Articles: sepsis.
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Intensive care medicine · Jul 1998
Randomized Controlled Trial Multicenter Study Meta Analysis Clinical TrialAntithrombin III in patients with severe sepsis. A randomized, placebo-controlled, double-blind multicenter trial plus a meta-analysis on all randomized, placebo-controlled, double-blind trials with antithrombin III in severe sepsis.
To evaluate the safety and potential efficacy of antithrombin III (AT III) in reducing mortality in patients with severe sepsis. ⋯ The administration of AT III was safe and well-tolerated. It was followed by a 39 % reduction in 30-day all-cause mortality (NS). The reduction in mortality was accompanied by a considerably shorter stay in the ICU. Patients treated with AT III exhibited a better performance in overall severity of illness and organ failure scores (Acute Physiology and Chronic Health Evaluation II, multiple organ failure, organ system failure), which was noticeable soon after initiation of treatment. Patients treated with AT III demonstrated a better resolution of pre-existing organ failures and a lower incidence of new organ failures during the observation period. A meta-analysis comprising this and two other double-blind, placebo-controlled trials with AT III with a total of 122 patients suffering from severe sepsis confirms the positive trend. The results of the meta-analysis demonstrate a 22.9 % reduction in 30-day all-cause mortality in patients treated with AT III. Although still too small to be confirmative, the meta-analysis clearly points to the fact that a sufficiently powered phase III trial is warranted to prove whether AT III has a beneficial role in the treatment of severe sepsis.
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Multicenter Study
Central vein catheter-related thrombosis in intensive care patients: incidence, risks factors, and relationship with catheter-related sepsis.
To evaluate the incidence and risk factors for catheter-related central vein thrombosis in ICU patients. ⋯ Catheter-related central vein thrombosis is a frequent complication of central venous catheterization in ICU patients and is closely associated with catheter-related sepsis.
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Intensive care medicine · Apr 1998
Randomized Controlled Trial Multicenter Study Clinical TrialAntithrombin III (ATIII) replacement therapy in patients with sepsis and/or postsurgical complications: a controlled double-blind, randomized, multicenter study.
ATIII is decreased in sepsis and/or shock and its baseline value correlates with mortality. The efficacy of ATIII therapy on mortality was assessed in a selected group of patients admitted to the intensive care unit (ICU) in a double-blind, randomized, multicenter study. ⋯ The results of ATIII treatment in this population of patients suggests that replacement therapy reduces mortality in the subgroup of septic shock patients only.
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One hundred and twenty-seven patients were studied prospectively for aerobic, anaerobic and fungal burn wound infections. All cases yielded organisms on culture. A total of 377 isolates were recovered (239 aerobes, 116 anaerobes and 22 fungi). ⋯ Seventeen patients presented with septic shock, 15 of them (88.2%) yielding positive anaerobic cultures. Bacteroides sp. were isolated from 14 patients with septic shock, and were recovered from the four patients who had anaerobic infection alone. These results indicate a significant role of Bacteroides sp. in burn wound sepsis.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections. A randomized, double-blind trial. The Texas Medical Center Catheter Study Group.
Central venous catheters are a principal source of nosocomial bloodstream infections, which are difficult to control. ⋯ Central venous catheters coated with minocycline and rifampin can significantly reduce the risk for catheter-related colonization and bloodstream infections. The use of these catheters may save costs.