scholarly journals Compliance and barriers to implementing the sepsis resuscitation bundle for patients developing septic shock in the general medical wards

2012 ◽  
Vol 111 (2) ◽  
pp. 77-82 ◽  
Author(s):  
Yao-Wen Kuo ◽  
Hou-Tai Chang ◽  
Pei-Chen Wu ◽  
Yen-Fu Chen ◽  
Ching-Kai Lin ◽  
...  
Keyword(s):  
Septic Shock ◽  
Medical Wards ◽  
Resuscitation Bundle

Resuscitation Bundle Compliance in Severe Sepsis and Septic Shock

2011 ◽  
Vol 26 (5) ◽  
pp. 304-313 ◽  
Author(s):  
Victor Coba ◽  
Melissa Whitmill ◽  
Roberta Mooney ◽  
H. Mathilda Horst ◽  
Mary-Margaret Brandt ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Bundle Compliance ◽  
Sepsis And Septic Shock ◽  
Resuscitation Bundle

scholarly journals Effects of sepsis resuscitation bundle in cirrhotic patients with septic shock

Critical Care ◽  
2010 ◽  
Vol 14 (Suppl 1) ◽  
pp. P403
Author(s):  
L Rinaldi ◽  
E Ferrari ◽  
D Trevisan ◽  
L Donno ◽  
M Girardis
Keyword(s):  
Septic Shock ◽  
Cirrhotic Patients ◽  
Resuscitation Bundle

Outcome of delayed resuscitation bundle achievement in emergency department patients with septic shock

2014 ◽  
Vol 9 (6) ◽  
pp. 671-676 ◽  
Author(s):  
Chang Hwan Sohn ◽  
Seung Mok Ryoo ◽  
Dong Woo Seo ◽  
Jae Ho Lee ◽  
Bum Jin Oh ◽  
...  
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Emergency Department Patients ◽  
Resuscitation Bundle

Protocol-Based Resuscitation Bundle to Improve Outcomes in Septic Shock Patients

2016 ◽  
Vol 44 (12) ◽  
pp. 2123-2130 ◽  
Author(s):  
Michael P. Thompson ◽  
Mathew J. Reeves ◽  
Brittany L. Bogan ◽  
Bruno DiGiovine ◽  
Patricia J. Posa ◽  
...  
Keyword(s):  
Septic Shock ◽  
Resuscitation Bundle

scholarly journals Putative invasive pulmonary aspergillosis within medical wards and intensive care units: a 4-year retrospective, observational, single-centre study

2021 ◽  
Author(s):  
Silvia Corcione ◽  
Tommaso Lupia ◽  
Stefania Raviolo ◽  
Giorgia Montrucchio ◽  
Alice Trentalange ◽  
...  
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Hospital Admissions ◽  
Invasive Pulmonary Aspergillosis ◽  
Positive Culture ◽  
Lower Airway ◽  
Organ Support ◽  
Pulmonary Aspergillosis ◽  
Medical Wards

AbstractBlot and colleagues have proposed putative invasive pulmonary aspergillosis (PIPA) definitions for troublesome diagnosis in suspected patients outside the classical criteria of immunosuppression. We retrospectively included in the study all admitted patients with an Aspergillus spp. positive culture within lower airway samples. Overall, Aspergillus spp. positivity in respiratory samples was 0.97 every 1000 hospital admissions (HA): 4.94 and 0.28/1000/HA, respectively, in intensive care units (ICUs) and medical wards (MW). 66.6% fulfilled PIPA criteria, and 33.4% were defined as colonized. 69.2% of PIPA diagnosis occurred in the ICU. Antifungal therapy was appropriate in 88.5% of subjects with PIPA and 37.5% of colonized, confirming the comparison between deads and lives. Patients with PIPA in the ICUs had more frequent COPD, sepsis or septic shock, acute kidney injury (AKI), needed more surgery, mechanical ventilation (MV), vasopressors, hemodialysis, blood or platelets transfusions. PIPA in MW had associated with a history of smoking, interstitial lung disease and inhaled steroid therapy. Overall mortality within 21 days was 50%: 54.2% in ICU, 36,8% in MW. Factors associated with death were length of hospitalization, influenza, pneumonia, liver transplant, AKI, ARDS, sepsis and septic shock. PIPA in the ICU had higher disease severity and needed more organ support than MW cases, despite that cases of PIPA in MW are emerging with trends difficult to demonstrate given the problematic diagnosis.

scholarly journals Polymyxin B and low-dose hydrocortisone treatment in a patient with uroseptic shock in a rural health unit

2021 ◽  
Vol 2021 (11) ◽  
Author(s):  
Toshio Arai ◽  
Yuichiro Mori ◽  
Saori Yoshizaki ◽  
Ryo Ando ◽  
Shunsuke Natori ◽  
...  
Keyword(s):  
Septic Shock ◽  
Low Dose ◽  
Polymyxin B ◽  
Percutaneous Nephrostomy ◽  
Upper Urinary Tract ◽  
Source Control ◽  
Extended Spectrum Beta Lactamase ◽  
Ureter Obstruction ◽  
Old Japanese ◽  
Medical Wards

ABSTRACT Sepsis has a high mortality rate; thus, in the intensive care unit, early diagnosis and adjunctive treatments are crucial. However, generally, most patients with sepsis from rural area initially visit the emergency department at a rural hospital and are managed in general medical wards in Japan. Here we report on an 81-year-old Japanese female manifesting septic shock caused by the upper urinary tract infection of extended-spectrum beta-lactamase-producing Escherichia coli secondary to the left ureter obstruction by the urothelial carcinoma. Broad-spectrum antibiotics were administered. Although critical for the source control of infection, drainage of the ureteropelvic junction could not be performed immediately because of catecholamine-resistant hypotension. Hence, we administered polymyxin B-immobilized fiber column direct hemoperfusion, followed by low-dose hydrocortisone administration. After 8 hours of infusion, she recovered from the septic shock and successfully underwent emergency percutaneous nephrostomy. This presented strategy may provide a new resolution of catecholamine-resistant patients in urosepsis.

Body Composition Analysis in Septic Shock Patients Receiving Protocol-Driven Resuscitation Bundle Therapy: A Prospective Observational Study

2021 ◽  
Author(s):  
Bora Chae ◽  
Yo Sep Shin ◽  
Seok-In Hong ◽  
Sang Min Kim ◽  
Youn-Jung Kim ◽  
...  
Keyword(s):  
Septic Shock ◽  
Body Composition ◽  
Impedance Analysis ◽  
Composition Analysis ◽  
Body Composition Analysis ◽  
Total Body ◽  
Poor Outcomes ◽  
The Relationship ◽  
Mean Time ◽  
Resuscitation Bundle

Abstract Background: Bio-electrical impedance analysis (BIA) is a rapid, simple, and noninvasive tool for assessing volume status in various diseases. Body composition analysis using BIA may identify factors associated with poor outcomes in critically ill patients. Little is known, however, about the relationship between the results of body composition analysis in the emergency department (ED) and mortality in septic shock patients.Objectives: This study assessed the association between parameters identified by body composition analysis and mortality in patients with septic shock who underwent protocol-driven resuscitation bundle therapy in the ED.Methods: Data were prospectively collected on adult patients with septic shock who underwent protocol-driven resuscitation bundle therapy between December 2019 and December 2020. Body composition was determined in the ED using BIA with the patient in the supine position. Septic shock was defined by sepsis-3 criteria, and the primary outcome was 30-day mortality. Results: The study included 218 patients, of whom 58 (26.6%) died within 30 days. The mean time from ED admission to the measurement of body composition was 5.4 hours. The average ratio of extracellular water (ECW) to total body water (TBW) was significantly higher in non-survivors than in survivors (0.412 vs. 0.400, p=0.001). The optimal ECW/TBW cutoff for predicting 30-day mortality was 0.40, with mortality rates being significantly higher in patients with ECW/TBW >0.4 than in patients with ECW/TBW≦0.4 (37.8% vs. 17.5%, p=0.001). Multivariate analysis showed that ECW/TBW >0.4 (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.05–4.23, p = 0.036), active cancer (OR, 2.39; 95% CI, 1.06–5.38, p=0.036), prothrombin time (OR, 2.77; 95% CI, 1.29–5.93, p=0.009), and initial lactate level (OR, 1.15; 95% CI, 1.03–1.28, p=0.010) were significantly associated with 30-day mortality.Conclusions: The ECW/TBW>0.40 is the only body composition parameter associated with 30-day mortality in patients with septic shock.

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