Latest & greatest articles for sepsis

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Top results for sepsis

1. Liberal versus conservative fluid therapy in adults and children with sepsis or septic shock.

Liberal versus conservative fluid therapy in adults and children with sepsis or septic shock. BACKGROUND: Sepsis and septic shock are potentially life-threatening complications of infection that are associated with high morbidity and mortality in adults and children. Fluid therapy is regarded as a crucial intervention during initial treatment of sepsis. Whether conservative or liberal fluid therapy can improve clinical outcomes in patients with sepsis and septic shock remains unclear (...) . OBJECTIVES: To determine whether liberal versus conservative fluid therapy improves clinical outcomes in adults and children with initial sepsis and septic shock. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, intensive and critical care conference abstracts, and ongoing clinical trials on 16 January 2018, and we contacted study authors to try to identify additional studies. SELECTION CRITERIA: We planned to include all randomized controlled trials (RCTs), quasi-RCTs, and cluster RCTs comparing

Cochrane2018

4. Levosimendan to prevent acute organ dysfunction in sepsis: the LeoPARDS RCT

Levosimendan to prevent acute organ dysfunction in sepsis: the LeoPARDS RCT Levosimendan to prevent acute organ dysfunction in sepsis: the LeoPARDS RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1

NIHR HTA programme2018

5. Validation of a Host Response Assay, SeptiCyte LAB, for Discriminating Sepsis from Systemic Inflammatory Response Syndrome in the ICU

Validation of a Host Response Assay, SeptiCyte LAB, for Discriminating Sepsis from Systemic Inflammatory Response Syndrome in the ICU 29624409 2018 10 01 1535-4970 198 7 2018 Oct 01 American journal of respiratory and critical care medicine Am. J. Respir. Crit. Care Med. Validation of a Host Response Assay, SeptiCyte LAB, for Discriminating Sepsis from Systemic Inflammatory Response Syndrome in the ICU. 903-913 10.1164/rccm.201712-2472OC A molecular test to distinguish between sepsis (...) and systemic inflammation of noninfectious etiology could potentially have clinical utility. This study evaluated the diagnostic performance of a molecular host response assay (SeptiCyte LAB) designed to distinguish between sepsis and noninfectious systemic inflammation in critically ill adults. The study employed a prospective, observational, noninterventional design and recruited a heterogeneous cohort of adult critical care patients from seven sites in the United States (n = 249). An additional group

EvidenceUpdates2018

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

Blood test could shorten antibiotic treatment in newborns with suspected sepsis Signal - Blood test could shorten antibiotic treatment in newborns with suspected sepsis Dissemination Centre Discover Portal NIHR DC Discover Blood test could shorten antibiotic treatment in newborns with suspected sepsis Published on 28 November 2017 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

NIHR Dissemination Centre2018

7. 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 Signal - Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Dissemination Centre Discover Portal NIHR DC Discover Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Published on 31 January 2018 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

NIHR Dissemination Centre2018

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

A focus on treating fever does not improve survival in sepsis Signal - A focus on treating fever does not improve survival in sepsis Dissemination Centre Discover Portal NIHR DC Discover A focus on treating fever does not improve survival in sepsis Published on 27 June 2017 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

NIHR Dissemination Centre2018

9. Giving immediate antibiotics reduces deaths from sepsis

Giving immediate antibiotics reduces deaths from sepsis Signal - Giving immediate antibiotics reduces deaths from sepsis Dissemination Centre Discover Portal NIHR DC Discover Giving immediate antibiotics reduces deaths from sepsis Published on 18 April 2017 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 to encourage

NIHR Dissemination Centre2018

10. 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 Signal - A trial of probiotics for treating sepsis in very premature babies poses more questions than it answers Dissemination Centre Discover Portal NIHR DC Discover A trial of probiotics for treating sepsis in very premature babies poses more questions than it answers Published on 23 December 2015 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

NIHR Dissemination Centre2018

11. Adding the extra antibiotic rifampicin did not improve cure rates after sepsis

Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Dissemination Centre Discover Portal NIHR DC Discover Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Published on 17 April 2018 Adding the antibiotic rifampicin did not improve cure rates or reduce deaths for people with bacterial blood infections caused by Staphylococcus aureus . It increased the risk (...) -threatening and one of the most common causes of sepsis world-wide. Lack of evidence about the best treatment regime has led to wide variations in practice. Mortality rates in the UK range from 10% to 30%. The usual treatment is with a penicillin or glycopeptide but varies by the subgroup of S. Aureus and whether the strain is methicillin-resistant. Case series show around 30% of people treated for S. aureus bacteraemia in the UK also received rifampicin, despite a lack of evidence for its use. The drug

NIHR Dissemination Centre2018

12. Ethanol locks in catheters for dialysis may prevent sepsis

Ethanol locks in catheters for dialysis may prevent sepsis Ethanol locks in catheters for dialysis may prevent sepsis Dissemination Centre Discover Portal NIHR DC Discover Ethanol locks in catheters for dialysis may prevent sepsis Published on 25 September 2018 doi: In patients with tunnelled central venous catheters used for dialysis, ethanol locks may reduce catheter-related bloodstream infections when compared with other locks, mainly saline. There was no increase in the risk of catheter

NIHR Dissemination Centre2018

13. Sepsis in adults

Sepsis in adults Sepsis in adults - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Sepsis in adults Last reviewed: August 2018 Last updated: September 2018 Important updates Corticosteroids reduce mortality but increase neuromuscular weakness in sepsis and septic shock Corticosteroids reduce mortality (by approximately 2%) but increase the risk of neuromuscular weakness in patients with sepsis or septic shock (...) , according to an international panel that reviewed conflicting recent evidence. The panel concluded that the overall body of evidence offers weak support for the use of corticosteroids in patients with sepsis with or without shock but said a no-steroid approach remained reasonable. Patient values and preferences may help guide the decision on whether or not to use corticosteroids. Patients who would prioritise living over quality-of-life would likely choose to have corticosteroid treatment, whereas those

BMJ Best Practice2018

14. Sepsis in children

Sepsis in children Sepsis in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Sepsis in children Last reviewed: September 2018 Last updated: October 2018 Summary Initial clinical presentation may be non-specific (especially in younger age groups). Given the time-critical nature of severe sepsis and septic shock, when sepsis is suspected on clinical grounds it is usually best to initiate sepsis investigations (...) and treatment, including administering antibiotics and fluid resuscitation. These should continue until sepsis has been excluded. Progression to organ failure and shock is often very rapid, so early recognition and treatment is crucial. Empirical broad-spectrum antibiotic therapy (based on the most probable pathogens) should be administered as soon as possible, and always within the first hour following recognition. Other treatments are primarily supportive, and should be delivered according

BMJ Best Practice2018

15. Timing of Renal-Replacement Therapy in Patients with Acute Kidney Injury and Sepsis.

Timing of Renal-Replacement Therapy in Patients with Acute Kidney Injury and Sepsis. BACKGROUND: Acute kidney injury is the most frequent complication in patients with septic shock and is an independent risk factor for death. Although renal-replacement therapy is the standard of care for severe acute kidney injury, the ideal time for initiation remains controversial. METHODS: In a multicenter, randomized, controlled trial, we assigned patients with early-stage septic shock who had severe acute

NEJM2018

16. Evaluation of Repeated Quick Sepsis-Related Organ Failure Assessment Measurements Among Patients With Suspected Infection

Evaluation of Repeated Quick Sepsis-Related Organ Failure Assessment Measurements Among Patients With Suspected Infection 30130261 2018 10 13 1530-0293 2018 Aug 20 Critical care medicine Crit. Care Med. Evaluation of Repeated Quick Sepsis-Related Organ Failure Assessment Measurements Among Patients With Suspected Infection. 10.1097/CCM.0000000000003360 Among patients with suspected infection, a single measurement of the quick Sepsis-related Organ Failure Assessment has good predictive validity (...) for sepsis, yet the increase in validity from repeated measurements is unknown. We sought to determine the incremental predictive validity for sepsis of repeated quick Sepsis-related Organ Failure Assessment measurements over 48 hours compared with the initial measurement. Retrospective cohort study. Twelve hospitals in southwestern Pennsylvania in 2012. All adult medical and surgical encounters in the emergency department, hospital ward, postanesthesia care unit, and ICU. None. Among 1.3 million adult

EvidenceUpdates2018

17. Sepsis-3 Septic Shock Criteria and Associated Mortality Among Infected Hospitalized Patients Assessed by a Rapid Response Team

Sepsis-3 Septic Shock Criteria and Associated Mortality Among Infected Hospitalized Patients Assessed by a Rapid Response Team 29778659 2018 08 06 1931-3543 154 2 2018 Aug Chest Chest Sepsis-3 Septic Shock Criteria and Associated Mortality Among Infected Hospitalized Patients Assessed by a Rapid Response Team. 309-316 S0012-3692(18)30741-4 10.1016/j.chest.2018.05.004 Rapid response teams (RRTs) respond to hospitalized patients with deterioration and help determine subsequent management (...) , including ICU admission. In such patients with sepsis and septic shock, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) clinical criteria have a potential role in detection, risk stratification, and prognostication; however, their accuracy in comparison with the systemic inflammatory response syndrome (SIRS)-based septic shock criteria is unknown. We sought to evaluate prognostic accuracy of the Sepsis-3 criteria for in-hospital mortality among infected hospitalized

EvidenceUpdates2018

18. Neonatal Sepsis of Early Onset, and Hospital-Acquired and Community-Acquired Late Onset: A Prospective Population-Based Cohort Study

Neonatal Sepsis of Early Onset, and Hospital-Acquired and Community-Acquired Late Onset: A Prospective Population-Based Cohort Study 30054165 2018 07 28 1097-6833 2018 Jul 24 The Journal of pediatrics J. Pediatr. Neonatal Sepsis of Early Onset, and Hospital-Acquired and Community-Acquired Late Onset: A Prospective Population-Based Cohort Study. S0022-3476(18)30761-3 10.1016/j.jpeds.2018.05.048 To assess the epidemiology of blood culture-proven early- (EOS) and late-onset neonatal sepsis (LOS (...) ). All newborn infants admitted to tertiary care neonatal intensive care units in Switzerland and presenting with blood culture-proven sepsis between September 2011 and December 2015 were included in the study. We defined EOS as infection occurring <3 days after birth, and LOS as infection ≥3 days after birth. Infants with LOS were classified as having community-acquired LOS if onset of infection was ≤48 hours after admission, and hospital-acquired LOS, if onset was >48 hours after admission

EvidenceUpdates2018

19. A Comparison of the Quick Sequential (Sepsis-Related) Organ Failure Assessment Score and the National Early Warning Score in Non-ICU Patients With/Without Infection

A Comparison of the Quick Sequential (Sepsis-Related) Organ Failure Assessment Score and the National Early Warning Score in Non-ICU Patients With/Without Infection 30130262 2018 08 21 1530-0293 2018 Aug 20 Critical care medicine Crit. Care Med. A Comparison of the Quick Sequential (Sepsis-Related) Organ Failure Assessment Score and the National Early Warning Score in Non-ICU Patients With/Without Infection. 10.1097/CCM.0000000000003359 The Sepsis-3 task force recommended the quick Sequential (...) (Sepsis-Related) Organ Failure Assessment score for identifying patients with suspected infection who are at greater risk of poor outcomes, but many hospitals already use the National Early Warning Score to identify high-risk patients, irrespective of diagnosis. We sought to compare the performance of quick Sequential (Sepsis-Related) Organ Failure Assessment and National Early Warning Score in hospitalized, non-ICU patients with and without an infection. Retrospective cohort study. Large U.K. General

EvidenceUpdates2018

20. Corticosteroids in Sepsis: An Updated Systematic Review and Meta-Analysis

Corticosteroids in Sepsis: An Updated Systematic Review and Meta-Analysis 29979221 2018 08 16 1530-0293 46 9 2018 Sep Critical care medicine Crit. Care Med. Corticosteroids in Sepsis: An Updated Systematic Review and Meta-Analysis. 1411-1420 10.1097/CCM.0000000000003262 This systematic review and meta-analysis addresses the efficacy and safety of corticosteroids in critically ill patients with sepsis. We updated a comprehensive search of MEDLINE, EMBASE, CENTRAL, and LILACS, and unpublished (...) sources for randomized controlled trials that compared any corticosteroid to placebo or no corticosteroid in critically ill children and adults with sepsis. Reviewers conducted duplicate screening of citations, data abstraction, and, using a modified Cochrane risk of bias tool, individual study risk of bias assessment. A parallel guideline committee provided input on the design and interpretation of the systematic review, including the selection of outcomes important to patients. We assessed overall

EvidenceUpdates2018