AbstractText: The objectives of this study were to 1) assess patterns of early crystalloid resuscitation provided to sepsis and septicshock patients at initial presentation and 2) determine the association between time to initial crystalloid resuscitation with hospital mortality, mechanical ventilation, ICU utilization, and length of stay AbstractText: Consecutive-sample ...
We estimated incidence, prevalence, and mortality of sepsis in adult Brazilian intensivecare units (ICUs) and association of ICU organisational factors with outcome ... day point prevalence study with follow-up of patients in ICU with sepsis in a nationally representative pseudo-random sample... 95% CI 237·9-351·2) of adult cases of ICU-treated sepsis per year, which yields about 420 000 cases annually, of ...
The authors then systematically evaluated each study, which formed the basis for this clinical statement.Patients with severe sepsis and septicshock should receive early and appropriate antibiotics in the emergency department. Patients with septic shock who received appropriate antimicrobial therapy within 1 h of recognition had the greatest benefit in mortality.
Infectious Diseases (6) Septic Shock (5), Sepsis (4), more mentions
AbstractText: To assess the agreement between transpulmonary thermodilution (TPT) and criticalcare echocardiography (CCE) in ventilated septicshock patients AbstractText: Ventilated patients in sinus rhythm requiring advanced hemodynamic assessment for septic shock were included in this prospective multicenter descriptive study. Patients were assessed successively using TPT and CCE in random order.
... Services' Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) quality measure and qualitatively assess emergency department (ED) sepsis quality improvement best practice implementation AbstractText: Using a standardized Web-based submission portal, we surveyed quality improvement data from volunteer hospital-based EDs participating in the Emergency Quality Network Sepsis Initiative ...
... XN and C reactive protein (CRP), for early diagnosis of sepsis during intensivecare unit (ICU) stay AbstractText: The study population consisted of 62 ICU patients, 21 of whom developed sepsis during ICU stay and 41 who did not ... The association with the risk of developing sepsis during ICU stay was also assessed.
Blood Disorders and Hematology (1) Sepsis (13), Infections (1), more mentions
... meeting two or more systemic inflammatory response syndrome (SIRS) criteria (sepsis-1) or a Sequential Organ Failure Assessment (SOFA) score ≥ 2 (sepsis-3) on the first day after ICU admission were selected from the Medical Information Mart for Intensive Care-III database, and their outcomes were compared using all-cause ...
OBJECTIVE: To examine the ability of the low-frequency/high-frequency (LF/HF) ratio of heart rate variability (HRV) analysis to identify patients with sepsis at risk of early deterioration.
METHODS: This is a prospective observational cohort study of patients with sepsis presenting to the Montefiore Medical Center ED from December 2014 through September 2015. On presentation, a single ECG Holter recording was obtained and analysed to obtain the LF/HF ratio of HRV. Initial Sequential Organ Failure Assessment (SOFA) scores were computed. Patients were followed for 72 hours to identify those with early deterioration.
RESULTS: 466 patients presenting to the ED with sepsis were analysed. Thirty-two (7%) reached at least one endpoint within 72 hours. An LF/HF ratio <1 had a sensitivity and specificity of 34% (95% CI (19% to 53%)) and 82% (95% CI (78% to 85%)), respectively, with positive and negative likelihood ratios of 1.9 (95% CI (1.1 to 3.2)) and 0.8 (95% CI (0.6 to 1.0)). An initial SOFA score ≥3 had a sensitivity and specificity of 38% (95% CI (22% to 56%)) and 92% (95% CI (89% to 95%)), with positive and negative likelihood ratios of 4.9 (95% CI (2.8 to 8.6)) and 0.7 (95% CI (0.5 to 0.9)). The composite measure of HRV+SOFA had improved sensitivity (56%, 95% CI (38% to 73%)) but at the expense of specificity (77%, 95% CI (72% to 80%)), with positive and negative likelihood ratios of 2.4 (95% CI (1.7 to 3.4)) and 0.6 (95% CI (0.4 to 0.9)). Receiver operating characteristic analysis did not identify a superior alternate threshold for the LF/HF ratio. Kaplan-Meier survival functions differed significantly (p=0.02) between low (<1) and high (≥1) LF/HF groups.
CONCLUSIONS: While we found a statistically significant relationship between HRV, SOFA and HRV+SOFA, and early deterioration, none reliably functioned as a clinical predictive tool. More complex multivariable models will likely be required to construct models with clinical utility.
Men's Health (2), Infectious Diseases (1) Sepsis (4), Communicable Diseases (1), more mentions
... aimed to assess the results of a quality improvement initiative in sepsis in an emerging setting and to analyze it according to the institutions' main source ... in the first two periods AbstractText: This quality improvement initiative in sepsis in an emerging country was associated with a reduction in mortality and with improved ...
... compared serum sPD-1 with procalcitonin (PCT), C-reactive protein (CRP), and the Mortality in Emergency Department Sepsis (MEDS) score AbstractText: A total of 60 healthy volunteers and 595 emergency department (ED) patients ... sPD-1 with PCT and the MEDS score improves the prognostic evaluation Keyword: Mortality in Emergency Department Sepsis score.
Men's Health (2) Sepsis (11), Septic Shock (1), Systemic Inflammatory Response Syndrome (1), more mentions
... international normalized ratio (PT-INR) measured on admission to the ICU in patients with severe sepsis or septicshock may be associated with mortality independent of SAPS 3 score AbstractText: All patients admitted to a tertiary general ICU from 2007 to 2014 diagnosed with severe sepsis or septicshock were eligible ...
OBJECTIVES: The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis.
METHODS: Electronic health records of 200 patients who were treated for suspected sepsis in our ED and ultimately discharged from our hospital with a diagnosis of sepsis were randomly selected for review from a population of adult ED patients (N=1880). Data extracted included the presence of SIRS criteria and the qSOFA score as well as time required to meet said criteria.
RESULTS: In this cohort, 94.5% met SIRS criteria while in the ED whereas only 58.3% met qSOFA. The mean time from arrival to SIRS documentation was 47.1min (95% CI: 36.5-57.8) compared to 84.0min (95% CI: 62.2-105.8) for qSOFA. The median ED "door" to positive SIRS criteria was 12min and 29min for qSOFA.
CONCLUSIONS: Although qSOFA may be valuable in predicting sepsis-related mortality, it performed poorly as a screening tool for identifying sepsis in the ED. As the time to meet qSOFA criteria was significantly longer than for SIRS, relying on qSOFA alone may delay initiation of evidence-based interventions known to improve sepsis-related outcomes.
Men's Health (7) Sepsis (11), Systemic Inflammatory Response Syndrome (1), more mentions