter severe sepsis educational program in Spain. Full Text available with Trip Pro

Improvement in process of care and outcome after a multicenter severe sepsis educational program in Spain. Concern exists that current guidelines for care of patients with severe sepsis and septic shock are followed variably, possibly due to a lack of adequate education.To determine whether a national educational program based on the Surviving Sepsis Campaign guidelines affected processes of care and hospital mortality for severe sepsis.Before and after design in 59 medical-surgical intensive (...) care units (ICUs) located throughout Spain. All ICU patients were screened daily and enrolled if they fulfilled severe sepsis or septic shock criteria. A total of 854 patients were enrolled in the preintervention period (November-December 2005), 1465 patients during the postintervention period (March-June 2006), and 247 patients during the long-term follow-up period 1 year later (November-December 2006) in a subset of 23 ICUs.The educational program consisted of training physicians and nursing

2008 JAMA

553. Probable early-onset group B streptococcal neonatal sepsis: a serious clinical condition related to intrauterine infection (Abstract)

Probable early-onset group B streptococcal neonatal sepsis: a serious clinical condition related to intrauterine infection The estimated incidence of true early-onset group B streptococcal (GBS) neonatal infection is based on positive GBS blood or cerebrospinal fluid (CSF) culture results, but the real burden of disease is underestimated owing to the high incidence of culture-negative sepsis possibly because of antibiotic administration to the mother.To examine the rate of probable early-onset (...) GBS neonatal sepsis and to assess its impact on total GBS neonatal disease.A multicentre longitudinal prospective surveillance of 107,021 deliveries.The rates of culture-proven and probable early-onset GBS sepsis were 0.39 and 0.47 per 1000 live births, respectively. Of great concern was the finding of three deaths related to the infection in the group with probable early-onset GBS sepsis.The use of chemoprophylaxis in GBS-colonised pregnant women, especially when it is incomplete, may

2008 EvidenceUpdates

554. Validation of the Mortality in Emergency Department Sepsis (MEDS) score in patients with the systemic inflammatory response syndrome (SIRS). (Abstract)

Validation of the Mortality in Emergency Department Sepsis (MEDS) score in patients with the systemic inflammatory response syndrome (SIRS). To prospectively and externally validate the Mortality in Emergency Department Sepsis (MEDS) score as a predictor of 28-day mortality in patients who present to the emergency department with a systemic inflammatory response syndrome.Multicentered prospective cohort study.Emergency departments at the University of Colorado Hospital and Denver Health Medical

2008 EvidenceUpdates

555. Systematic review of randomized clinical trials on the use of hydroxyethyl starch for fluid management in sepsis

Systematic review of randomized clinical trials on the use of hydroxyethyl starch for fluid management in sepsis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2008 DARE.

556. Statins for infection and sepsis: a systematic review of the clinical evidence Full Text available with Trip Pro

Statins for infection and sepsis: a systematic review of the clinical evidence Statins for infection and sepsis: a systematic review of the clinical evidence Statins for infection and sepsis: a systematic review of the clinical evidence Falagas M E, Makris G C, Matthaiou D K, Rafailidis P I CRD summary This review assessed the effectiveness of statins in treating sepsis and infection. It concluded that statins may have a positive role, but that trial results were needed before firmer (...) conclusions could be drawn. The authors' cautious conclusions reflected the limited evidence well, and are likely to be reliable. Authors' objectives To assess the effectiveness of statins in treating sepsis and infection. Searching PubMed, Scopus and The Cochrane Library databases were searched (terms were reported). References from identified articles and were also searched. There were no time, language or publication restrictions on any searches; the final search date was 30 June 2007. Study selection

2008 DARE.

557. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. Full Text available with Trip Pro

Intensive insulin therapy and pentastarch resuscitation in severe sepsis. The role of intensive insulin therapy in patients with severe sepsis is uncertain. Fluid resuscitation improves survival among patients with septic shock, but evidence is lacking to support the choice of either crystalloids or colloids.In a multicenter, two-by-two factorial trial, we randomly assigned patients with severe sepsis to receive either intensive insulin therapy to maintain euglycemia or conventional insulin (...) renal failure and renal-replacement therapy than was Ringer's lactate.The use of intensive insulin therapy placed critically ill patients with sepsis at increased risk for serious adverse events related to hypoglycemia. As used in this study, HES was harmful, and its toxicity increased with accumulating doses. (ClinicalTrials.gov number, NCT00135473.)2008 Massachusetts Medical Society

2008 NEJM Controlled trial quality: uncertain

558. Corticosteroids in Sepsis Now Less Stimulating

Corticosteroids in Sepsis Now Less Stimulating Corticosteroids in Sepsis Now Less Stimulating – Clinical Correlations Search Corticosteroids in Sepsis Now Less Stimulating April 30, 2008 4 min read Commentary by Joe Philip MD, PGY-2 CORTICUS was the long-awaited trial addressing the use of corticosteroids in sepsis that was this past January. Months prior to the leading auther Charles Sprung publishing it, the Tisch and Bellevue intensive care units halted corticotropin stimulation testing (...) . Corticosteroids have warranted much publicity since CORTICUS came out—and rightly so as practice across the country has changed because of it. The Survinig Sepsis Campaign has now downgraded the recommendation on the use of corticosteroids in sepsis from C down to 2C based on this trial, which did not show a mortality benefit in those with septic shock. Should practice change as a result? Don’t get me wrong, I was thrilled as an intern when I realized that I didn’t have to jump from bed 1 to bed 6 to bed 13

2008 Clinical Correlations

559. Grand Rounds: “Activated Protein C, Translational Research models of Sepsis and Stroke”

Grand Rounds: “Activated Protein C, Translational Research models of Sepsis and Stroke” Grand Rounds: “Activated Protein C, Translational Research models of Sepsis and Stroke” – Clinical Correlations Search Grand Rounds: “Activated Protein C, Translational Research models of Sepsis and Stroke” January 28, 2009 3 min read | | Sites We Follow: Useful Links: Questions? Comments? Contact us! © New York University. All rights reserved. Electronic ISSN 1944-0030. The content of this site is intended

2008 Clinical Correlations

560. REsearching severe Sepsis and Organ dysfunction in children: a gLobal perspective (RESOLVE) study group. Drotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial

REsearching severe Sepsis and Organ dysfunction in children: a gLobal perspective (RESOLVE) study group. Drotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2008 PedsCCM Evidence-Based Journal Club