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Latest & greatest articles for sepsis
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on sepsis or other clinical topics then use Trip today.
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SARS-CoV-2 and viral sepsis: observations and hypotheses. Since the outbreak of coronavirus disease 2019 (COVID-19), clinicians have tried every effort to understand the disease, and a brief portrait of its clinical features have been identified. In clinical practice, we noticed that many severe or critically ill COVID-19 patients developed typical clinical manifestations of shock, including cold extremities and weak peripheral pulses, even in the absence of overt hypotension. Understanding (...) the mechanism of viral sepsis in COVID-19 is warranted for exploring better clinical care for these patients. With evidence collected from autopsy studies on COVID-19 and basic science research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and SARS-CoV, we have put forward several hypotheses about SARS-CoV-2 pathogenesis after multiple rounds of discussion among basic science researchers, pathologists, and clinicians working on COVID-19. We hypothesise that a process called viral sepsis
Sepsis and the Emergency Department Patron: HRH Princess Royal 7-9 Bream’s Buildings Tel +44 (0)20 7404 1999 London Fax +44 (0)20 7067 1267 EC4A 1DT www.rcem.ac.uk Position statement Sepsis and the Emergency Department November 2019 Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection  . Sepsis is a life-threatening condition that arises when the response to an infection injures tissues and organs . Septic shock is a subset of sepsis (...) in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality . An article recently published in the Lancet has provoked some interest with regards to how sepsis may be presented in the media . Patients attending the Emergency Department as a result of infection represent a significantly larger group than those attending with sepsis or septic shock. Whilst recognizing that the incidence of ‘true sepsis’ or septic shock is relatively
Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) Surviving Sepsis Campaign: Guidelines on the Management of C... : Read Online: Critical Care Medicine | Society of Critical Care Medicine ')} You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Your account has been temporarily locked Your account has been temporarily locked due to incorrect sign in attempts (...) , Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations. Results: The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which four are best practice statements, nine are strong recommendations, and 35 are weak recommendations. No recommendation was provided for six
Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children Surviving Sepsis Campaign International Guidelines for the M... : Pediatric Critical Care Medicine ')} You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Your account has been temporarily locked Your account has been temporarily locked due to incorrect sign in attempts (...) , PA. 15 Texas Children’s Hospital, Houston, TX. 16 Paris South University Hospitals—Assistance Publique Hopitaux de Paris, Paris, France. 17 Physiopathology and Therapeutic Innovation Unit—INSERM U999, South Paris-Saclay University, Paris, France. 18 King’s College Hospital, London, United Kingdom. 19 University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom. 20 The Latin America Sepsis Institute, São Paulo, Brazil. 21 Nationwide Children’s
Long-term courses of sepsis survivors: effects of a primary care management intervention Sepsis survivors face mental and physical sequelae even years after discharge from the intensive care unit. The aim of this study was to evaluate the long-term courses of sepsis survivors and the effects of a primary care management intervention in sepsis aftercare.This study presents a 24-month follow-up of a randomized controlled trial that recruited 291 patients who survived sepsis (including septic (...) shock) from nine German intensive care units. Participants were randomized to usual care (n=143) or to a 12-month-intervention (n=148). The intervention included training of patients and their primary care physicians (PCP) in evidence-based post-sepsis care, case management provided by trained nurses, and clinical decision support for PCPs by consulting physicians. Usual care was provided by PCPs in the control group. At the 24-month follow-up, 12 months after the 1-year-intervention, survival
Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Sepsis is life-threatening organ dysfunction due to a dysregulated host response to infection. It is considered a major cause of health loss, but data for the global burden of sepsis are limited. As a syndrome caused by underlying infection, sepsis is not part of standard Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimates. Accurate estimates (...) are important to inform and monitor health policy interventions, allocation of resources, and clinical treatment initiatives. We estimated the global, regional, and national incidence of sepsis and mortality from this disorder using data from GBD 2017.We used multiple cause-of-death data from 109 million individual death records to calculate mortality related to sepsis among each of the 282 underlying causes of death in GBD 2017. The percentage of sepsis-related deaths by underlying GBD cause in each
The Combined SIRS + qSOFA (qSIRS) Score is More Accurate Than qSOFA Alone in Predicting Mortality in Patients with Surgical Sepsis in an LMIC Emergency Department qSOFA has been proposed as a prognostic tool in patients with sepsis. This study set out to assess the sensitivity of several scores, namely: the pre-ICU qSOFA, the qSOFA with lactate (qSOFA L), SIRS score, qSOFA + SIRS score (qSIRS) and qSIRS with lactate (qSIRS L) in predicting in-hospital mortality in patients with surgical sepsis (...) as well as the sensitivity of these scores in predicting high-grade sepsis. The secondary aim was to determine which of these scores is best suited to predict high-grade surgical sepsis.This was a retrospective cohort study that was conducted between December 2012 and August 2017 in a public metropolitan surgical service. Data from patients aged > 13 years, who were admitted to the hospital and who had an emergency surgical procedure for source control were retrieved from a prospectively maintained
Effect of Selepressin vs Placebo on Ventilator- and Vasopressor-Free Days in Patients With Septic Shock: The SEPSIS-ACT Randomized Clinical Trial. Norepinephrine, the first-line vasopressor for septic shock, is not always effective and has important catecholaminergic adverse effects. Selepressin, a selective vasopressin V1a receptor agonist, is a noncatecholaminergic vasopressor that may mitigate sepsis-induced vasodilatation, vascular leakage, and edema, with fewer adverse effects.To test
Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS-ALI Randomized Clinical Trial. Experimental data suggest that intravenous vitamin C may attenuate inflammation and vascular injury associated with sepsis and acute respiratory distress syndrome (ARDS).To determine the effect of intravenous vitamin C infusion on organ failure scores and biological markers of inflammation (...) and vascular injury in patients with sepsis and ARDS.The CITRIS-ALI trial was a randomized, double-blind, placebo-controlled, multicenter trial conducted in 7 medical intensive care units in the United States, enrolling patients (N = 167) with sepsis and ARDS present for less than 24 hours. The study was conducted from September 2014 to November 2017, and final follow-up was January 2018.Patients were randomly assigned to receive intravenous infusion of vitamin C (50 mg/kg in dextrose 5% in water, n = 84
Screening Triage Tools and Management Algorithms for Adult Sepsis Patients: Clinical Utility and Guidelines Screening Triage Tools and Management Algorithms for Adult Sepsis Patients: Clinical Utility and Guidelines | CADTH.ca Find the information you need Screening Triage Tools and Management Algorithms for Adult Sepsis Patients: Clinical Utility and Guidelines Screening Triage Tools and Management Algorithms for Adult Sepsis Patients: Clinical Utility and Guidelines Last updated: August 13 (...) , 2019 Project Number: RA1058-000 Product Line: Research Type: Devices and Systems Report Type: Reference List Result type: Report Question What is the clinical utility of screening triage tools and/or management algorithms in adult patients in the emergency department with suspected sepsis? What is the clinical utility of screening triage tools and/or management algorithms in adult inpatients with suspected sepsis? What are the evidence-based guidelines regarding the use of screening triage tools
Detection and Diagnosis of Sepsis in Rural and Remote Areas: An Environmental Scan Detection and Diagnosis of Sepsis in Rural and Remote Areas: An Environmental Scan | CADTH.ca Find the information you need Detection and Diagnosis of Sepsis in Rural and Remote Areas: An Environmental Scan Detection and Diagnosis of Sepsis in Rural and Remote Areas: An Environmental Scan Last updated: January 9, 2019 Project Number: ES0327-000 Product Line: Result type: Report CADTH undertook an Environmental (...) Scan to understand current practices for detecting and diagnosing sepsis in remote and rural health care settings across Canada. The key objectives of this Environmental Scan were: To describe the current guidance (i.e., policies, protocols, guidelines, algorithms) for detecting and diagnosing sepsis in rural and remote health care settings in Canada To describe current practice for detecting and managing sepsis in rural and remote health care settings in Canada and how this compares to recommended
Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis: A Diagnostic Study. Administering antimicrobial agents before obtaining blood cultures could potentially decrease time to treatment and improve outcomes, but it is unclear how this strategy affects diagnostic sensitivity.To determine the sensitivity of blood cultures obtained shortly after initiation of antimicrobial therapy in patients with severe manifestations (...) of sepsis.Patient-level, single-group, diagnostic study. (ClinicalTrials.gov: NCT01867905).7 emergency departments in North America.Adults with severe manifestations of sepsis, including systolic blood pressure less than 90 mm Hg or a serum lactate level of 4 mmol/L or more.Blood cultures were obtained before and within 120 minutes after initiation of antimicrobial treatment.Sensitivity of blood cultures obtained after initiation of antimicrobial therapy.Of 3164 participants screened, 325 were included
Association Between State-Mandated Protocolized Sepsis Care and In-hospital Mortality Among Adults With Sepsis. Beginning in 2013, New York State implemented regulations mandating that hospitals implement evidence-based protocols for sepsis management, as well as report data on protocol adherence and clinical outcomes to the state government. The association between these mandates and sepsis outcomes is unknown.To evaluate the association between New York State sepsis regulations (...) and the outcomes of patients hospitalized with sepsis.Retrospective cohort study of adult patients hospitalized with sepsis in New York State and in 4 control states (Florida, Maryland, Massachusetts, and New Jersey) using all-payer hospital discharge data (January 1, 2011-September 30, 2015) and a comparative interrupted time series analytic approach.Hospitalization for sepsis before (January 1, 2011-March 31, 2013) vs after (April 1, 2013-September 30, 2015) implementation of the 2013 New York State sepsis
Does the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) Improve Survival in Septic Adults? Does the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) Improve Survival in Septic Adults? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 4, Pages 363–365 Does the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) Improve Survival in Septic Adults? x (...) all Collapse all Article Outline Take-Home Message No high- or moderate-level evidence shows that the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) hemodynamic interventions improve survival in sepsis. Methods Data Sources The authors searched PubMed, EMBASE, Scopus, Web of Science, and without language restrictions from inception to November 28, 2017. They also searched the references of analyzed studies and other review articles. Study Selection Investigators included randomized
Effect of a Recombinant Human Soluble Thrombomodulin on Mortality in Patients With Sepsis-Associated Coagulopathy: The SCARLET Randomized Clinical Trial. Previous research suggested that soluble human recombinant thrombomodulin may reduce mortality among patients with sepsis-associated coagulopathy.To determine the effect of human recombinant thrombomodulin vs placebo on 28-day all-cause mortality among patients with sepsis-associated coagulopathy.The SCARLET trial was a randomized, double (...) -blind, placebo-controlled, multinational, multicenter phase 3 study conducted in intensive care units at 159 sites in 26 countries. All adult patients admitted to one of the participating intensive care units between October 2012 and March 2018 with sepsis-associated coagulopathy and concomitant cardiovascular and/or respiratory failure, defined as an international normalized ratio greater than 1.40 without other known etiology and a platelet count in the range of 30 to 150 × 109/L or a greater than
Derivation, Validation, and Potential Treatment Implications of Novel Clinical Phenotypes for Sepsis. Sepsis is a heterogeneous syndrome. Identification of distinct clinical phenotypes may allow more precise therapy and improve care.To derive sepsis phenotypes from clinical data, determine their reproducibility and correlation with host-response biomarkers and clinical outcomes, and assess the potential causal relationship with results from randomized clinical trials (RCTs).Retrospective (...) analysis of data sets using statistical, machine learning, and simulation tools. Phenotypes were derived among 20 189 total patients (16 552 unique patients) who met Sepsis-3 criteria within 6 hours of hospital presentation at 12 Pennsylvania hospitals (2010-2012) using consensus k means clustering applied to 29 variables. Reproducibility and correlation with biological parameters and clinical outcomes were assessed in a second database (2013-2014; n = 43 086 total patients and n = 31 160 unique
Enteral lactoferrin for the treatment of sepsis and necrotizing enterocolitis in neonates. Neonatal sepsis and necrotizing enterocolitis (NEC) cause significant neonatal mortality and morbidity despite appropriate antibiotic therapy. Enhancing host defense and modulating inflammation by using lactoferrin as an adjunct to antibiotics in the treatment of sepsis, NEC, or both, may improve clinical outcomes.The primary objective was to assess safety and efficacy of oral lactoferrin as an adjunct (...) to antibiotics in the treatment of neonates with suspected or confirmed sepsis, NEC, or both.We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 9), MEDLINE via PubMed, PREMEDLINE, (1966 to 20 September 2018) Embase (1980 to 20 September 2018), and CINAHL (1982 to 20 September 2018). We also searched clinical trial databases, conference proceedings, the reference lists of retried articles and clinical trials