Articles: sepsis.
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This case report highlights the use of continuous infusion of meropenem in a 42-year-old septic female patient with periprosthetic infection and end-stage renal disease receiving prolonged intermittent renal replacement therapy (PIRRT). Antibiotic infusion in patients receiving renal replacement therapy has its own peculiarities. There are many studies on the optimal dosing regimen for meropenem in renal dysfunction, but studies on the optimal infusion duration in these patients are limited. ⋯ The patient was further transferred to a specialized nephrology department for further treatment. We believe that in this clinical case, the use of continuous infusion of meropenem in the complex therapy of sepsis in a patient with CKD undergoing PIRRT sessions helped to lead to clinical improvement in the patient. Further studies are needed.
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Background: Acute respiratory distress syndrome (ARDS) is a serious pathological process with high mortality. Ferroptosis is pivotal in sepsis, whose regulatory mechanisms in sepsis-induced ARDS remains unknown. We aimed to determine key ferroptosis-related genes in septic ARDS and investigate therapeutic traditional Chinese medicine. ⋯ Conclusions: Ferroptosis-related genes of IL1B , MAPK 3, and TXN serve as potential diagnostic genes for sepsis-induced ARDS. Sea buckthorn may be therapeutic medication for ARDS. This study provides a new direction for septic ARDS treatment.
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The latest meta-analysis indicated potential survival benefits from ultra-short-acting β-blockers in patients with sepsis with persistent tachycardia. However, subsequent multicenter randomized controlled trials (RCTs) have reported conflicting findings, prompting the need for an updated meta-analysis to incorporate these newly published RCTs. ⋯ In this updated meta-analysis, the use of esmolol or landiolol did not reduce mortality in patients with sepsis with persistent tachycardia. However, results were not robust and outcomes differed between single-center and multicenter RCTs. Moreover, sensitivity analyses showed the fragility of the primary outcome. Further studies regarding ultra-short-acting β-blockers with advanced cardiac monitoring or serial echocardiography are warranted.
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Intensive care medicine · Jan 2025
ReviewManagement of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.
To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings. ⋯ Using a Delphi method, international experts reached consensus to generate expert clinical practice statements providing guidance to clinicians worldwide on the management of sepsis in resource-limited settings. These statements complement existing guidelines where evidence is lacking and add relevant aspects of sepsis management that are not addressed by current international guidelines. Future studies are needed to assess the effects of these practice statements and address remaining uncertainties.
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Intensive care medicine · Jan 2025
Multicenter Study Observational StudyLeft ventricular diastolic dysfunction is prevalent but not associated with mortality in patients with septic shock.
Prognostic impact of left ventricular diastolic dysfunction (LVDD) in septic shock patients has not been determined using current diagnostic guidelines. We assessed the relation between LVDD during the first 3 days following intensive care unit (ICU) admission for septic shock and Day-28 mortality. ⋯ LVDD was highly prevalent in patients with septic shock but not associated with mortality. It appeared improving in one-third of survivors.