Articles: sepsis.
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Multicenter Study
Early alterations of the innate and adaptive immune statuses in sepsis according to the type of underlying infection.
Although major changes of the immune system have been described in sepsis, it has never been studied whether these may differ in relation to the type of underlying infection or not. This was studied for the first time. ⋯ Major differences of the early statuses of the innate and adaptive immune systems exist between sepsis and severe sepsis/shock in relation to the underlying type of infection. These results may have a major impact on therapeutics.
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Multicenter Study Clinical Trial
Plasma dia-filtration for severe sepsis.
The mortality rate in severe sepsis is 30-50%, and independent liver and renal dysfunction impacts significantly on hospital and intensive care mortality. If 4 or more organs fail, mortality is > 90%. Recently, we reported a novel plasmapheresis--plasma diafiltration (PDF)--the concept of which is plasma filtration with dialysis. ⋯ On average, 12.0 +/- 16.4 sessions (range 2-70) per patient were performed. The 28-day mortality rate was 36.4%, while the predicted death rate was 68.0 +/- 17.7%. These findings suggest that PDF is a simple modality and may become a useful strategy for treatment of patients with septic multiple organ failure.
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Critical care medicine · Dec 2009
Multicenter StudyPotential clinical utility of polymerase chain reaction in microbiological testing for sepsis.
To evaluate the potential improvement of antimicrobial treatment by utilizing a new multiplex polymerase chain reaction (PCR) assay that identifies sepsis-relevant microorganisms in blood. ⋯ Rapid PCR identification of microorganisms may contribute to a reduction of early inadequate antibiotic treatment in sepsis.
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Am. J. Respir. Crit. Care Med. · Nov 2009
Multicenter StudyEffectiveness of treatments for severe sepsis: a prospective, multicenter, observational study.
Several Surviving Sepsis Campaign Guidelines recommendations are reevaluated. ⋯ In severe sepsis, early administration of broad-spectrum antibiotics in all patients and administration of drotrecogin alfa (activated) in the most severe patients reduce mortality.
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J. Thromb. Haemost. · Nov 2009
Multicenter Study Controlled Clinical TrialEvaluation of anti-activated protein C antibody development in patients with severe sepsis from four clinical studies with drotrecogin alpha (activated).
Drotrecogin alpha (activated) (DAA) is a recombinant human activated protein C (APC), which is an antithrombotic protein. ⋯ The proportion of patients with anti-APC antibodies was low and was similar between DAA-treated and placebo-treated patients. No relationship between anti-APC antibody development and adverse reactions was observed. There was no evidence that the anti-APC antibodies detected represented a specific immune response to DAA therapy.