Latest & greatest articles for sepsis

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Top results for sepsis

81. Use of plasma exchange in pediatric severe sepsis in children's hospitals

Use of plasma exchange in pediatric severe sepsis in children's hospitals PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2018 PedsCCM Evidence-Based Journal Club

82. Association Between the New York Sepsis Care Mandate and In-Hospital Mortality for Pediatric Sepsis. (Full text)

Association Between the New York Sepsis Care Mandate and In-Hospital Mortality for Pediatric Sepsis. The death of a pediatric patient with sepsis motivated New York to mandate statewide sepsis treatment in 2013. The mandate included a 1-hour bundle of blood cultures, broad-spectrum antibiotics, and a 20-mL/kg intravenous fluid bolus. Whether completing the bundle elements within 1 hour improves outcomes is unclear.To determine the risk-adjusted association between completing the 1-hour (...) pediatric sepsis bundle and individual bundle elements with in-hospital mortality.Statewide cohort study conducted from April 1, 2014, to December 31, 2016, in emergency departments, inpatient units, and intensive care units across New York State. A total of 1179 patients aged 18 years and younger with sepsis and septic shock reported to the New York State Department of Health who had a sepsis protocol initiated were included.Completion of a 1-hour sepsis bundle within 1 hour compared

2018 JAMA PubMed

83. Derivation and Validation of a Biomarker-Based Clinical Algorithm to Rule Out Sepsis From Noninfectious Systemic Inflammatory Response Syndrome at Emergency Department Admission: A Multicenter Prospective Study

Derivation and Validation of a Biomarker-Based Clinical Algorithm to Rule Out Sepsis From Noninfectious Systemic Inflammatory Response Syndrome at Emergency Department Admission: A Multicenter Prospective Study To derive and validate a predictive algorithm integrating a nomogram-based prediction of the pretest probability of infection with a panel of serum biomarkers, which could robustly differentiate sepsis/septic shock from noninfectious systemic inflammatory response syndrome.Multicenter (...) of infection. Then, the best combination of procalcitonin, soluble phospholipase A2 group IIA, presepsin, soluble interleukin-2 receptor α, and soluble triggering receptor expressed on myeloid cell-1 was applied in order to categorize patients as "likely" or "unlikely" to be infected. The predictive algorithm required only procalcitonin backed up with soluble phospholipase A2 group IIA determined in 29% of the patients to rule out sepsis/septic shock with a negative predictive value of 93%. In a validation

2018 EvidenceUpdates

84. Steroids in Sepsis and Septic Shock

Steroids in Sepsis and Septic Shock Emergency Medicine > Journal Club > Archive > May 2018 Toggle navigation May 2018 Steroids in Sepsis and Septic Shock Vignette You're working the weekend shift in TCC when you get a page: triage patient to 3L for low BP. You meet the patient in the room and find a critically ill-appearing 55 year-old female with one week of cough and increased shortness of breath. Her vital signs are: HR 125 BP 65/30 Sp02 89% on room air RR 28 She is struggling to breathe (...) antibiotics), the patient's blood pressure still only 80/45. You place a right-sided internal jugular central line under ultrasound guidance and start a norepinephrine drip. Your deftly placed arterial line begins to demonstrate an improved BP and MAP and you find the patient a bed in the medical ICU. As the patient is being transferred, you begin to wonder whether steroids would be beneficial in this patient with clear septic shock. After all, you know that much of the problem in sepsis

2018 Washington University Emergency Medicine Journal Club

85. Adaptation of a Biomarker-Based Sepsis Mortality Risk Stratification Tool for Pediatric Acute Respiratory Distress Syndrome

Adaptation of a Biomarker-Based Sepsis Mortality Risk Stratification Tool for Pediatric Acute Respiratory Distress Syndrome PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2018 PedsCCM Evidence-Based Journal Club

86. Automated monitoring compared to standard care for the early detection of sepsis in critically ill patients. (PubMed)

Automated monitoring compared to standard care for the early detection of sepsis in critically ill patients. Sepsis is a life-threatening condition that is usually diagnosed when a patient has a suspected or documented infection, and meets two or more criteria for systemic inflammatory response syndrome (SIRS). The incidence of sepsis is higher among people admitted to critical care settings such as the intensive care unit (ICU) than among people in other settings. If left untreated sepsis can (...) quickly worsen; severe sepsis has a mortality rate of 40% or higher, depending on definition. Recognition of sepsis can be challenging as it usually requires patient data to be combined from multiple unconnected sources, and interpreted correctly, which can be complex and time consuming to do. Electronic systems that are designed to connect information sources together, and automatically collate, analyse, and continuously monitor the information, as well as alerting healthcare staff when pre

2018 Cochrane

87. Sepsis and septic shock. (PubMed)

Sepsis and septic shock. Sepsis is a common condition that is associated with unacceptably high mortality and, for many of those who survive, long-term morbidity. Increased awareness of the condition resulting from ongoing campaigns and the evidence arising from research in the past 10 years have increased understanding of this problem among clinicians and lay people, and have led to improved outcomes. The World Health Assembly and WHO made sepsis a global health priority in 2017 and have (...) adopted a resolution to improve the prevention, diagnosis, and management of sepsis. In 2016, a new definition of sepsis (Sepsis-3) was developed. Sepsis is now defined as infection with organ dysfunction. This definition codifies organ dysfunction using the Sequential Organ Failure Assessment score. Ongoing research aims to improve definition of patient populations to allow for individualised management strategies matched to a patient's molecular and biochemical profile. The search continues

2018 Lancet

88. Empirical antimicrobial treatment in haemato-/oncological patients with neutropenic sepsis (Full text)

Empirical antimicrobial treatment in haemato-/oncological patients with neutropenic sepsis Neutropenic sepsis in haemato-/oncological patients is a medical emergency, as infections may show a fulminant clinical course. Early differentiation between sepsis and febrile neutropenic response often proves to be challenging. To assess the severity of the illness, different tools, which are discussed in this article, are available. Once the diagnosis has been established, the correct use of early

2018 ESMO open PubMed

89. Predictive Validity of Sepsis-3 Definitions and Sepsis Outcomes in Critically Ill Patients: A Cohort Study in 49 ICUs in Argentina

Predictive Validity of Sepsis-3 Definitions and Sepsis Outcomes in Critically Ill Patients: A Cohort Study in 49 ICUs in Argentina The new Sepsis-3 definitions have been scarcely assessed in low- and middle-income countries; besides, regional information of sepsis outcomes is sparse. Our objective was to evaluate Sepsis-3 definition performance in Argentina.Cohort study of 3-month duration beginning on July 1, 2016.Forty-nine ICUs.Consecutive patients admitted to the ICU with suspected (...) infection that triggered blood cultures and antibiotic administration.None.Patients were classified as having infection, sepsis (infection + change in Sequential Organ Failure Assessment ≥ 2 points), and septic shock (vasopressors + lactate > 2 mmol/L). Patients on vasopressors and lactate less than or equal to 2 mmol/L (cardiovascular dysfunction) were analyzed separately, as those on vasopressors without serum lactate measurement. Systemic inflammatory response syndrome was also recorded. Main outcome

2018 EvidenceUpdates

90. Clinical Evaluation of Sepsis-1 and Sepsis-3 in the ICU

Clinical Evaluation of Sepsis-1 and Sepsis-3 in the ICU There has been considerable controversy between sepsis-1 and sepsis-3 criteria.Patients with infection meeting two or more systemic inflammatory response syndrome (SIRS) criteria (sepsis-1) or a Sequential Organ Failure Assessment (SOFA) score ≥ 2 (sepsis-3) on the first day after ICU admission were selected from the Medical Information Mart for Intensive Care-III database, and their outcomes were compared using all-cause death as the end (...) point. Subgroup analysis was also performed based on prior chronic organ dysfunction.There were 21,491 infected patients included. Of those meeting the diagnostic criteria for sepsis-1, 13.42% did not satisfy sepsis-3 criteria, and this population had a 21-day mortality rate of 6.96%. In contrast, 7.00% of the patients meeting sepsis-3 criteria did not meet sepsis-1 criteria, and their 21-day mortality rate was 10.76%. When excluding preexisting organ conditions, 18.41% of patients with sepsis-1 did

2018 EvidenceUpdates

91. Prediction of pediatric sepsis mortality within 1 h of intensive care admission

Prediction of pediatric sepsis mortality within 1 h of intensive care admission PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2018 PedsCCM Evidence-Based Journal Club

92. Appropriate and timely antibiotic administration for neonatal sepsis in Mesoamérica (Full text)

Appropriate and timely antibiotic administration for neonatal sepsis in Mesoamérica Neonatal sepsis is a leading cause of mortality among children under-5 in Latin America. The Salud Mesoamérica Initiative (SMI), a multicountry results-based aid programme, was designed to improve maternal, newborn and child health in impoverished communities in Mesoamérica. This study examines the delivery of timely and appropriate antibiotics for neonatal sepsis among facilities participating in the SMI (...) project. A multifaceted health facility survey was implemented at SMI inception and approximately 18 months later as a follow-up. A random sample of medical records from neonates diagnosed with sepsis was reviewed, and data regarding antibiotic administration were extracted. In this paper, we present the percentage of patients who received timely (within 2 hours) and appropriate antibiotics. Multilevel logistic regression was used to assess for potential facility-level determinants of timely

2018 BMJ global health PubMed

93. Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score With Excess Hospital Mortality in Adults With Suspected Infection in Low- and Middle-Income Countries. (Full text)

Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score With Excess Hospital Mortality in Adults With Suspected Infection in Low- and Middle-Income Countries. The quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) score has not been well-evaluated in low- and middle-income countries (LMICs).To assess the association of qSOFA with excess hospital death among patients with suspected infection in LMICs and to compare qSOFA with the systemic (...) of presentation to study hospital.Predictive validity (measured as incremental hospital mortality beyond that predicted by baseline risk factors, as a marker of sepsis or analogous severe infectious course) of the qSOFA score (primary) and SIRS criteria (secondary).The cohorts were diverse in enrollment criteria, demographics (median ages, 29-54 years; males range, 36%-76%), HIV prevalence (range, 2%-43%), cause of infection, and hospital mortality (range, 1%-39%). Among 6218 patients with nonmissing outcome

2018 JAMA PubMed

94. Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis

Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Discover Portal Discover Portal Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Published on 31 January 2018 doi: The risk of death in adults with sepsis was 30% lower when each dose of antibiotic was given intravenously over three hours compared to a bolus or less (...) than 60 minutes. This systematic review included adults on intensive care units with a range of ages, severity of sepsis and other symptoms. A variety of antibiotics of the anti-pseudomonal beta-lactam class were used in the trials. These included carbapenems, penicillins and cephalosporins. In the UK, current guidance for intravenous use of these drugs is to give them over a period of up to 30 minutes. This review provides high-quality evidence that suggests that all patients should be given

2018 NIHR Dissemination Centre

95. Blood test could shorten antibiotic treatment in newborns with suspected sepsis

Blood test could shorten antibiotic treatment in newborns with suspected sepsis Blood test could shorten antibiotic treatment in newborns with suspected sepsis Discover Portal Discover Portal Blood test could shorten antibiotic treatment in newborns with suspected sepsis Published on 28 November 2017 doi: Measuring procalcitonin levels in newborns with suspected sepsis in the first days of life reduced antibiotic duration by 10 hours compared with standard care. There was no increase (...) in the risk of re-infection or death. Systemic infection can be rapidly life-threatening in newborn babies, so those with risk factors are often treated pre-emptively with intravenous antibiotics. If sepsis is not confirmed by blood culture the decision whether to discontinue antibiotics needs to be made, but results of the blood culture takes time. Procalcitonin is released into the blood in response to inflammation, and low levels may give an earlier indication that there is no serious infection

2018 NIHR Dissemination Centre

96. A focus on treating fever does not improve survival in sepsis

A focus on treating fever does not improve survival in sepsis A focus on treating fever does not improve survival in sepsis Discover Portal Discover Portal A focus on treating fever does not improve survival in sepsis Published on 27 June 2017 doi: Specifically treating fever in adults with sepsis did not reduce the number of people dying within 28 days. It also had no effect on the frequency of hospital-acquired infections, reversing septic shock, lowering heart rate or improving breathing (...) . Sepsis is a rare complication of an infection. Among the 123,000 people a year in England who develop sepsis around 30% will die from it, so improving our understanding of how to treat sepsis is clearly important. Early treatment of sepsis is important for a number of reasons, but the findings of this review imply that it is not necessary to specifically treat fever. We don’t know whether there might be benefits for people with very high temperatures. Share your views on the research. Why

2018 NIHR Dissemination Centre

97. Giving antibiotics immediately reduces deaths from sepsis

Giving antibiotics immediately reduces deaths from sepsis Giving immediate antibiotics reduces deaths from sepsis Discover Portal Discover Portal Giving immediate antibiotics reduces deaths from sepsis Published on 18 April 2017 doi: Giving immediate antibiotics (defined as within one hour) when people present to emergency departments with suspected sepsis reduces their risk of dying by a third compared with later administration. This meta-analysis of observational data from 23,596 people (...) in emergency department settings confirmed that giving antibiotics within one hour was linked to a lower risk of in-hospital mortality compared with giving antibiotics later. This adds weight to recommendations from NICE and other organisations that antibiotics should be administered straight away in people with suspected sepsis. However, in practice up to a third of people in the UK do not receive antibiotics within the hour. NHS England and the UK Sepsis Trust have recently launched a campaign

2018 NIHR Dissemination Centre

98. A trial of probiotics for treating sepsis in very premature babies poses more questions than it answers

A trial of probiotics for treating sepsis in very premature babies poses more questions than it answers A trial of probiotics for treating sepsis in very premature babies poses more questions than it answers Discover Portal Discover Portal A trial of probiotics for treating sepsis in very premature babies poses more questions than it answers Published on 23 December 2015 doi: Contrary to a previous review of trials, this large, NIHR-funded trial found that probiotic treatment did not prevent (...) two common life-threatening conditions in very premature babies. The conditions were necrotising enterocolitis, which is a severe gut inflammation/infection that can result in the death of intestinal tissue, and sepsis (blood poisoning) from bacteria that have crossed from the gut into the bloodstream. This trial used a single strain of a harmless bacterium, known as a “probiotic”, prepared to high quality standards fit for medicines, and chosen because it is commonly used in dietary supplements

2018 NIHR Dissemination Centre

99. A Comparison of the Quick-SOFA and Systemic Inflammatory Response Syndrome Criteria for the Diagnosis of Sepsis and Prediction of Mortality: A Systematic Review and Meta-Analysis

A Comparison of the Quick-SOFA and Systemic Inflammatory Response Syndrome Criteria for the Diagnosis of Sepsis and Prediction of Mortality: A Systematic Review and Meta-Analysis Several studies were published to validate the quick Sepsis-related Organ Failure Assessment (qSOFA), namely in comparison with the systemic inflammatory response syndrome (SIRS) criteria. We performed a systematic review and meta-analysis with the aim of comparing the qSOFA and SIRS in patients outside the ICU.We (...) searched MEDLINE, CINAHL, and the Web of Science database from February 23, 2016 until June 30, 2017 to identify full-text English-language studies published after the Sepsis-3 publication comparing the qSOFA and SIRS and their sensitivity or specificity in diagnosing sepsis, as well as hospital and ICU length of stay and hospital mortality. Data extraction from the selected studies followed the recommendations of the Meta-analyses of Observational Studies in Epidemiology group and the Preferred

2018 EvidenceUpdates

100. Adaptation and Validation of a Pediatric Sequential Organ Failure Assessment Score and Evaluation of the Sepsis-3 Definitions in Critically Ill Children.

Adaptation and Validation of a Pediatric Sequential Organ Failure Assessment Score and Evaluation of the Sepsis-3 Definitions in Critically Ill Children. PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2018 PedsCCM Evidence-Based Journal Club