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Outcomes in Critically Ill Septic Patients Who Survived CPR

A new study looks at the long-term post-discharge survival among ICU patients with sepsis who received in-hospital cardiopulmonary resuscitation.  
medscape.com
over 3 years ago
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Ebola Survivors: Low Risk to Care Providers After Viremia Clearance

Patients who are recovering from Ebola virus infection probably pose little risk to healthcare workers six weeks after viremia has cleared, according to a new study.  
medscape.com
over 3 years ago
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7

The Dangers of Over-Resuscitation in Sepsis - emdocs

In previous discussions, we have addressed that IV fluid choices affect patient outcomes in septic shock, and we have shown the evidence that invasive monitoring coupled with aggressive treatments are actually harming our patients.  The question we now face is what is the result of over-resuscitation?   
emdocs.net
over 3 years ago
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Diagnosing Sepsis Is Subjective and Highly Variable

What accounts for the variability in the diagnosis of severe sepsis -- and what approaches may help improve consistency?  
medscape.com
over 3 years ago
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50

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 for critically ill patients. These improvements include lung protective ventilation, more judicious use of blood products, and strategies to reduce nosocomial infections.  
feeds.bmj.com
over 3 years ago
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14

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 for critically ill patients. These improvements include lung protective ventilation, more judicious use of blood products, and strategies to reduce nosocomial infections.  
feeds.bmj.com
over 3 years ago
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11

Late mortality after sepsis

A new series of definitions of sepsis1 along with simple guidance for early diagnosis has recently been published, and a NICE guideline is due shortly.2 Sepsis is an extreme manifestation of the body responding to a severe infection—in part adaptive and protective, but potentially maladaptive and life threatening. Naturally, perhaps, the focus has been on early diagnosis and management. This is not always performed well, as highlighted by a 2015 report from the UK National Confidential Enquiry into Patient Outcome and Death.3 In a linked paper, Prescott and colleagues (doi:10.1136/bmj.i2375) report that patients who survive an episode of sepsis have a significant excess risk of mortality for a prolonged period of time.4 In the past, staff working in intensive care units discharged patients to the rest of the hospital with a feeling of a job well done; somehow that part of the patient’s journey had come to an end and recovery was about to begin. Since then numerous publications have challenged this optimistic assumption. For substantial numbers of patients, leaving the intensive care unit does not represent the end of something, rather it represents the start of something else, often not anticipated by them or understood by others. Many studies have described the difficulties sustained by patients and of course their families. Such difficulties include loss of muscle mass and strength,5 cognitive dysfunction, anxiety and depression,6 and post-traumatic stress.7 Along with this come challenges, both medical and financial, for those who become informal caregivers.8 9 In the UK this has been addressed, at least in ambition, with the publication of NICE guidelines for rehabilitation after critical illness.10  
feeds.bmj.com
over 3 years ago
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Rosuvastatin vs Placebo in Sepsis-Associated ARDS

How do patients with sepsis and acute respiratory distress syndrome fare one year after treatment with rosuvastatin?  
medscape.com
over 3 years ago
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Late mortality after sepsis: propensity matched cohort study

Objectives To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself.  
feeds.bmj.com
over 3 years ago
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6

Mortality Predictors of Staphylococcus aureus Bacteremia

What factors might influence mortality and outcome in patients with S. aureus bacteremia?  
medscape.com
over 3 years ago
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8

Sepsis is not a disease - Intensive Care Network

So the ED crowd have stolen a march on us following the recent publication of the Sepsis 3.0 Consensus Definitions. And fair play to them for doing so; it has really helped to get the details out in the open.  
intensivecarenetwork.com
over 3 years ago
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28-Day Mortality of Hospital Acquired Fungemias in ICUs

Which ICU patients are most at risk for mortality after contracting hospital-acquired fungemias? This study identifies the prognostic factors.  
medscape.com
over 3 years ago
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Septic shock: Who should be treated with early pressors? - emdocs

emDocs post containing very useful emergency medicine information  
emdocs.net
over 3 years ago
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277

Understanding lactate in sepsis & Using it to our advantage

Introduction with a case 0 Once upon a time a 60-year-old man was transferred from the oncology ward to the ICU for treatment of neutropenic septic shock.   
emcrit.org
over 3 years ago
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6

Diabetes Increases Risk for Community-Acquired Bacteremia CME/CE

: Diabetes is associated with a markedly increased risk for community-acquired <em>Staphylococcus aureus</em> bacteremia, particularly for diabetes of long duration with poor glycemic control and complications.  
medscape.org
over 3 years ago
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199

Inhalational Anaesthetics

All Anaesthetics Analgesia Anatomy Conditions Emergency Medicine ICU Immunology Intubation Pharmacology Physics Physiology Renal Sepsis Techniques Vaccine #WDSD16  
propofology.com
over 3 years ago
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Sepsis Mortality Rates Depend on Data Source Used, CDC Says

According to a new study published by the Centers for Disease Control and Prevention, estimates of sepsis-related death rates vary widely, depending on the data source analyzed.  
medscape.com
over 3 years ago
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Varying Estimates of Sepsis Mortality Using Death Certificates and Administrative Codes — United States, 1999–2014 | MMWR

The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for Disease Control and Prevention (CDC).  
cdc.gov
over 3 years ago
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Does the Australian Sepsis Kills program work? - Intensive Care Network

The Sepsis Kills quality improvement initiative was formally launched in 2011. Has it provided any benefit yet? Is it too early to tell? What happens now that Sepsis 3.0 has been released?  
intensivecarenetwork.com
over 3 years ago