Septic Shock in the Elderly

1990 ◽  
pp. 621-633
Author(s):  
A. Shibusawa ◽  
H. Ogata
Keyword(s):  
Septic Shock ◽  
The Elderly

scholarly journals Clinical conundrums in management of sepsis in the elderly

2015 ◽  
Vol 3 (3) ◽  
pp. 106-112 ◽  
Author(s):  
Vishal Sehgal ◽  
Sukhminder Jit Singh Bajwa ◽  
John A. Consalvo ◽  
Anurag Bajaj
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Septic Shock ◽  
Kidney Injury ◽  
The Elderly ◽  
Nutritional Deficiencies ◽  
Surviving Sepsis Campaign ◽  
Clostridium Difficile Colitis ◽  
Sepsis And Septic Shock

Abstract In 2012, surviving sepsis campaign came out with updated international guidelines for management of severe sepsis and septic shock. Paradoxically, there are no specific guidelines for management of sepsis in the elderly, although the elderly are more predisposed to sepsis, and morbidity and mortality related to sepsis. Sepsis in the elderly is, more often than not, complicated by clinical conundrums such as congestive heart failure (CHF), atrial fibrillation (AF), chronic kidney disease (CKD), acute kidney injury (AKI), delirium, dementia, ambulatory dysfunction, polypharmacy, malglycemia, nutritional deficiencies, and antibiotic resistance. Also, with recurrent admissions to the hospital and widespread use of antibiotics, the elderly are more susceptible to Clostridium difficile colitis.

scholarly journals Phosphate Enema Causing Life-Threatening Rectal Perforation

2020 ◽  
pp. 167
Author(s):  
Keyword(s):  
Septic Shock ◽  
Early Recognition ◽  
The Elderly ◽  
Elderly Male ◽  
Rectal Perforation ◽  
Good Outcome ◽  
Rectal Washout ◽  
Life Threatening ◽  
Phosphate Enema

We report a near fatal rectal perforation due to a phosphate enema in an elderly male. The presentation in septic shock within 4 hours of the enema is quite rare. Early recognition and prompt management are essential for a good outcome. A defunctioning colostomy is standard for these cases but we recommend a distal rectal washout since intraluminal faeces in a loaded rectum could be a cause of ongoing sepsis. Although enemas are commonly used for constipation in the elderly, suppositories and oral preparations should be used preferentially where appropriate.

OUTCOME OF SEPTIC SHOCK IN THE ELDERLY FOLLOWING THE IMPLEMENTATION OF THE SEPSIS BUNDLE: A PROPENSITY-ADJUSTED ANALYSIS

CHEST Journal ◽  
2007 ◽  
Vol 132 (4) ◽  
pp. 494A ◽  
Author(s):  
Morohunfolu E. Akinnusi ◽  
Leith Alsawalha ◽  
Lilibeth A. Pineda ◽  
Ali A. El Solh
Keyword(s):  
Septic Shock ◽  
The Elderly ◽  
Adjusted Analysis ◽  
Sepsis Bundle

scholarly journals Concomitant primary peritonitis, septic shock and empyema thoracis in a young girl: a rare case report

2019 ◽  
Vol 6 (11) ◽  
pp. 4156
Author(s):  
Scott Arockia Singh ◽  
D. Devaprasath Jeyasekharan ◽  
S. Sabu Jeyasekharan ◽  
P. Bala Vidhyasagar ◽  
C. Nithila ◽  
...  
Keyword(s):  
Septic Shock ◽  
The Elderly ◽  
Free Fluid ◽  
Emergency Laparotomy ◽  
Empyema Thoracis ◽  
Hollow Viscus ◽  
Source Of Infection ◽  
Primary Peritonitis ◽  
High Dependency ◽  
Rare Case Report

Primary peritonitis is a condition in which there is no intraabdominal source of infection demonstrated during laparotomy. It is uncommon and can affect any age group from childhood to the elderly. We report here a case of Primary peritonitis with septic shock as a presenting feature, associated with empyema thoracis. This combination was not reported previously in the literature. Our patient was a 15-yr old girl with a ten day history of fever, cough, dyspnea, abdominal pain and loose stools initially treated elsewhere. She was brought to the emergency in a gasping state, bradycardia, hypotension, tachypnoea and a distended abdomen. She was intubated, resuscitated and a bedside ultrasound revealed free fluid present all over peritoneal cavity. Emergency laparotomy under general anesthesia showed extensive thick yellow coloured nonfoul-smelling purulent fluid all over the peritoneal spaces with distended bowel loops. A thorough search confirmed no evidence of hollow-viscus perforation, peritoneal lavage, appendicectomy and laparostomy were done. Postoperatively she was ventilated electively and managed in a high dependency care unit with broad spectrum antibiotics and respiratory supportive measures. However she continued to have high fever, tachycardia, tachypneic and developed left massive pyothorax. Thoracoscopic drainage of the flakes of pus in the pleural cavity with extensive decortication done. Then, once her sepsis was well controlled, underwent laparostomy closure. However, post laparostomy-closure had signs of LV dysfunction with respiratory failure and managed with cardiac drugs. She had a turbulent postoperative course, gradually recovered, and was discharged home after nine weeks of admission.

Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

1990 ◽  
Vol 48 (3) ◽  
pp. 966-967
Author(s):  
J. Jacob ◽  
M.F.M. Ismail
Keyword(s):  
The Elderly ◽  
Ultrastructural Changes ◽  
Pokeweed Mitogen ◽  
Asymmetric Structure ◽  
Luminal Surface ◽  
Bladder Epithelium ◽  
Aldehyde Groups ◽  
Cell Surface Changes ◽  
Phosphate Buffered Saline ◽  
Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

The effect of dental geriatric curricula on attitudes toward the elderly

1988 ◽  
Vol 52 (9) ◽  
pp. 516-518 ◽  
Author(s):  
J Mann ◽  
TJ Bomberg ◽  
JM Holtzman ◽  
DB Berkey
Keyword(s):  
The Elderly

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

2015 ◽  
Vol 25 (2) ◽  
pp. 61-69
Author(s):  
Angel L. Ball ◽  
Adina S. Gray
Keyword(s):  
Depressive Symptoms ◽  
The Elderly ◽  
Environmental Communication ◽  
Pharmacological Intervention ◽  
Team Approach ◽  
Discussion Paper ◽  
Term Care ◽  
Anticholinergic Medications ◽  
Inappropriate Treatment ◽  
Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

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