Articles: sepsis.
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Critical care medicine · Sep 2023
Multicenter Study Observational StudyEfficacy of Carbapenems Compared With Noncarbapenem Broad-Spectrum Beta-Lactam Antibiotics as Initial Antibiotic Therapy Against Sepsis: A Nationwide Observational Study.
As causative pathogens are not usually identified at the time of initiating antibiotics in sepsis, carbapenems are commonly used as an initial treatment. To reduce indiscriminate use of carbapenems, the efficacy of alternative empiric regimens, such as piperacillin-tazobactam and the fourth-generation cephalosporins, should be elucidated. This study aimed to evaluate survival effect associated with carbapenems as initial therapy for sepsis compared with these antibiotics. ⋯ Compared with the noncarbapenem broad-spectrum antibiotics, carbapenems as an initial therapy for sepsis were not associated with significantly lower mortality.
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Intensive care medicine · Sep 2023
Multicenter Study Observational StudySepsis-associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. A multicenter, observational study.
The Acute Disease Quality Initiative (ADQI) Workgroup recently released a consensus definition of sepsis-associated acute kidney injury (SA-AKI), combining Sepsis-3 and Kidney Disease Improving Global Outcomes (KDIGO) AKI criteria. This study aims to describe the epidemiology of SA-AKI. ⋯ SA-AKI occurs in 1 in 6 ICU patients, is diagnosed on day 1 and carries significant morbidity and mortality risk with patients mostly admitted from home via the ED. However, most SA-AKI is stage 1 and mostly due to low UO, which carries much lower risk than diagnosis by other criteria.
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Revista médica de Chile · Sep 2023
Multicenter Study[Antibiotic treatment of choice for urinary sepsis associated with ureteral lithiasis in Chile. Multicenter study].
Inadequate antibiotic coverage in septic patients is associated with higher morbidity and mortality. This multicentric study reports antibiotic susceptibility in patients with ureterolithiasis-associated urosepsis, aiming to propose an optimal empirical therapy for this disease in the Chilean population. ⋯ The microorganisms found in our cohort were similar to those in international reports. Since the highest level of susceptibility was for amikacin, we propose its use as empirical therapy for urosepsis associated with ureterolithiasis in Chile. It is always necessary to consider the potential nephrotoxic effects of amikacin. An association of beta-lactams and glycopeptides should be considered in patients with risk factors for enterococcal infections.
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Pediatr Crit Care Me · Sep 2023
Multicenter StudyA Targeted Analysis of Serial Cytokine Measures and Nonpulmonary Organ System Failure in Children With Acute Respiratory Failure: Individual Measures and Trajectories Over Time.
There is a need for research exploring the temporal trends of nonpulmonary organ dysfunction (NPOD) and biomarkers in order to identify unique predictive or prognostic phenotypes. We examined the associations between the number and trajectories of NPODs and plasma biomarkers of early and late inflammatory cascade activation, specifically plasma interleukin-1 receptor antagonist (IL-1ra) and interleukin-8 (IL-8), respectively, in the setting of acute respiratory failure (ARF). ⋯ Both the inflammatory biomarkers and number of NPODs exhibit distinct trajectories over time with strong associations with one another. These biomarkers and their trajectory patterns may be useful in evaluating the severity of multiple organ dysfunction syndrome in critically ill children and identifying those phenotypes with time-sensitive, treatable traits.
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Journal of critical care · Aug 2023
Randomized Controlled Trial Multicenter StudySafety, tolerability, pharmacokinetics, and efficacy of kukoamine B in patients with sepsis: A randomized phase IIa trial.
To evaluate the safety, tolerability, pharmacokinetics, and efficacy of kukoamine B (KB), an alkaloid compound with high affinity for both lipopolysaccharide (LPS) and oligodeoxynucle-otides containing CpG motifs (CpG DNA), in patients with sepsis-induced organ failure. ⋯ In patients with sepsis-induced organ failure, KB was safe and well tolerated. Further investigation is warranted.