Articles: sepsis.
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Observational Study
Renin and angiotensin (1-7) offer predictive value in pediatric sepsis: findings from prospective observational cohorts.
Background: Pediatric sepsis is a common and complex syndrome characterized by a dysregulated immune response to infection. Aberrations in the renin-angiotensin system (RAS) are factors in several infections of adults. However, the precise impact of RAS dysregulation in pediatric sepsis remains unclear. ⋯ Nonsurvivors had higher levels of renin (8,207 ± 7,903) compared to survivors (2,433 ± 3,193) ( P = 0.0001) and lower levels of angiotensin (1-7) (60.9 ± 51.1) compared to survivors (104.0 ± 85.1) ( P < 0.05). A combination of renin, angiotensin (1-7) and procalcitonin achieved a model for diagnosis with an area under the receiver operating curve of 0.87 (95% CI: 0.81-0.92). Conclusion: Circulating renin and angiotensin (1-7) have predictive value in pediatric sepsis.
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Hypothermia is associated with poor outcomes in sepsis patients, and hypothermic sepsis patients exhibit temperature alterations during initial treatment. The objective of this study was to classify hypothermic sepsis patients based on body temperature trajectories and investigate the associations of these patients with 28-day mortality. ⋯ In hypothermic sepsis patients, an increase of 1 °C or more in body temperature after the initial 6 h is associated with a reduced risk of 28-day mortality.
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Machine learning (ML) has been tried in predicting outcomes following sepsis. This study aims to identify the utility of stacked ensemble algorithm in predicting mortality. ⋯ The random forest showed high accuracy in train and moderate accuracy in the test data. We suggest more regional open-access intensive care databases that can aid making machine learning a bigger support for healthcare personnel.
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The aim of this study was to investigate the optimal CVP range in sepsis and septic shock patients admitted to intensive care unit. ⋯ We observed U-shaped association between mean CVP level and hospital mortality in septic shock patients and J-shaped association in non-septic shock patients. This may imply that patients with different severity of sepsis have different CVP requirements. We need to monitor and manage CVP according to the circulatory status of the sepsis patient.
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Journal of critical care · Oct 2024
Enhancing Sepsis prognosis: Integrating social determinants and demographic variables into a comprehensive model for critically ill patients.
The Sequential Organ Failure Assessment (SOFA) score monitors organ failure and defines sepsis but may not fully capture factors influencing sepsis mortality. Socioeconomic and demographic impacts on sepsis outcomes have been highlighted recently. ⋯ Adding patient-specific demographic and socioeconomic information to clinical metrics significantly improves sepsis mortality prediction. This suggests a more comprehensive, multidimensional prognostic approach is needed for accurate sepsis outcome predictions.