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Latest & greatest articles for sepsis
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on sepsis or other clinical topics then use Trip today.
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Assessing Fluid Resuscitation in Adults with Sepsis Who Are Not Mechanically Ventilated: a Systematic Review of Diagnostic Test Accuracy Studies Fluid resuscitation is a widely used intervention that is mandated in the management of sepsis. While its use can be life-saving, its overuse is associated with harm. Despite this, the best means of assessing a need for fluid resuscitation in an acute medical setting is unclear.To assess studies of diagnostic tests that identify the need for fluid (...) resuscitation in adults with sepsis, as defined by the presence of fluid responsiveness.Protocol registration was performed in advance (PROSPERO:CRD42017048651). Research database searches were performed alongside additional searches to identify grey literature. Diagnostic test accuracy studies that assessed any fluid assessment tool were identified independently by two authors, before data extraction and quality assessments were performed.Adults with sepsis, without intensive care organ support, who would
Does the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) Improve Survival in Septic Adults? Does the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) Improve Survival in Septic Adults? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 4, Pages 363–365 Does the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) Improve Survival in Septic Adults? x (...) all Collapse all Article Outline Take-Home Message No high- or moderate-level evidence shows that the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) hemodynamic interventions improve survival in sepsis. Methods Data Sources The authors searched PubMed, EMBASE, Scopus, Web of Science, and without language restrictions from inception to November 28, 2017. They also searched the references of analyzed studies and other review articles. Study Selection Investigators included randomized
Effect of a Recombinant Human Soluble Thrombomodulin on Mortality in Patients With Sepsis-Associated Coagulopathy: The SCARLET Randomized Clinical Trial. Previous research suggested that soluble human recombinant thrombomodulin may reduce mortality among patients with sepsis-associated coagulopathy.To determine the effect of human recombinant thrombomodulin vs placebo on 28-day all-cause mortality among patients with sepsis-associated coagulopathy.The SCARLET trial was a randomized, double (...) -blind, placebo-controlled, multinational, multicenter phase 3 study conducted in intensive care units at 159 sites in 26 countries. All adult patients admitted to one of the participating intensive care units between October 2012 and March 2018 with sepsis-associated coagulopathy and concomitant cardiovascular and/or respiratory failure, defined as an international normalized ratio greater than 1.40 without other known etiology and a platelet count in the range of 30 to 150 × 109/L or a greater than
Derivation, Validation, and Potential Treatment Implications of Novel Clinical Phenotypes for Sepsis. Sepsis is a heterogeneous syndrome. Identification of distinct clinical phenotypes may allow more precise therapy and improve care.To derive sepsis phenotypes from clinical data, determine their reproducibility and correlation with host-response biomarkers and clinical outcomes, and assess the potential causal relationship with results from randomized clinical trials (RCTs).Retrospective (...) analysis of data sets using statistical, machine learning, and simulation tools. Phenotypes were derived among 20 189 total patients (16 552 unique patients) who met Sepsis-3 criteria within 6 hours of hospital presentation at 12 Pennsylvania hospitals (2010-2012) using consensus k means clustering applied to 29 variables. Reproducibility and correlation with biological parameters and clinical outcomes were assessed in a second database (2013-2014; n = 43 086 total patients and n = 31 160 unique
Enteral lactoferrin for the treatment of sepsis and necrotizing enterocolitis in neonates. Neonatal sepsis and necrotizing enterocolitis (NEC) cause significant neonatal mortality and morbidity despite appropriate antibiotic therapy. Enhancing host defense and modulating inflammation by using lactoferrin as an adjunct to antibiotics in the treatment of sepsis, NEC, or both, may improve clinical outcomes.The primary objective was to assess safety and efficacy of oral lactoferrin as an adjunct (...) to antibiotics in the treatment of neonates with suspected or confirmed sepsis, NEC, or both.We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 9), MEDLINE via PubMed, PREMEDLINE, (1966 to 20 September 2018) Embase (1980 to 20 September 2018), and CINAHL (1982 to 20 September 2018). We also searched clinical trial databases, conference proceedings, the reference lists of retried articles and clinical trials
Plasma interleukin-6 concentration for the diagnosis of sepsis in critically ill adults. The definition of sepsis has evolved over time, along with the clinical and scientific knowledge behind it. For years, sepsis was defined as a systemic inflammatory response syndrome (SIRS) in the presence of a documented or suspected infection. At present, sepsis is defined as a life-threatening organ dysfunction resulting from a dysregulated host response to infection. Even though sepsis is one (...) of the leading causes of mortality in critically ill patients, and the World Health Organization (WHO) recognizes it as a healthcare priority, it still lacks an accurate diagnostic test. Determining the accuracy of interleukin-6 (IL-6) concentrations in plasma, which is proposed as a new biomarker for the diagnosis of sepsis, might be helpful to provide adequate and timely management of critically ill patients, and thus reduce the morbidity and mortality associated with this condition.To determine
Association of Corticosteroid Treatment With Outcomes in Adult Patients With Sepsis: A Systematic Review and Meta-analysis Although corticosteroids are widely used for adults with sepsis, both the overall benefit and potential risks remain unclear.To conduct a systematic review and meta-analysis of the efficacy and safety of corticosteroids in patients with sepsis.MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until March 20, 2018 (...) , and updated on August 10, 2018. The terms corticosteroids, sepsis, septic shock, hydrocortisone, controlled trials, and randomized controlled trial were searched alone or in combination. Randomized clinical trials (RCTs) were included that compared administration of corticosteroids with placebo or standard supportive care in adults with sepsis.Meta-analyses were conducted using a random-effects model to calculate risk ratios (RRs) and mean differences (MDs) with corresponding 95% CIs. Two independent
Blood test could shorten antibiotic treatment in newborns with suspected sepsis Blood test could shorten antibiotic treatment in newborns with suspected sepsis Discover Portal Discover Portal Blood test could shorten antibiotic treatment in newborns with suspected sepsis Published on 28 November 2017 doi: Measuring procalcitonin levels in newborns with suspected sepsis in the first days of life reduced antibiotic duration by 10 hours compared with standard care. There was no increase (...) in the risk of re-infection or death. Systemic infection can be rapidly life-threatening in newborn babies, so those with risk factors are often treated pre-emptively with intravenous antibiotics. If sepsis is not confirmed by blood culture the decision whether to discontinue antibiotics needs to be made, but results of the blood culture takes time. Procalcitonin is released into the blood in response to inflammation, and low levels may give an earlier indication that there is no serious infection
Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Discover Portal Discover Portal Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Published on 31 January 2018 doi: The risk of death in adults with sepsis was 30% lower when each dose of antibiotic was given intravenously over three hours compared to a bolus or less (...) than 60 minutes. This systematic review included adults on intensive care units with a range of ages, severity of sepsis and other symptoms. A variety of antibiotics of the anti-pseudomonal beta-lactam class were used in the trials. These included carbapenems, penicillins and cephalosporins. In the UK, current guidance for intravenous use of these drugs is to give them over a period of up to 30 minutes. This review provides high-quality evidence that suggests that all patients should be given
A focus on treating fever does not improve survival in sepsis A focus on treating fever does not improve survival in sepsis Discover Portal Discover Portal A focus on treating fever does not improve survival in sepsis Published on 27 June 2017 doi: Specifically treating fever in adults with sepsis did not reduce the number of people dying within 28 days. It also had no effect on the frequency of hospital-acquired infections, reversing septic shock, lowering heart rate or improving breathing (...) . Sepsis is a rare complication of an infection. Among the 123,000 people a year in England who develop sepsis around 30% will die from it, so improving our understanding of how to treat sepsis is clearly important. Early treatment of sepsis is important for a number of reasons, but the findings of this review imply that it is not necessary to specifically treat fever. We don’t know whether there might be benefits for people with very high temperatures. Share your views on the research. Why
Giving immediate antibiotics reduces deaths from sepsis Giving immediate antibiotics reduces deaths from sepsis Discover Portal Discover Portal Giving immediate antibiotics reduces deaths from sepsis Published on 18 April 2017 doi: Giving immediate antibiotics (defined as within one hour) when people present to emergency departments with suspected sepsis reduces their risk of dying by a third compared with later administration. This meta-analysis of observational data from 23,596 people (...) in emergency department settings confirmed that giving antibiotics within one hour was linked to a lower risk of in-hospital mortality compared with giving antibiotics later. This adds weight to recommendations from NICE and other organisations that antibiotics should be administered straight away in people with suspected sepsis. However, in practice up to a third of people in the UK do not receive antibiotics within the hour. NHS England and the UK Sepsis Trust have recently launched a campaign
Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Discover Portal Discover Portal Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Published on 17 April 2018 doi: Adding the antibiotic rifampicin did not improve cure rates or reduce deaths for people with bacterial blood infections caused by Staphylococcus aureus . It increased the risk of adverse reactions (...) of the most common causes of sepsis world-wide. Lack of evidence about the best treatment regime has led to wide variations in practice. Mortality rates in the UK range from 10% to 30%. The usual treatment is with a penicillin or glycopeptide but varies by the subgroup of S. aureus and whether the strain is methicillin-resistant. Case series show around 30% of people treated for S. aureus bacteraemia in the UK also received rifampicin, despite a lack of evidence for its use. The drug can cause liver
Ethanol locks in catheters for dialysis may prevent sepsis Ethanol locks in catheters for dialysis may prevent sepsis Discover Portal Discover Portal Ethanol locks in catheters for dialysis may prevent sepsis Published on 25 September 2018 doi: In patients with tunnelled central venous catheters used for dialysis, ethanol locks may reduce catheter-related bloodstream infections when compared with other locks, mainly saline. There was no increase in the risk of catheter blockage with ethanol
Sepsis associated acute kidney injury. Sepsis is defined as organ dysfunction resulting from the host's deleterious response to infection. One of the most common organs affected is the kidneys, resulting in sepsis associated acute kidney injury (SA-AKI) that contributes to the morbidity and mortality of sepsis. A growing body of knowledge has illuminated the clinical risk factors, pathobiology, response to treatment, and elements of renal recovery that have advanced our ability to prevent (...) , detect, and treat SA-AKI. Despite these advances, SA-AKI remains an important concern and clinical burden, and further study is needed to reduce the acute and chronic consequences. This review summarizes the relevant evidence, with a focus on the risk factors, early recognition and diagnosis, treatment, and long term consequences of SA-AKI. In addition to literature pertaining to SA-AKI specifically, pertinent sepsis and acute kidney injury literature relevant to SA-AKI was included.Published
Bacterial pathogens and resistance causing community acquired paediatric sepsis in low- and middle-income countries: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content
The value of venous-to-arterial carbon dioxide difference to arteriovenous oxygen content difference ratio in prognosis of severe sepsis and septic shock: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears
Sepsis biomarkers for prognosis of critically ill adult patients: a suite of prognostic factors systematic reviews Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated
Accuracy of intercellular adhesion molecule-1 for diagnosing sepsis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g
The association between proteomic and metabolomic profiles and outcomes in patients with sepsis and septic shock: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record