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Surg Infect (Larchmt) 2019 Apr 20. Epub 2019 Apr 20.

Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.

Sepsis is an uncommon occurrence after appendectomy, but the morbidity and mortality of patients who develop sepsis after appendectomy remains exceedingly high. The purpose of this study is to identify risk factors and adverse post-operative outcomes associated with sepsis after appendectomy in adults. The American College of Surgery National Surgical Quality Improvement Program participant user database was queried from 2012 to 2015. Read More

Shock 2019 Apr 16. Epub 2019 Apr 16.

Department of Intensive Care Medicine, Radboud university medical center, Nijmegen, the Netherlands.

Aim: Comparing the effects of different vasopressors in septic shock patients is hampered by high heterogeneity and the fact that current guidelines dictate the use of norepinephrine. Herein, we studied the effects of three vasopressor agents, norepinephrine, phenylephrine and vasopressin, on the macro- and microcirculation during experimental human endotoxemia, a standardized, controlled model of systemic inflammation in humans in vivo.

Methods: We performed a randomized controlled study in which 40 healthy male volunteers were assigned to a five-hour infusion of either 0. Read More

Shock 2019 Apr 16. Epub 2019 Apr 16.

Department of Critical Care Medicine.

Background: Patients with septic shock in whom Norepinephrine (NE) infusion alone is insufficient to raise blood pressure require the concomitant administration of Vasopressin (VP). However, current guidelines do not advise clinicians as to which vasoactive agent to discontinue first once the patient's septic shock begins to resolve. Moreover, there is controversial data guiding clinicians on how to discontinue vasopressors for septic shock patients who are receiving a combination therapy of NE and VP. Read More

J Clin Neurosci 2019 Apr 17. Epub 2019 Apr 17.

Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address:

The epidemiologic trend of acute bacterial meningitis can change more dramatically than any other bacterial disease, and a decrease in spontaneous adult bacterial meningitis (ABM) has been noted in serial studies of the epidemiologic trend of ABM in Taiwan. The purpose of this study was to analyze the clinical characteristics, laboratory data and therapeutic outcomes of 149 patients with spontaneous Gram-negative (G(-)) ABM collected during a study period of 31 years (1986-2016). The 149 patients included 107 men and 42 women, aged 18-86 years. Read More

Am J Infect Control 2019 Apr 16. Epub 2019 Apr 16.

Department of Respiratory Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China. Electronic address:

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) tops the list of threats to human health. Studies exploring predictors of mortality in patients with CRAB infection produced conflicting results.

Methods: A systematic search of the PubMed, Embase, and the Cochrane Library databases was performed from inception to June 2018 to identify studies reporting mortality predictors in patients infected with CRAB. Read More

Cytokine 2019 Apr 16;120:22-27. Epub 2019 Apr 16.

Department of Anesthesiology and Intensive TherapyCare, 4th Military Hospital of Wroclaw, Weigla 5, 50-981 Wroclaw, Poland; Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland. Electronic address:

Purpose: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection and a syndrome shaped by pathogen and host factors with characteristic that evolve over time. The study was conducted to evaluate the prognostic and discriminative value of IL-18 assessment in comparison to PCT, CRP, WBC in early stage of sepsis and septic shock.

Methods: An observational and prospective study was conducted in the group of 40 ICU patients with diagnosis of sepsis or septic shock, serum PCT, IL-18, CRP and WBC measurements were performed on admission, and on the 2nd, 3rd and 5th therapy day. Read More

Clin J Am Soc Nephrol 2019 Apr 18. Epub 2019 Apr 18.

Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Background And Objectives: Major adverse kidney events, a composite of death, new kidney replacement therapy, or persistent kidney dysfunction, is a potential patient-centered outcome for clinical trials in sepsis-associated kidney injury. We sought to determine the incidence of major adverse kidney events within 30 days and validate this end point in pediatric sepsis.

Design, Setting, Participants, & Measurements: We conducted a retrospective observational study using the Pediatric Health Information Systems Plus database of patients >6 months to <18 years old with a diagnosis of severe sepsis/septic shock; orders for bacterial blood culture, antibiotics, and at least one fluid bolus on hospital day 0/1; and known hospital disposition between January 2007 and December 2011. Read More

BMC Gastroenterol 2019 Apr 18;19(1):58. Epub 2019 Apr 18.

Honjoudaiichi Hospital, 110, Iwabuchishita, Yurihonnjou, Akita, 015-8567, Japan.

Background: Vitamin K deficiency results in serious coagulation dysfunction, but hemorrhagic shock is rare. Herein, we describe a case of vitamin K deficiency and abnormality in the path of the intercostal artery, the combination of which led to hemorrhagic shock.

Case Presentation: An 83-year-old woman was hospitalized for suspected gallstones. Read More

Australas Emerg Care 2019 Mar 15;22(1):13-21. Epub 2018 Dec 15.

Department of Emergency Medicine, University of Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Introduction: An emergency department (ED) is often the first point of medical contact for sepsis patient, which plays an important role in early identification and management of high-risk septic patients. The present study was aim to evaluate emergency personnel's knowledge and attitude toward identification and management of systemic inflammatory response syndrome (SIRS) and sepsis.

Methods: This cross-sectional study was conducted in a tertiary teaching hospital and recruited all emergency personnel. Read More

Crit Care Med 2019 Apr 15. Epub 2019 Apr 15.

Departamento de Ciencias Biologicas, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile.

Objectives: To determine whether circulating endothelial cells from septic shock patients and from nonseptic shock patients are transformed in activated fibroblast by changing the expression level of endothelial and fibrotic proteins, whether the level of the protein expression change is associated with the amount of administered resuscitation fluid, and whether this circulating endothelial cell protein expression change is a biomarker to predict sepsis survival.

Design: Prospective study.

Setting: Medical-surgical ICUs in a tertiary care hospital. Read More

Innate Immun 2019 Apr 18:1753425919842320. Epub 2019 Apr 18.

2 Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.

Sepsis, the 10th leading cause of death, is the most expensive condition in the United States. The immune response in sepsis transitions from hyperinflammatory to a hypoinflammatory and immunosuppressive phase; individual variations regarding timing and overlap between hyper- and hypoinflammation exist in a number of patients. While one third of the sepsis-related deaths occur during hyperinflammation, majority of the sepsis-mortality occurs during the hypoinflammatory phase. Read More

Crit Care 2019 Apr 17;23(1):131. Epub 2019 Apr 17.

EA 7426 « Pathophysiology of injury-induced immunosuppression (PI3) » Lyon 1 University / Hospices Civils de Lyon / bioMérieux, Hôpital Edouard Herriot 5 place d'Arsonval, 69003, Lyon, France.

Background: Sepsis is the leading cause of mortality for critically ill patients worldwide. Patients develop T lymphocyte dysfunctions leading to T-cell exhaustion associated with increased risk of death. As interleukin-7 (IL-7) is currently tested in clinical trials to reverse these dysfunctions, it is important to evaluate the expression of its specific CD127 receptor on the T-cell surface of patients with septic shock. Read More

Clin Microbiol Infect 2019 Apr 14. Epub 2019 Apr 14.

Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena / Departamento de Medicina, Universidad de Sevilla / Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain.

Background: Pseudomonas aeruginosa is mostly a nosocomial pathogen affecting predisposed patients. However, community-onset bloodstream infections (CO-BSI) caused by this organism are not exceptional.

Objectives: To assess the predisposing factors for CO-BSI due to P. Read More

Rev Soc Bras Med Trop 2019 Apr 11;52:e20180121. Epub 2019 Apr 11.

Departamento de Saúde Coletiva, Programa de Pós-graduação em Saúde Coletiva e Programa de Pós-graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil.

Introduction: This study aimed to analyze the survival of septic patients and to assess prognostic factors.

Methods: Patients with sepsis, severe sepsis, and septic shock were followed up and clinical and laboratory data were collected. The sepsis-related organ failure assessment (SOFA) score was calculated. Read More

J Intensive Care 2019 5;7:20. Epub 2019 Apr 5.

Department of Emergency and Critical Care, Nagoya, University Graduate School of Medicine, Tsurumai-cho 64, Syowa-ku, Nagoya, Aichi 4668560 Japan.

Background: Currently, the appropriate method of management of patients with refractory septic shock remains unclear. This study aimed to evaluate the factors associated with response to epinephrine in norepinephrine-refractory septic shock.

Methods: A retrospective single-center observational study was performed using data from adult patients (≥ 18 years old) admitted to our emergency and medical intensive care unit (ICU) from January 2014 to December 2017 who had received epinephrine to treat norepinephrine-refractory septic shock. Read More

Sci Rep 2019 Apr 16;9(1):6145. Epub 2019 Apr 16.

Institute for Computational Medicine, The Johns Hopkins University, Maryland, USA.

Septic shock is a life-threatening condition in which timely treatment substantially reduces mortality. Reliable identification of patients with sepsis who are at elevated risk of developing septic shock therefore has the potential to save lives by opening an early window of intervention. We hypothesize the existence of a novel clinical state of sepsis referred to as the "pre-shock" state, and that patients with sepsis who enter this state are highly likely to develop septic shock at some future time. Read More

Crit Care 2019 Apr 16;23(1):124. Epub 2019 Apr 16.

La Jolla Pharmaceutical Company, San Diego, CA, USA.

The mainstay of hemodynamic treatment of septic shock is fluid resuscitation followed by vasopressors where fluids alone are insufficient to achieve target blood pressure. Norepinephrine, a catecholamine, is the first-line vasopressor used worldwide but given that all routinely used catecholamines target the same adrenergic receptors, many clinicians may add a non-catecholamine vasopressor where refractory hypotension due to septic shock is present. However, the timing of this additional intervention is variable. Read More

J Am Coll Surg 2019 Apr 13. Epub 2019 Apr 13.

Department of Surgery, University of Florida, Gainsville, FL.

Background: Glucagon-like peptide-1 (GLP-1) is a gut derived incretin hormone that stimulates insulin secretion, cellular glucose uptake and has immune-regulatory functions. GLP-1 is markedly altered following trauma and sepsis, but the implications remain unclear.

Study Design: We performed an analysis of a prospective, longitudinal cohort study of critically-ill surgical patients with sepsis. Read More

Am J Clin Pathol 2019 Apr 16. Epub 2019 Apr 16.

Division of Hematology and HSCT, Department of Oncology, King Abdul Aziz Medical City, Riyadh, KSA.

Objectives: The prevalence of concomitant myeloid neoplasms was recently reported to be unexpectedly high among adults without non-Langerhans cell histiocytosis (non-LCH); however, the coexistence of non-LCH with RUNX1 genetic aberration has not been reported previously.

Methods: Herein, we report a 23-year-old woman with severe pancytopenia diagnosed with non-LCH following presentation with pancytopenia and marrow examination showing histiocytosis positive for CD45, CD68, CD136, and lysozyme but negative for CD1a, langerin, and S100.

Results: Whole-exome sequencing showed RUNX1 mutation and NF1 mutation. Read More

Exp Ther Med 2019 May 5;17(5):3373-3382. Epub 2019 Mar 5.

Department of Intensive Care Unit, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China.

Application values of thromboelastography (TEG) in dynamic monitoring of coagulation parameters of sepsis patients were investigated. Eighty-one patients with sepsis who were admitted to the ICU department of the General Hospital of Ningxia Medical University from April 1, 2015 to December 31, 2015 were collected. Clinical data of the patients were collected. Read More

Crit Care 2019 Apr 15;23(1):118. Epub 2019 Apr 15.

Department of Critical Care Medicine, University of Pittsburgh, 1215.4 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.

Background: We hypothesized that the cardiovascular responses to Surviving Sepsis Guidelines (SSG)-defined resuscitation are predictable based on the cardiovascular state.

Methods: Fifty-five septic patients treated by SSG were studied before and after volume expansion (VE), and if needed norepinephrine (NE) and dobutamine. We measured mean arterial pressure (MAP), cardiac index (CI), and right atrial pressure (Pra) and calculated pulse pressure and stroke volume variation (PPV and SVV), dynamic arterial elastance (Ea), arterial elastance (Ea) and left ventricular (LV) end-systolic elastance (Ees), Ees/Ea (VAC), LV ejection efficiency (LVeff), mean systemic pressure analogue (Pmsa), venous return pressure gradient (Pvr), and cardiac performance (Eh), using standard formulae. Read More

Thromb Haemost 2019 Apr 15. Epub 2019 Apr 15.

Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.

Background:  Activation of the complement system is part of the dysregulated immune response in sepsis. The mannose-binding lectin-associated serine proteases (MASP)-1 and -2 activate the lectin pathway of the complement system. Besides, these proteins can activate coagulation in vitro. Read More

J Hosp Med 2019 Apr 8;14:E1-E9. Epub 2019 Apr 8.

Department of Medicine, Hofstra-Northwell School of Medicine, Hempstead, New York.

Background: Differences between hospital-presenting sepsis (HPS) and emergency department-presenting sepsis (EDPS) are not well described.

Objectives: We aimed to (1) quantify the prevalence of HPS versus EDPS cases and outcomes; (2) compare HPS versus EDPS characteristics at presentation; (3) compare HPS versus EDPS in process and patient outcomes; and (4) estimate risk differences in patient outcomes attributable to initial resuscitation disparities.

Design: Retrospective consecutive-sample cohort. Read More

Crit Care Med 2019 Apr 12. Epub 2019 Apr 12.

Department of Medicine, Division of Pulmonary Critical Care and Sleep, Alpert Medical School of Brown University, Providence, RI.

Objectives: It is unclear if a low- or high-volume IV fluid resuscitation strategy is better for patients with severe sepsis and septic shock.

Design: Prospective randomized controlled trial.

Setting: Two adult acute care hospitals within a single academic system. Read More

Crit Care Med 2019 Apr 8. Epub 2019 Apr 8.

Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Objectives: To examine long-term survival and quality of life of patients with early septic shock.

Design: Prospective, randomized, parallel-group trial.

Setting: Fifty-one hospitals in Australia, New Zealand, Finland, Hong Kong, and the Republic of Ireland. Read More

Case Rep Transplant 2019 10;2019:3682378. Epub 2019 Mar 10.

Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

We are presenting a case of a middle-aged woman with history of remote kidney transplantation who had multiple admissions for septic shock-like picture, recurrent fever, and hypotension. Her shock manifestation would resolve after stress dose steroid administration and less than 24 hours of vasopressor administration. Initially, extensive workup was performed without revealing etiology. Read More

G Ital Nefrol 2019 Apr;36(2)

Struttura Complessa Universitaria di Nefrologia e Dialisi - CMID, Ospedale San Giovanni Bosco, ASL Città di Torino, Torino.

Acute renal injury (AKI) occurs in 19% of patients with sepsis, 23% of those with severe sepsis and up to 50% of patients with septic shock. AKI represents an independent prognostic factor of mortality (about 45%); epidemiological studies have pointed out that the onset of AKI in sepsis (S-AKI) correlates with an unfavourable outcome, reaching a mortality of 75%. Over the years, efforts have been made to prevent and treat "low flow" hemodynamic damage resulting from shock by increasing renal blood flow, improving cardiac output and perfusion pressure. Read More

Biosci Trends 2019 Apr 15. Epub 2019 Apr 15.

Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences.

Adhesions due to previous upper abdominal surgery may complicate later liver transplantation. Here we report successful living donor liver transplantation (LDLT) in a patient with a history of total gastrectomy. A 32-year-old Japanese woman developed end-stage liver failure due to alcoholic cirrhosis. Read More

Blood Purif 2019 12;47 Suppl 3:1-9. Epub 2019 Apr 12.

Baxter, Baxter Deutschland GmbH, Unterschleissheim, Germany.

Background: Septic shock is a leading cause of acute kidney injury (AKI). Endotoxins and cytokine levels are associated with the occurrence and severity of AKI, and different blood purification devices are available to remove them from circulation. One such device, oXiris, is a hollow-fibre purification filter that clears both endotoxins and cytokines. Read More

Blood Purif 2019 12;47 Suppl 3:1-7. Epub 2019 Apr 12.

Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.

Background: Sepsis is a dysregulated host response to an infection and can result in organ dysfunctions and death. Extracorporeal blood purification techniques aim to improve the prognosis of these patients by modulating the unbalanced immune response. This study reports our experience with the use of the oXiris® membrane for septic shock patients requiring continuous renal replacement therapy (CRRT). Read More

Blood Purif 2019 12;47 Suppl 3:1-3. Epub 2019 Apr 12.

Perioperative and Intensive Care, Skåne University Hospital, Lund, Sweden.

Background: Lipopolysaccharide (endotoxin) from the outer Gram-negative bacterial wall can induce a harmful immunologic response, involving hemodynamic deprivation, and is one important motor driving the septic cascade. The positively charged poly-imine ethylene layer on the oXiris membrane is capable of adsorbing negatively charged endotoxin molecules and removing them from the blood compartment. Endotoxin is detrimental and should be removed from blood. Read More

Blood Purif 2019 12;47 Suppl 3:1-5. Epub 2019 Apr 12.

Cardiac Surgery European Hospital Rome, Rome, Italy.

Background: Extracorporeal treatment may be useful during sepsis, but definitive recommendations are lacking. Aim of this study is to review retrospectively the medical records of septic patients submitted to continuous renal replacement therapy (CRRT) with the adsorbing membrane oXiris and evaluate (1) the safety of the device, (2) the cardiorenal response, and (3) the immunological response.

Materials And Methods: The medical records of 60 septic patients submitted to CRRT with the membrane oXiris from April 2011 to December 2018 have been reviewed. Read More

Am J Emerg Med 2019 Apr 5. Epub 2019 Apr 5.

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; Capital Medical University, Beijing 100010, China; Beijing institute of Traditional Chinese Medicine, Beijing 100010, China; Beijing Key Laboratory of Basic Research with Traditional Chinese Medicine on Infectious Diseases, Beijing 100010, China. Electronic address:

Objective: To evaluate the efficacy and safety of Shenfu injection (SFI) combined with standard therapy versus standard therapy for septic shock, three groups of patients with septic shock were analyzed based on the level of mean arterial lactate. They were mean arterial lactate level < 4.5 mmol/L, 4. Read More

Chem Biol Interact 2019 Apr 11;306:62-69. Epub 2019 Apr 11.

Department of Biotechnology, Asia University, Taichung, Taiwan; College of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan; Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan. Electronic address:

Myocardial fibrosis is a critical event during septic shock. Upregulation in the fibrosis signaling cascade proteins such as fibroblast growth factor (FGF), urokinase plasminogen activator (uPA), tissue plasminogen activator (tPA) and activation of matrix metalloproteinases (MMPs) are widely associated with the development of myocardial infarction, dilated cardiomyopathy, cardiac fibrosis and heart failure. However, evidences suggest that the common upstream mediators of fibrosis cascade play little role in cardiac fibrosis induced by LPS; further, it is unknown if LPS directly triggers the expressions and/or activity of FGF-2, uPA, tPA, MMP-2 and MMP-9 in cardiac fibroblasts. Read More

Adv Exp Med Biol 2019 ;1117:111-129

Brandenburg Antiinfektiva GmbH, c/o Forschungszentrum Borstel, Borstel, Germany.

Antimicrobial peptides (AMPs) are in the focus of scientific research since the 1990s. In most cases, the main aim was laid on the design of AMP to kill bacteria effectively, with particular emphasis on broadband action and independency on antibiotic resistance. However, so far no approved drug on the basis of AMP has entered the market. Read More

Eur J Clin Microbiol Infect Dis 2019 Apr 13. Epub 2019 Apr 13.

Azrieli Faculty of Medicine, Bar-ilan University, Ramat Gan, Israel.

Little is known about the incidence, risk factors, clinical characteristics, and outcomes of patients with polymicrobial SA (PMSA). We aimed to determine the unique characteristics of patients with PMSA by comparing them to patients with monomicrobial SA (MMSA). We conducted a retrospective cohort study of patients 18 years and older admitted to a single tertiary care medical center, between 1998 and 2015, with surgically treated culture-positive SA affecting one or more joints. Read More

IDCases 2019 21;15:e00528. Epub 2019 Mar 21.

Department of Infectious Diseases, Fattouma Bourguiba Hospital, Monastir, Tunisia.

Mediterranean spotted fever is a generally benign disease but with the potential of serious manifestations. We report a case of Mediterranean spotted fever in a 56-year-old woman, with pet dog exposure, who presented with a septic shock pattern. Based on clinical symptoms, history, and laboratory results, the diagnosis of Mediterranean spotted fever was suspected and the outcome was favorable with doxycycline treatment. Read More

Acute Med Surg 2019 Apr 10;6(2):192-196. Epub 2019 Feb 10.

The Emergency and Critical Care Center Mie University Hospital Tsu Mie Japan.

Case: Fulminant myocarditis (FM) and septic cardiomyopathy (SC) are two different disease entities, and distinction between them is important. A 34-year-old man had refractory shock, multiple organ failure, and elevation of cardiogenic markers. Echocardiogram showed tachycardia with extended ST elevation, and a rapid test for influenza A virus was positive. Read More

Resuscitation 2019 Apr 8. Epub 2019 Apr 8.

Medical Intensive Care Unit, Cochin University Hospital, APHP, Paris, France; Paris Descartes University, Sorbonne Paris Cité-Medical School, Paris, France; Sudden Death Expertise Centre, INSERM U970 (team 4), Paris Cardiovascular Research Centre, Paris, France. Electronic address:

Background: After resuscitation of cardiac arrest (CA), an acute circulatory failure occurs in about 50% of cases, which shares many characteristics with septic shock. Most frequently, supportive treatments are poorly efficient to prevent multiple organ failure and death. We evaluated whether an early plasma removal of inflammatory mediators using high cut-off continuous veno-venous hemodialysis (HCO-CVVHD) could improve hemodynamic status and outcome of these patients. Read More

J Infect 2019 Apr 8. Epub 2019 Apr 8.

APHP Medical and infectious diseases ICU Bichat hospital, F75018 Paris, France; IAME UMR 1137, Université Paris-Diderot Equipe 5 DeScID, France.

Objectives: We aimed to assess the characteristics, outcomes and costs of septic shock complicating Systemic Lupus Erythematosus (SLE).

Methods: Characteristics of SLE patients experiencing a septic shock in France from 2010 to 2015 were analyzed through the French medico-administrative database. Factors associated with the 1-year post-admission mortality were analyzed, the crude 1-year survival of SLE patients experiencing septic shock was compared to those admitted for another reason, and we compared the 1-year outcome associated with SLE septic shock survival to a matched SLE ICU control population. Read More

J Biol Regul Homeost Agents 2019 Mar-Apr;33(2):525-530

Department of Nephrology, The Second Affiliated Hospital of Mudanjiang Medical University, MudanJiang, Heilongjiang, China.

Sepsis is a systemic inflammatory response that can further develop into severe sepsis (septic shock), which eventually leads to multiple organ dysfunction syndrome (MODS). This study aimed to assess the effects of continuous renal replacement therapy (CRRT) on acute renal injury caused by severe sepsis by monitoring biochemical parameters. A total of 60 patients with septic shock and acute kidney injury were included. Read More

mSphere 2019 04 10;4(2). Epub 2019 Apr 10.

Infectious Diseases Service, Hospital São Lucas da PUCRS, Porto Alegre, Brazil

The objective of this study is to evaluate the impact of carbapenem-resistant (CRE) infection on sepsis 30-day mortality. A retrospective cohort of patients >18 years old with sepsis and organ dysfunction or septic shock was conducted. Univariate analysis was done for variables potentially related to 30-day mortality, and the ones with values of <0. Read More

J Clin Med 2019 Apr 9;8(4). Epub 2019 Apr 9.

Department of Pharmacy Practice, Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, USA.

A recent study suggested mortality benefits using vitamin C, hydrocortisone, and thiamine combination therapy (triple therapy) in addition to standard care in patients with severe sepsis and septic shock. In order to further evaluate the effects of triple therapy in real-world clinical practice, we conducted a retrospective observational cohort study at an academic tertiary care hospital. A total of 94 patients (47 in triple therapy group and 47 in standard care group) were included in the analysis. Read More

Gut Liver 2019 Feb 27. Epub 2019 Feb 27.

Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.

Background/aims: : The incidence and cause of early mortality in acute pancreatitis (AP) arenot fully understood. Refeeding syndrome (RFS) is a fatal clinical complication that can occuras a result of fluid and electrolyte shifts during early nutritional rehabilitation for malnourishedpatients. This study was conducted to determine the clinical implications of RFS in patientswith AP. Read More

Rev Bras Ter Intensiva 2019 Jan-Mar;31(1):47-56

Grupo Académico de Epidemiología Clínica, Universidad de Antioquia - Medellín, Colombia.

Objective: To determine the association between the primary site of infection and in-hospital mortality as the main outcome, or the need for admission to the intensive care unit as a secondary outcome, in patients with sepsis admitted to the emergency department.

Methods: This was a secondary analysis of a multicenter prospective cohort. Patients included in the study were older than 18 years with a diagnosis of severe sepsis or septic shock who were admitted to the emergency departments of three tertiary care hospitals. Read More

Rev Med Suisse 2019 Apr;15(646):792-796

Service des maladies infectieuses, HUG, 1211 Genève 14.

It is well established in daily clinical practice, on the basis of randomized studies, to add corticosteroïds to the antibiotherapy in cases of S. pneumoniae H. influenzae meningitis, tuberculous meningitis and Pneumocystis jiroveci pneumonia in HIV patients. Read More

Rev Med Suisse 2019 Apr;15(646):780-785

Service des maladies infectieuses, HUG, 1211 Genève 14.

Animal and human bites are a common cause of admission to the emergency room and the infections are common, although they are often trivialized. Complications can range from simple cellulitis to septic shock especially in asplenic patients with Capnoyctophaga canimorsus infection. Other less common infections are possible such as rat-bite fever, leptospirosis, tularemia, and evaluation of post-exposure prophylaxis (anti-tetanus, anti-rabies, HIV, HBV) is essential. Read More

Rev Esp Quimioter 2019 Apr 9. Epub 2019 Apr 9.

Fernando Ramasco, Anesthesiology and Surgical Critical Care Departament, University Hospital of La Princesa, C/ Diego de León 62, Madrid, 28006, Spain.

Objective: To assess the impact of the first months of application of a Code Sepsis in a high complexity hospital, analyzing patient´s epidemiological and clinical characteristics and prognostic factors.

Methods: A long-term observational study was carried out throughout a consecutive period of seven months (February 2015 - September 2015). The relationship with mortality of risk factors, and analytic values was analyzed using uni- and multivariate analyses. Read More

Eur J Clin Microbiol Infect Dis 2019 Apr 9. Epub 2019 Apr 9.

Department of Pharmacology-Toxicology, Radboudumc, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.

Reduced target attainment of β-lactam antibiotics is reported in critically ill patients. However, as target attainment of cefotaxime in severely ill pediatric sepsis patients may differ from adults due to age-related variation in pharmacokinetics, we aimed to assess target attainment of cefotaxime in this pilot study using meningococcal septic shock patients as a model for severe sepsis. Secondary analysis of prospectively collected data from a randomized controlled trial. Read More