Articles: sepsis.
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Randomized Controlled Trial Multicenter Study
Benefit/risk profile of high-dose antithrombin in patients with severe sepsis treated with and without concomitant heparin.
A randomised, prospective, placebo-controlled phase III multicentre clinical trial (KyberSept) has been performed to test the efficacy of high-dose antithrombin therapy in patients with severe sepsis. Concomitant low-dose heparin has been routinely given in two thirds of patients for deep vein thrombosis prophylaxis. This study analyses heparin - antithrombin interactions in terms of long-term mortality, adverse events, and thromboembolic events. ⋯ Rates of thromboembolic events were similar when antithrombin was given with or without concomitant heparin. In the treatment of severe sepsis, high-dose antithrombin may sufficiently protect against development of venous thromboembolism when no concomitant heparin is given. Combined administration of the two increases bleeding risk and probably abolishes efficacy of antithrombin.
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Intensive care medicine · Mar 2006
Multicenter StudyAn evaluation of systemic inflammatory response syndrome signs in the Sepsis Occurrence In Acutely Ill Patients (SOAP) study.
To define the frequency and prognostic implications of SIRS criteria in critically ill patients hospitalized in European ICUs. ⋯ Although common in the ICU, SIRS has prognostic importance in predicting infections, severity of disease, organ failure and outcome.
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Critical care medicine · Feb 2006
Multicenter StudySepsis in European intensive care units: results of the SOAP study.
To better define the incidence of sepsis and the characteristics of critically ill patients in European intensive care units. ⋯ This large pan-European study documents the high frequency of sepsis in critically ill patients and shows a close relationship between the proportion of patients with sepsis and the intensive care unit mortality in the various countries. In addition to age, a positive fluid balance was among the strongest prognostic factors for death. Patients with intensive care unit acquired sepsis have a worse outcome despite similar severity scores on intensive care unit admission.
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J. Thromb. Haemost. · Jan 2006
Randomized Controlled Trial Multicenter StudyTreatment effects of high-dose antithrombin without concomitant heparin in patients with severe sepsis with or without disseminated intravascular coagulation.
Disseminated intravascular coagulation (DIC) is a serious complication of sepsis that is associated with a high mortality. ⋯ High-dose AT without concomitant heparin in septic patients with DIC may result in a significant mortality reduction. The adapted ISTH DIC score may identify patients with severe sepsis who potentially benefit from high-dose AT treatment.
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Multicenter Study
Procalcitonin is not sufficiently reliable to be the sole marker of neonatal sepsis of nosocomial origin.
It has recently been suggested that serum procalcitonin (PCT) is of value in the diagnosis of neonatal sepsis, with varying results. The aim of this prospective multicenter study was to assess the usefulness of PCT as a marker of neonatal sepsis of nosocomial origin. ⋯ Serum PCT concentrations showed a moderate diagnostic reliability for the detection of nosocomial neonatal sepsis from the time of suspicion of infection. PCT is not sufficiently reliable to be the sole marker of sepsis, but would be useful as part of a full sepsis evaluation.