Articles: sepsis.
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Critical care medicine · Jun 2018
Multicenter StudyThe Impact of Acute Organ Dysfunction on Long-Term Survival in Sepsis.
To estimate the impact of each of six types of acute organ dysfunction (hepatic, renal, coagulation, neurologic, cardiac, and respiratory) on long-term mortality after surviving sepsis hospitalization. ⋯ Acute sepsis-related neurologic dysfunction was the organ dysfunction most strongly associated with short- and long-term mortality and represents a key mediator of long-term adverse outcomes following sepsis.
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Journal of critical care · Jun 2018
Multicenter Study Observational StudyThe impact of organ dysfunctions on mortality in patients with severe sepsis: A multicenter prospective observational study.
Disseminated intravascular coagulations (DIC), acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI) are major organ dysfunctions that occur in patients with sepsis. This study aimed to elucidate the impact of these organ dysfunctions on mortality in patients with severe sepsis. ⋯ DIC and AKI are frequent complications in patients with severe sepsis. In this study, DIC, and AKI stage 3 were independent risk factors of in-hospital mortality.
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Journal of critical care · Jun 2018
Multicenter Study Observational StudyEarly glycemia and mortality in critically ill septic patients: Interaction with insulin-treated diabetes.
To investigate the relationship between dysglycemia and hospital mortality in patients with and without a preadmission diagnosis of insulin treated diabetes mellitus (ITDM). ⋯ Septic patients with a pre-existing diagnosis of ITDM show a different relationship between hospital mortality and highest glucose levels and glycemic variability in the first 24 h than those without ITDM. These findings provide a rationale for an ITDM-specific approach to the management of dysglycemia.
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Sepsis is one of the main reasons for non-elective admission to pediatric intensive care units (PICUs), but little is known about determinants influencing outcome. We characterized children admitted with community-acquired sepsis to European PICUs and studied risk factors for mortality and disability. ⋯ Despite widespread immunization campaigns, invasive bacterial disease remains responsible for substantial morbidity and mortality in critically ill children in high-income countries. Almost one third of sepsis survivors admitted to the PICU were discharged with some disability. More research is required to delineate the long-term outcome of pediatric sepsis and to identify interventional targets. Our findings emphasize the importance of improved early sepsis-recognition programs to address the high burden of disease.
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Critical care medicine · May 2018
Randomized Controlled Trial Multicenter Study Pragmatic Clinical TrialPrognostic Value of Secretoneurin in Patients With Severe Sepsis and Septic Shock: Data From the Albumin Italian Outcome Sepsis Study.
Secretoneurin directly influences cardiomyocyte calcium handling, and circulating secretoneurin levels seem to improve risk prediction in patients with myocardial dysfunction by integrating information on systemic stress, myocardial function, and renal function. Accordingly, in this study, we hypothesized that secretoneurin would improve risk prediction in patients with sepsis and especially in patients with septic shock as these patients are more hemodynamically unstable. ⋯ Secretoneurin provides early and potent prognostic information in septic patients with cardiovascular instability.