Articles: sepsis.
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Multicenter Study
Pharmacokinetics, Pharmacodynamics and Safety of Nivolumab in Patients With Sepsis-induced immunosuppression: A multicenter, open-label phase 1/2 study.
Sepsis often induces an immunosuppressive state, which is associated with high mortality rates. Immunostimulation may be beneficial for sepsis. We investigated the pharmacokinetics, pharmacodynamics, and safety of nivolumab, a human programmed death-1 immune checkpoint inhibitor approved for the treatment of several cancers. ⋯ A single dose of 960 mg nivolumab appeared to be well tolerated and sufficient to maintain nivolumab blood concentrations. Both 480 mg and 960 mg nivolumab seemed to improve immune system indices over time.
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Journal of critical care · Jun 2020
Multicenter Study Observational StudyRelationship between norepinephrine dose, tachycardia and outcome in septic shock: A multicentre evaluation.
Septic shock is associated with massive release of endogenous catecholamines. Adrenergic agents may exacerbate catecholamine toxicity and contribute to poor outcomes. We sought to determine whether an association existed between tachycardia and mortality in septic shock patients requiring norepinephrine for more than 6 h despite adequate volume resuscitation. ⋯ Use of high-dose norepinephrine and concurrent tachycardia are associated with poor outcomes in septic shock.
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The Journal of pediatrics · Jun 2020
Multicenter StudyOutcomes of Young Infants with Hypothermia Evaluated in the Emergency Department.
To assess the prevalence of serious infections and mortality among infants ≤90 days of age presenting to the emergency department with hypothermia. ⋯ Of infants with hypothermia ≤90 days of age, 8.3% had serious bacterial infections or HSV. Compared with literature from febrile infants, hypothermia is associated with a high mortality rate. Complex chronic conditions were particularly associated with poor outcomes. Additional research is required to risk stratify young infants with hypothermia.
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Multicenter Study
National Early Warning Score Is Modestly Predictive of Care Escalation after Emergency Department-to-Floor Admission.
Decompensation on the medical floor is associated with increased in-hospital mortality. ⋯ This multicenter study found NEWS was superior to the qSOFA score and SI in predicting early, unplanned escalation of care for ED patients admitted to a general medical-surgical floor.
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Multicenter Study Observational Study
Interleukin-6 improves infection identification when added to physician judgment during evaluation of potentially septic patients.
Identifying infection is critical in early sepsis screening. This study assessed whether biomarkers of endothelial activation and/or inflammation could improve identification of infection among Emergency Department (ED) patients with organ dysfunction. ⋯ In ED patients with organ dysfunction, plasma interleukin-6 may improve infection discrimination when added to physician judgment.