Articles: sepsis.
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Anaesth Intensive Care · Jan 2025
Effects of polymyxin B haemoperfusion on septic shock caused by Gram-positive bacteria.
Polymyxin B haemoperfusion is commonly used to adsorb endotoxins in septic shock caused by Gram-negative bacterial infections. Polymyxin B haemoperfusion has been reported to improve hypotension in Gram-positive bacterial infections; however, its efficacy and mechanism in treating such cases are unclear. We hypothesised that polymyxin B haemoperfusion would be equally effective in improving haemodynamics during Gram-positive bacterial infections as in Gram-negative bacterial infections. ⋯ Although there was no significant difference in the VIS in polymyxin B haemoperfusion between patients with GNR and GPC infections, there was a significant decrease in the VIS over time, even when GPC was the causative organism. In addition, the degree of reduction in the VIS was significantly different in both the GNR and GPC groups compared with that in the non-extracorporeally treated group. Thus, polymyxin B haemoperfusion for septic shock caused by GNR reduced the VIS and could be effective even in cases of GPC infection.
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The storage of reusable medical devices (RMDs) is the final reprocessing phase and the step that directly precedes point-of-care delivery. Reusable medical devices, including surgical tools necessitating sterilization and semicritical devices such as endoscopes, undergo high-level disinfection. The rigorous reprocessing protocols and subsequent storage of RMDs are crucial in preserving their sterility and asepsis. This ensures they are available, clean, and safe for patient use, thereby significantly reducing the risk of surgical site infection. The stringent requirements for RMD storage are a testament to the critical role it plays in patient safety, making it a demanding task for health care organizations (HCOs) to comply with. These challenges are further amplified in austere environments. This integrative review aims to identify optimal storage practices, emphasize the critical importance of RMD storage in the Military Health System, and derive implications for policies and future considerations. ⋯ Although surgical teams' capabilities are crucial in delivering effective care in a dynamic environment, the management and storage of RMDs are equally essential. Numerous organizations have outlined rigorous guidelines for HCOs to comply with, which can be intensified in austere conditions. Ultimately, a commitment to integrating the literature and developing the groundwork for clinical practice guidelines can improve the safe storage of RMDs in both standard and austere environments.
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The aim of this retrospective observational case-control study was to examine the significance of different renal Doppler marker variations within the initial 24-hour period as potential predictors of Acute Kidney Injury (AKI) in patients with sepsis. ⋯ CVP, SOFA score, CRP, lactate, VIS, and RRI not reduction following 24h of ICU treatment can be utilized as predictive indicators for early detection of SA-AKI in sepsis patients.
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Multicenter Study Observational Study
Predicting early diagnosis of intensive care unit-acquired weakness in septic patients using critical ultrasound and biological markers.
Early diagnosis of intensive care unit-acquired weakness (ICUAW) is crucial for improving the outcomes of critically ill patients. Hence, this study was designed to identify predisposing factors for ICUAW and establish a predictive model for the early diagnosis of ICUAW. ⋯ Conclusively, a nomogram model is constructed for diagnosing ICUAW in septic patients, which is simple and rapid and allows for visual representation, with excellent diagnostic capability.