Articles: sepsis.
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Acute renal failure in the critically ill patient may have a wide range of clinical presentations and necessitate numerous nursing interventions. This article reviews the etiologies, pathophysiology, and diagnoses related to acute kidney dysfunction with a particular emphasis on sequelae related to sepsis. Additionally, the nursing care for managing patients with acute renal failure with the available renal replacement modalities is discussed.
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Crit Care Nurs Clin North Am · Jun 1994
ReviewAnti-infective drugs in the prevention and treatment of sepsis syndrome.
Anti-infective drugs may be used to prevent or treat infectious diseases. Preventing serious infections using aerosolized drugs, selective decontamination of the intestinal tract, or devices impregnated with anti-infective materials generally has been unsuccessful. Treatment of serious infections arising from the community or hospital setting requires knowledge of the most likely pathogens responsible for the illness, the antimicrobial susceptibility of those organisms, and the proper dosing of antimicrobial therapy.
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Sepsis and organ failure are significant causes of morbidity and mortality in the geriatric patient. A number of factors contribute to increased risk of septic complications in the elderly. ⋯ Atypical presentation is also common with infection in the elderly. The key to blunting the effects of severe infection in the elderly is rapid diagnosis and aggressive resuscitation.
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Sepsis is noted for producing disruptions in hemostasis. The patient-related risk factors, clinical presentation, and management strategies are dependent upon the presiding disorder. ⋯ Nursing care focuses on prevention, early recognition, and supportive care for the thrombotic or bleeding patient. An overview of the disorders of hemostasis in sepsis and nursing care of these patients are described in this article.
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Pediatr. Infect. Dis. J. · Jun 1994
Neonatal sepsis and meningitis in a developing Latin American country.
In a retrospective study at Hospital del Niño in Panama City, Panama, 577 neonates with culture-proved sepsis and/or meningitis were identified during an 18-year period (1975 to 1992). Overall there was an incidence of 3.5 cases/1000 live births. Three hundred thirty-three patients (58%) were of low birth weight (< 2500 g) and 260 (45%) were premature. ⋯ The case-fatality rate was 32%. Mortality was greater in infants with early onset sepsis than in those with late infections (44% vs. 22%, P < 0.0001; odds ratio, 2.8; 95% confidence interval, 1.9 to 4.1) and lesser in neonates infected by coagulase-negative staphylococci than in those infected by any other pathogen (12 vs. 39%, P < 0.001; odds ratio, 0.2; 95% confidence interval, 0.1 to 0.4). These findings provide guidelines for the selection of empiric antimicrobial agents in our country and possibly in other Latin American countries and suggest that a continued thorough epidemiologic evaluation is needed to anticipate bacteriologic changes over time.