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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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Effects of hydroxyethylstarch and gelatin on renal function in severe sepsis: a multicentre randomised study. Hydroxyethylstarch used for volume restoration in brain-dead kidney donors has been associated with impaired kidney function in the transplant recipients. We undertook a multicentre randomised study to assess the frequency of acute renal failure (ARF) in patients with severe sepsis or septic shock treated with hydroxyethylstarch or gelatin.Adults with severe sepsis or septic shock were (...) -5.83], p=0.026).The use of this preparation of hydroxyethylstarch as a plasma-volume expander is an independent risk factor for ARF in patients with severe sepsis or septic shock.
2001LancetControlled trial quality: predicted high
Efficacy and safety of recombinant human activated protein C for severe sepsis. Drotrecogin alfa (activated), or recombinant human activated protein C, has antithrombotic, antiinflammatory, and profibrinolytic properties. In a previous study, drotrecogin alfa activated produced dose-dependent reductions in the levels of markers of coagulation and inflammation in patients with severe sepsis. In this phase 3 trial, we assessed whether treatment with drotrecogin alfa activated reduced the rate (...) with severe sepsis and may be associated with an increased risk of bleeding.
Xigris for severe sepsis - horizon scanning review Xigris for severe sepsis - horizon scanning review Xigris for severe sepsis - horizon scanning review NHSC Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation NHSC. Xigris for severe sepsis - horizon scanning review. Birmingham: National Horizon Scanning Centre (NHSC). New and Emerging (...) Technology Briefing. 2001 Authors' objectives To summarise the current research evidence on Xigris (previously known as Zovant) for severe sepsis. Authors' conclusions - Clinical impact: The clinical impact associated with the introduction of Xigris may be significant as it is a new treatment for a patient group that has a very high (30-50%) mortality rate. - Service impact: It is likely that there will be some service impact associated with the introduction of Xigris as intensive care staff will need
Early goal-directed therapy in the treatment of severe sepsis and septic shock. Goal-directed therapy has been used for severe sepsis and septic shock in the intensive care unit. This approach involves adjustments of cardiac preload, afterload, and contractility to balance oxygen delivery with oxygen demand. The purpose of this study was to evaluate the efficacy of early goal-directed therapy before admission to the intensive care unit.We randomly assigned patients who arrived at an urban (...) emergency department with severe sepsis or septic shock to receive either six hours of early goal-directed therapy or standard therapy (as a control) before admission to the intensive care unit. Clinicians who subsequently assumed the care of the patients were blinded to the treatment assignment. In-hospital mortality (the primary efficacy outcome), end points with respect to resuscitation, and Acute Physiology and Chronic Health Evaluation (APACHE II) scores were obtained serially for 72 hours
Caring for the critically ill patient. High-dose antithrombin III in severe sepsis: a randomized controlled trial. Activation of the coagulation system and depletion of endogenous anticoagulants are frequently found in patients with severe sepsis and septic shock. Diffuse microthrombus formation may induce organ dysfunction and lead to excess mortality in septic shock. Antithrombin III may provide protection from multiorgan failure and improve survival in severely ill patients.To determine (...) if high-dose antithrombin III (administered within 6 hours of onset) would provide a survival advantage in patients with severe sepsis and septic shock.Double-blind, placebo-controlled, multicenter phase 3 clinical trial in patients with severe sepsis (the KyberSept Trial) was conducted from March 1997 through January 2000.A total of 2314 adult patients were randomized into 2 equal groups of 1157 to receive either intravenous antithrombin III (30 000 IU in total over 4 days) or a placebo (1% human
Prophylactic antibiotic administration reduces sepsis and mortality in acute necrotizing pancreatitis: a meta-analysis Prophylactic antibiotic administration reduces sepsis and mortality in acute necrotizing pancreatitis: a meta-analysis Prophylactic antibiotic administration reduces sepsis and mortality in acute necrotizing pancreatitis: a meta-analysis Sharma V K, Howden C W Authors' objectives To evaluate the role of prophylactic antibiotics that can achieve minimum inhibitory concentration (...) receiving no antibiotic prophylaxis were excluded. Outcomes assessed in the review The included studies had to report the rates of local pancreatic infections, sepsis and mortality in each treatment arm. How were decisions on the relevance of primary studies made? Both authors independently reviewed each study. Assessment of study quality The authors do not state that they assessed validity. Data extraction The authors do not state how the data were extracted for the review, or how many of the reviewers
A Randomized, Double-Masked, Placebo-Controlled Trial of Recombinant Granulocyte Colony-Stimulating Factor Administration to Preterm Infants With the Clinical Diagnosis of Early-Onset Sepsis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Intravenous immunoglobulin for treating sepsis and septic shock. Death from severe sepsis and septic shock is common, and researchers have explored whether antibodies to the endotoxins in some bacteria reduces mortality. This review summarises the effects of intravenous immunoglobulin (IVIG) in patients with bacterial sepsis or septic shock on mortality, bacteriological failure rates, and duration of stay in hospital.We searched the Cochrane Controlled Trials Register, Medline 1966 to April (...) 1999, EMBASE 1988 to February 1999; we contacted investigators active in the field for unpublished data.Randomised trials comparing intravenous immunoglobulin (monoclonal or polyclonal) with placebo or no intervention, in patients with bacterial sepsis or septic shock.Inclusion criteria, trial quality assessment, and data abstraction were done in duplicate. We conducted pre-specified subgroup analyses by type of immunoglobulin preparation.Twenty-three out of 49 studies met our inclusion criteria
Vancomycin for prophylaxis against sepsis in preterm neonates. Nosocomial, late onset sepsis occurs in up to 50% of infants of less than 1000gm at birth. The commonest organism isolated is coagulase negative staphylococcus (CoNS). A number of studies have evaluated the efficacy or prophylactic low dose vancomycin given either as a continuous infusion added to the infant's hyperalimentation fluid or by intermittent intravenous administration and these studies in very low birth weight infants (...) are the subject of this review.To evaluate the safety and efficacy of vancomycin prophylaxis for the prevention of late-onset sepsis, coagulase negative staphylococcal sepsis, mortality, and effects on length of stay, total vancomycin exposure, evidence of vancomycin toxicity, and the development of vancomycin resistant organisms in the preterm neonate.Searches were made of Medline, (MeSH terms: Vancomycin and Sepsis; limits: age groups, newborn infants), HealthStar and EMBase, electronic abstracts, personal
Recombinant bactericidal/permeability-increasing protein (rBPI21) as adjunctive treatment for children with severe meningococcal sepsis: a randomised trial. rBPI21 Meningococcal Sepsis Study Group. Endotoxin is a primary trigger of the inflammatory processes that lead to shock, multiorgan failure, and purpura fulminans in meningococcal sepsis. Bactericidal/permeability-increasing protein (BPI) is a natural protein, stored within the neutrophil granules, that binds to and neutralises the effects (...) of endotoxin in vitro, in laboratory animals, and in humans. To establish whether a recombinant 21-kDa modified fragment of human BPI (rBPI21), containing the active antimicrobial and endotoxin-neutralising moiety, would decrease death and long-term disability from meningococcal sepsis, we did a randomised, double-blind, placebo-controlled trial of rBPI21 in children with severe meningococcal sepsis.We enrolled children (2 weeks to 18 years of age) presenting to 22 centres in the UK and the USA
2000LancetControlled trial quality: predicted high
E5 murine monoclonal antiendotoxin antibody in gram-negative sepsis: a randomized controlled trial. E5 Study Investigators. Knowledge and understanding of gram-negative sepsis have grown over the past 20 years, but the ability to treat severe sepsis successfully has not.To assess the efficacy and safety of E5 in the treatment of patients with severe gram-negative sepsis.A multicenter, double-blind, randomized, placebo-controlled trial conducted at 136 US medical centers from April 1993 to April (...) 1997, designed with 90% power to detect a 25% relative risk reduction, incorporating 2 planned interim analyses.Intensive care units at university medical centers, Veterans Affairs medical centers, and community hospitals.Adults aged 18 years or older, with signs and symptoms consistent with severe sepsis and documented or probable gram-negative infection.Patients were assigned to receive 2 doses of either E5, a murine monoclonal antibody directed against endotoxin (n = 550; 2 mg/kg per day
Recombinant bactericidal/permeability-increasing protein (rBPI21) as adjunctive treatment for children with severe meningococcal sepsis: a randomised trial. PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Hypoproteinemia predicts acute respiratory distress syndrome development, weight gain, and death in patients with sepsis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Preventing early-onset group B streptococcal sepsis: strategy development using decision analysis Preventing early-onset group B streptococcal sepsis: strategy development using decision analysis Preventing early-onset group B streptococcal sepsis: strategy development using decision analysis Benitz W E, Gould J B, Druzin M L Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods (...) of the study Integrated obstetrical and neonatal regimens appropriate to the population served should be adopted by each obstetrical service. Surveillance of costs, complications, and benefits will be essential to guide continued iterative improvement of these strategies. Source of funding Sources of funding were not stated. Bibliographic details Benitz W E, Gould J B, Druzin M L. Preventing early-onset group B streptococcal sepsis: strategy development using decision analysis. Pediatrics 1999; 103(6
Applying epidemiology-based outcomes research to clinical decision-making: a hypothetical model of biotechnology therapy in gram-negative sepsis Applying epidemiology-based outcomes research to clinical decision-making: a hypothetical model of biotechnology therapy in gram-negative sepsis Applying epidemiology-based outcomes research to clinical decision-making: a hypothetical model of biotechnology therapy in gram-negative sepsis Wang E C, Grasela T H, Walawander C A Record Status (...) This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Biotechnology therapy in gram-negative sepsis. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population The 2 populations studied were patients with nosocomial
Effect of the immunomodulating agent, pentoxifylline, in the treatment of sepsis in prematurely delivered infants: a placebo-controlled, double-blind trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?