Articles: sepsis.
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Pediatric emergency care · Nov 2021
Multicenter StudyHow Are Clinicians Treating Children With Sepsis in Emergency Departments in Latin America?: An International Multicenter Survey.
Guidelines adherence in emergency departments (EDs) relies partly on the availability of resources to improve sepsis care and outcomes. Our objective was to assess the management of pediatric septic shock (PSS) in Latin America's EDs and to determine the impact of treatment coordinated by a pediatric emergency specialist (PEMS) versus nonpediatric emergency specialists (NPEMS) on guidelines adherence. ⋯ In some Latin American countries, there is variability in self-reported adherence to the evidence-based recommendations for the treatment of PSS during the first hour. The coordination by PEMS support greater adherence to these recommendations.
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Randomized Controlled Trial Multicenter Study
Proteomic signatures for perioperative oxygen delivery in skin after major elective surgery: mechanistic sub-study of a randomised controlled trial.
Maintaining adequate oxygen delivery (DO2) after major surgery is associated with minimising organ dysfunction. Skin is particularly vulnerable to reduced DO2. We tested the hypothesis that reduced perioperative DO2 fuels inflammation in metabolically compromised skin after major surgery. ⋯ ISRCTN76894700.
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Journal of critical care · Oct 2021
Randomized Controlled Trial Multicenter StudyFrequency and risk factors of post-intensive care syndrome components in a multicenter randomized controlled trial of German sepsis survivors.
Post-intensive care syndrome (PICS) is a combination of cognitive, psychiatric and physical impairments in survivors of critical illness and intensive care. There is little data on long-term co-occurrence of associated impairments. ⋯ Almost all study participants showed impairments associated with PICS in at least one domain. The proposed classification models for PICS appear to be too broad to identify specific risk factors beyond its individual components.
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Multicenter Study
Incidence and Impact of Dysglycemia in Patients with Sepsis Under Moderate Glycemic Control.
Glycemic control strategies for sepsis have changed significantly over the last decade, but their impact on dysglycemia and its associated outcomes has been poorly understood. In addition, there is controversy regarding the detrimental effects of hyperglycemia in sepsis. To evaluate the incidence and risks of dysglycemia under current strategy, we conducted a preplanned subanalysis of the sepsis cohort in a prospective, multicenter FORECAST study. ⋯ In conclusion, a significantly high incidence of dysglycemia was observed in our sepsis cohort under moderate glycemic control. Late hyperglycemia in addition to early hypoglycemia was associated with poor outcomes at least in nondiabetic patients. More sophisticated approaches are necessary to reduce the incidence of these serious complications.
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Randomized Controlled Trial Multicenter Study
A randomized trial of Mycobacterium w in severe presumed Gram-negative sepsis (MIST).
Mycobacterium w (Mw), an immunomodulator, has been shown to resolve early organ failure in severe sepsis. ⋯ The use of Mw was associated with a significant reduction in mortality in patients with severe presumed gram-negative sepsis. Further studies are required to confirm our findings.