Articles: sepsis.
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Randomized Controlled Trial
Use of heparin-coated central venous lines to prevent catheter-related bloodstream infection.
Bloodstream infections related to the use of central venous catheters are an important cause of patient morbidity, mortality, and increased health care costs. Catheter-related infection may be due to fibrin deposition associated with catheters. Interventions designed to decrease fibrin deposition have the potential to reduce catheter-related infections. ⋯ Six and seven patients experienced severe bleeding in the heparin-coated and control groups, respectively (P = 1.00). We did not observe heparin-induced thrombocytopenia. The use of heparin-coated catheters can be a safe and effective approach to the prevention of catheter-related bloodstream infection in patients with hematooncologic disease.
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Intensive care medicine · Apr 2007
Randomized Controlled Trial Multicenter StudyEpidemiology of sepsis in Germany: results from a national prospective multicenter study.
To determine the prevalence and mortality of ICU patients with severe sepsis in Germany, with consideration of hospital size. ⋯ The expected number of newly diagnosed cases with severe sepsis in Germany amounts to 76-110 per 100,000 adult inhabitants. To allow better comparison between countries, future epidemiological studies should use standardized study methodologies with respect to sepsis definitions, hospital size, and daily and monthly variability.
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Randomized Controlled Trial Multicenter Study
Drotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial.
Drotrecogin alfa (activated) (DrotAA) is used for the treatment of adults with severe sepsis who have a high risk of dying. A phase 1b open-label study has indicated that the pharmacokinetics and pharmacodynamics of DrotAA are similar in children and adults. We initiated the RESOLVE (REsearching severe Sepsis and Organ dysfunction in children: a gLobal perspectiVE) trial to investigate the efficacy and safety of the drug in children. ⋯ Although we did not record any efficacy of DrotAA in children with severe sepsis, serious bleeding events were similar between groups and the overall safety profile acceptable, except in children younger than 60 days. However, we gained important insights into clinical and laboratory characteristics of childhood severe sepsis, and have identified issues that need to be addressed in future trials in critically ill children.
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Randomized Controlled Trial
Propranolol does not increase inflammation, sepsis, or infectious episodes in severely burned children.
Propranolol, a nonselective beta1-2 antagonist, attenuates hypermetabolism and catabolism in severely burned patients. However, recent data suggest that propranolol impairs immune function and enhances inflammation. The purpose of the present study was to determine the effect of propranolol administration on infection, sepsis, and inflammation in severely burned pediatric patients. ⋯ Propranolol treatment attenuates hypermetabolism and does not cause increased incidence of infection and sepsis.
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Hepato Gastroenterol · Mar 2007
Randomized Controlled TrialCan procalcitonin help us in timing of re-intervention in septic patients after multiple trauma or major surgery?
In surgical sepsis, the rapid identification of source of infection at an early stage after surgery or serious trauma is crucial for favorable outcome. The discrimination between local and generalized infection is critical for correct treatment. ⋯ We observed a clear tendency to decrease extent of multiple organ dysfunction syndrome in patients, in which therapeutic decision was made earlier using procalcitonin as an additional marker separating local infection from generalized one.