Articles: sepsis.
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Background: Acute kidney injury (AKI) occurs frequently in septic patients and correlates with increased mortality. Because clinical studies investigating hydrocortisone, ascorbic acid, and thiamine (HAT) have demonstrated discordant results, studies were performed using mortality stratification for therapy to identify candidates for therapy and determine mechanisms of organ injury. Methods: Sepsis was induced using the cecal ligation and puncture (CLP) model of sepsis with fluid and antibiotic support. ⋯ There was no evidence of global hypoxia or organ injury because hepatic parameters remained normal. Conclusions: Our data show that in CLP-induced sepsis, P-Die mice have increased inflammation, OS, and kidney injury. Hydrocortisone, ascorbic acid, and thiamine therapy decreased renal OS and injury in the P-Die group when given after the onset of sepsis-induced physiologic changes.
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J Coll Physicians Surg Pak · Oct 2022
Randomized Controlled TrialNeuromuscular Electrical Stimulator as a Protective Treatment against Intensive Care Unit Muscle Wasting in Sepsis/Septic Shock Patients.
To investigate the efficacy of neuromuscular electrical stimulation (NMES) application in preventing muscle wasting in intensive care unit (ICU) patients diagnosed with sepsis/septic shock. ⋯ Intensive care unit, Acquired weakness, Neuromuscular electrical stimulation, Muscle wasting, Sepsis.
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Randomized Controlled Trial Multicenter Study
Restrictive Fluids Versus Standard Care in Adults with Sepsis in the Emergency Department (REFACED) - a Multicenter, Randomized Feasibility Trial.
Fluid treatment in sepsis is a challenge and clinical equipoise exists regarding intravenous (IV) volumes. We aimed to determine whether a 24-h protocol restricting IV fluid was feasible in adult patients with sepsis without shock presenting to the emergency department (ED). ⋯ A protocol restricting IV crystalloid fluids in ED patients with sepsis reduced 24-h fluid volumes compared to standard care. A future trial powered toward patient-centered outcomes appears feasible.
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Randomized Controlled Trial
A prediction model for 30-day mortality of sepsis patients based on intravenous fluids and electrolytes.
To establish a prediction model for the 30-day mortality in sepsis patients. The data of 1185 sepsis patients were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) and all participants were randomly divided into the training set (n = 829) and the testing set (n = 356). The model was established in the training set and verified in the testing set. ⋯ In the XGBoost forest model without variables related to IV fluid management and electrolytes for the 30-day mortality of sepsis patients, in the training set, the AUC was 0.830 (95% CI: 0.829-0.831), the sensitivity was 0.717 (95% CI: 0.669-0.765), the specificity was 0.797 (95% CI: 0.762-0.833), and the accuracy was 0.765 (95% CI: 0.736-0.794). In the testing set, the AUC was 0.751 (95% CI: 0.750-0.753), the sensitivity was 0.612 (95% CI: 0.533-0.691), the specificity was 0.756 (95% CI: 0.698-0.814), and the accuracy was 0.697(95% CI: 0.649-0.744). The prediction model including variables associated with IV fluids and electrolytes had good predictive value for the 30-day mortality of sepsis patients.