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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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Urinary Tissue Inhibitor of Metalloproteinase-2 and Insulin-Like Growth Factor-Binding Protein 7 for Risk Stratification of Acute Kidney Injury in Patients With Sepsis To examine the performance of the urinary biomarker panel tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7 in patients with sepsis at ICU admission. To investigate the effect of nonrenal organ dysfunction on tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding (...) protein 7 in this population.In this ancillary analysis, we included patients with sepsis who were enrolled in either of two trials including 39 ICUs across Europe and North America. The primary endpoint was moderate-severe acute kidney injury (equivalent to Kidney Disease Improving Global Outcome stage 2-3) within 12 hours of enrollment. We assessed biomarker performance by calculating the area under the receiver operating characteristic curve, sensitivity, specificity, and negative and positive
Effect of Sodium Selenite Administration and Procalcitonin-Guided Therapy on Mortality in Patients With Severe Sepsis or Septic Shock: A Randomized Clinical Trial High-dose intravenous administration of sodium selenite has been proposed to improve outcome in sepsis by attenuating oxidative stress. Procalcitonin-guided antimicrobial therapy may hasten the diagnosis of sepsis, but effect on outcome is unclear.To determine whether high-dose intravenous sodium selenite treatment and procalcitonin (...) -guided anti-infectious therapy in patients with severe sepsis affect mortality.The Placebo-Controlled Trial of Sodium Selenite and Procalcitonin Guided Antimicrobial Therapy in Severe Sepsis (SISPCT), a multicenter, randomized, clinical, 2 × 2 factorial trial performed in 33 intensive care units in Germany, was conducted from November 6, 2009, to June 6, 2013, including a 90-day follow-up period.Patients were randomly assigned to receive an initial intravenous loading dose of sodium selenite, 1000 µg
Clinical Criteria to Identify Patients With Sepsis 27458952 2016 08 22 2018 12 02 1538-3598 316 4 2016 Jul 26 JAMA JAMA Clinical Criteria to Identify Patients With Sepsis. 453 10.1001/jama.2016.6407 Makam Anil N AN Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas. Nguyen Oanh Kieu OK Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas. eng KL2 TR001103 TR NCATS NIH HHS United States R24 HS022418 HS AHRQ HHS United (...) States Letter Comment United States JAMA 7501160 0098-7484 AIM IM JAMA. 2016 Jul 26;316(4):454 27458955 JAMA. 2016 Feb 23;315(8):762-74 26903335 Female Hospital Mortality Humans Male Organ Dysfunction Scores Sepsis diagnosis mortality 2016 7 27 6 0 2016 7 28 6 0 2016 8 23 6 0 ppublish 27458952 2536624 10.1001/jama.2016.6407 PMC5349293 NIHMS850954 Circulation. 2007 Feb 20;115(7):928-35 17309939 Circ Cardiovasc Qual Outcomes. 2014 Sep;7(5):778-9 25097213 JAMA. 2016 Feb 23;315(8):762-74 26903335 JAMA
Hypopyon and Klebsiella Sepsis. 27355556 2016 07 07 2016 06 30 1533-4406 374 26 2016 Jun 30 The New England journal of medicine N. Engl. J. Med. IMAGES IN CLINICAL MEDICINE. Hypopyon and Klebsiella Sepsis. e33 10.1056/NEJMicm1509932 Mustafa Osama M OM Alfaisal University, Riyadh, Saudi Arabia email@example.com. Aduriz-Lorenzo Patricio M PM Dubai Hospital, Dubai, United Arab Emirates. eng Case Reports Journal Article United States N Engl J Med 0255562 0028-4793 AIM IM Anterior Eye Segment
Effect of a Primary Care Management Intervention on Mental Health-Related Quality of Life Among Survivors of Sepsis: A Randomized Clinical Trial. Survivors of sepsis face long-term sequelae that diminish health-related quality of life and result in increased care needs in the primary care setting, such as medication, physiotherapy, or mental health care.To examine if a primary care-based intervention improves mental health-related quality of life.Randomized clinical trial conducted between (...) February 2011 and December 2014, enrolling 291 patients 18 years or older who survived sepsis (including septic shock), recruited from 9 intensive care units (ICUs) across Germany.Participants were randomized to usual care (n = 143) or to a 12-month intervention (n = 148). Usual care was provided by their primary care physician (PCP) and included periodic contacts, referrals to specialists, and prescription of medication, other treatment, or both. The intervention additionally included PCP and patient
Risk of Recurrence After Surviving Severe Sepsis: A Matched Cohort Study To examine the risk of recurrence in adults who survived first-episode severe sepsis for at least 3 months.A matched cohort study.Inpatient claims data from Taiwan's National Health Insurance Research Database.We analyzed 10,818 adults who survived first-episode severe sepsis without recurrence for at least 3 months in 2000 (SS group; mean age, 62.7 yr; men, 54.7%) and a group of age/sex-matched (1:1) population controls (...) who had no prior history of severe sepsis. All subjects were followed from the study entry to the occurrence of end-point, death, or until December 31, 2008, whichever date came first.None.Primary end-point was severe sepsis that occurred after January 1, 2001 (the study entry). Relative risk of the end-point was assessed using competing risk regression model. During the follow-up period, severe sepsis and death occurred in 35.0% and 26.5% of SS group and in 4.3% and 18.6% of controls
Severe sepsis caused by Capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient A 61-year-old man with an unremarkable medical history was admitted with fever 7 days after being bitten by his dog. On day 3, he showed altered mental status, and laboratory data showed progressive hemolytic anemia, thrombocytopenia, hyperbilirubinemia, renal dysfunction, coagulopathy, and schistocytosis. Severe sepsis complicated with thrombotic microangiopathy caused (...) by Capnocytophaga canimorsus was suspected.Plasma exchange was applied to treat the thrombotic microangiopathy and resulted in platelet count increase and improved renal function, hyperbilirubinemia, and schistocytosis. Blood culture results confirmed the presence of C. canimorsus. The patient was discharged in good condition.Capnocytophaga canimorsus is rare cause of severe sepsis, and should be suspected even in immunocompetent patients with dog-bite history. Capnocytophaga canimorsus infection may
Sepsis: pathophysiology and clinical management. Sepsis, severe sepsis, and septic shock represent increasingly severe systemic inflammatory responses to infection. Sepsis is common in the aging population, and it disproportionately affects patients with cancer and underlying immunosuppression. In its most severe form, sepsis causes multiple organ dysfunction that can produce a state of chronic critical illness characterized by severe immune dysfunction and catabolism. Much has been learnt (...) about the pathogenesis of sepsis at the molecular, cell, and intact organ level. Despite uncertainties in hemodynamic management and several treatments that have failed in clinical trials, investigational therapies increasingly target sepsis induced organ and immune dysfunction. Outcomes in sepsis have greatly improved overall, probably because of an enhanced focus on early diagnosis and fluid resuscitation, the rapid delivery of effective antibiotics, and other improvements in supportive care
Late mortality after sepsis: propensity matched cohort study. To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself. Observational cohort study. US Health and Retirement Study. 960 patients aged ≥65 (1998-2010) with fee-for-service Medicare coverage who were admitted to hospital with sepsis. Patients were matched to 777 adults not currently in hospital, 788 patients admitted with non-sepsis infection, and 504 (...) patients admitted with acute sterile inflammatory conditions. Late (31 days to two years) mortality and odds of death at various intervals. Sepsis was associated with a 22.1% (95% confidence interval 17.5% to 26.7%) absolute increase in late mortality relative to adults not in hospital, a 10.4% (5.4% to 15.4%) absolute increase relative to patients admitted with non-sepsis infection, and a 16.2% (10.2% to 22.2%) absolute increase relative to patients admitted with sterile inflammatory conditions (P
Splenic volume in severe sepsis is associated with disease severity and pneumococcal infection A small spleen, which is occasionally found in patients with pneumococcal sepsis, may increase pneumococcal susceptibility because of splenic malfunction. However, a small spleen may also originate from severe disease. We carried out a retrospective study to evaluate the association between splenic volume and severe pneumococcal sepsis or disease severity.We reviewed the medical records of 23 patients (...) with severe pneumococcal sepsis treated at our institution between January 2004 and September 2015 (pneumococcal group) and 61 patients with severe non-pneumococcal bacteremia treated between April 2011 and September 2015 (control group). Splenic volume measured by abdominal computed tomography on admission was compared between the two groups. Correlations between Acute Physiology and Chronic Health Evaluation (APACHE) II scores and splenic volume on admission and the change in splenic volume from the non
Incidence, Risk Factors, and Attributable Mortality of Secondary Infections in the Intensive Care Unit After Admission for Sepsis. Sepsis is considered to induce immune suppression, leading to increased susceptibility to secondary infections with associated late mortality.To determine the clinical and host genomic characteristics, incidence, and attributable mortality of intensive care unit (ICU)-acquired infections in patients admitted to the ICU with or without sepsis.Prospective (...) observational study comprising consecutive admissions of more than 48 hours in 2 ICUs in the Netherlands from January 2011 to July 2013 stratified according to admission diagnosis (sepsis or noninfectious).The primary outcome was ICU-acquired infection (onset >48 hours). Attributable mortality risk (fraction of mortality that can be prevented by elimination of the risk factor, acquired infection) was determined using time-to-event models accounting for competing risk. In a subset of sepsis admissions (n
Modified early warning scoring (MEWS): evaluating the evidence for tool inclusion of sepsis screening criteria and impact on mortality and failure to rescue To evaluate current research evidence reporting outcomes from modified early warning scoring system tools utilisation to prevent failure to rescue in hospitalised adult medical-surgical/telemetry patients.Early sepsis detection exhibits clinical significance to practitioners and patients. Thorough and timely clinical observations, along (...) in detection of inpatients at-risk for clinical deterioration, limited high-level data and no clinical trials linking use of modified early warning scoring system tool usage to robust outcomes were found. Established criteria for validating modified early warning scoring system criteria, organisational-specific reliability testing and multi-site trials are recommended.Development of all-cause illness screening tools, including sepsis, is imperative. The clinical picture may be quantified with scoring tools
The Impact of Timing of Antibiotics on Outcomes in Severe Sepsis and Septic Shock: A Systematic Review and Meta-Analysis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?