Articles: sepsis.
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Anesteziol Reanimatol · Nov 1995
Comparative Study[Assessment of the severity of patient status in sepsis and septic shock].
A score for quantitative evaluation of the severity of clinical status has been created for a more objective assessment of the clinical status of patients with sepsis and septic shock. The system includes five sections: physiological parameters, level of respiratory support, age, localization of the focus, concomitant diseases. The final score represents a sum of scores for the above sections. ROC analysis demonstrated a higher prognostic value of the proposed score in comparison with the APACHE-II for patients with grave sepsis.
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The Journal of pediatrics · Oct 1995
Case ReportsPenicillin- and cephalosporin-resistant strains of Streptococcus pneumoniae causing sepsis and meningitis in children with sickle cell disease.
We investigated the possibility that antimicrobial-resistant pneumococci were causing invasive disease in children with sickle-cell disease (SCD). ⋯ Pneumococcal sepsis, meningitis, and infections of other foci in children with SCD may be caused by S. pneumoniae that is resistant to one or more antimicrobial agents, including penicillin. The addition of vancomycin to the antibiotics currently used for initial management should be considered in areas where the antibiotic resistance of S. pneumoniae is prevalent.
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S-ethylisothiourea (3936W92) is a nonamino acid antagonist of nitric oxide synthase. Its selectivity for the inducible form of nitric oxide synthase is twice as high as for the constitutive form of the enzyme. We tested 3936W92 in 20 sheep, which were surgically prepared for chronic study. ⋯ After 24 h of sepsis, nine sheep received a continuous infusion of 3936W92 over the next 24 h, whereas the control group (n = 9) received saline instead. Two sheep died within the first 24 h of sepsis. 3936W92 caused a complete reversal of the hyperdynamic circulation, while sheep in the control group remained hyperdynamic. Although the cardiac index decreased significantly during treatment with 3936W92 (7.9 +/- .8 vs. 6.0 +/- .7 l/min/m2), a simultaneous increase in oxygen extraction prevented oxygen consumption from falling.
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To examine the incidence, risk factors, and outcome of severe sepsis in intensive care unit (ICU) patients. ⋯ Only three of four patients presenting with clinically suspected severe sepsis have documented infection. However, patients with clinically suspected sepsis but without microbiological documentation and patients with documented infection share common risk factors and are at similarly high risk of death. In addition to the severity of illness score, acute organ failures and the characteristics of underlying diseases should be accounted for in stratification of patients and outcome analyses.