Delays in Administration of the Second Antibiotic Dose in Patients With Severe Sepsis and Septic Shock

2019 ◽  
pp. 001857871988902
Author(s):  
Jana L. Randolph ◽  
Kin Chan ◽  
Amanda Albright ◽  
Aleda Chen
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Large Scale ◽  
Retrospective Chart Review ◽  
Single Center ◽  
Single Center Study ◽  
Sepsis And Septic Shock ◽  
The Impact ◽  
Antibiotic Dose ◽  
Dose Delay

Purpose: The aim of this study was to determine the incidence of significant delays in administration of the second antibiotic dose in patients treated for severe sepsis and septic shock at a single community teaching hospital as well as to assess patient outcomes associated with second dose delays. Methods: This single-center, retrospective chart review evaluated patients who received at least 2 antibiotic doses for severe sepsis or septic shock. Patients were classified as having experienced a significant second dose delay if the actual interval between the first and the second antibiotic doses was greater than or equal to 125% of the recommended dosing interval. Results: Of 197 patients, 38 (19.3%) experienced a significant second antibiotic dose delay. The rate of significant delays was 17.1% in patients treated initially in the emergency department and 30.3% in patients treated initially in another inpatient location. Conclusions: This single-center study found a 19.3% rate of significant delays in antibiotic second dose administration in patients with severe sepsis and septic shock. This study was not powered to identify differences in outcomes in patients with and without significant second dose delays. Additional large-scale studies are needed to investigate the impact of antibiotic second dose delays on outcomes in patients with sepsis.

scholarly journals The impact of duration of organ dysfunction on the outcome of patients with severe sepsis and septic shock

Clinics ◽  
2008 ◽  
Vol 63 (4) ◽  
Author(s):  
Flávio G. R. Freitas ◽  
Reinaldo Salomão ◽  
Nathalia Tereran ◽  
Bruno Franco Mazza ◽  
Murillo Assunção ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Organ Dysfunction ◽  
Sepsis And Septic Shock ◽  
The Impact

scholarly journals Tricuspid Annular Plane of Systolic Excursion (TAPSE) for the Evaluation of Patients with Severe Sepsis and Septic Shock

2020 ◽  
Vol 21 (2) ◽  
pp. 348-352
Author(s):  
Shadi Lahham ◽  
Clifton Lee ◽  
Qumber Ali ◽  
John Moeller ◽  
Chanel Fischetti ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Length Of Stay ◽  
Large Scale ◽  
Admission Rate ◽  
Hospital Length Of Stay ◽  
Point Of Care Ultrasound ◽  
Septic Cardiomyopathy ◽  
Icu Admission ◽  
Sepsis And Septic Shock

Introduction: Sepsis is a systemic infection that can rapidly progress into multi organ failure and shock if left untreated. Previous studies have demonstrated the utility of point of care ultrasound (POCUS) in the evaluation of patients with sepsis. However, limited data exists on the evaluation of the tricuspid annular plane of systolic excursion (TAPSE) in patients with sepsis. Methods: We prospectively enrolled patients who presented to the emergency department (ED) with concern for severe sepsis or septic shock in a pilot study. In patients that screened positive, the treating physician then performed POCUS to measure the TAPSE value. We compared the intensive care unit (ICU) admission rate, hospital length of stay, and morbidity with their respective TAPSE values. Results: We enrolled 24 patients in the study. Eight patients had TAPSE values less than 16 millimeters (mm), two patients had TAPSE values between 16mm-20mm, and fourteen patients had TAPSE values greater than 20mm. There was no statistically significant association between TAPSE levels and ICU admission (p=0.16), or death (p=0.14). The difference of length of stay (LOS) was not statistically significant in case of hospital LOS (p= 0.72) or ICU LOS. Conclusion: Our pilot data did not demonstrate a correlation between severe sepsis or septic shock and TAPSE values. This may be due to several factors including patient comorbidities, strict definitions of sepsis and septic shock, as well as the absence of septic cardiomyopathy (SCM) in patients with sepsis and septic shock. Future large-scale studies are needed to determine if TAPSE can be beneficial in the ED evaluation of patients with concern for SCM.

The Impact of Protocol Based Management of Severe Sepsis and Septic Shock on Clinical Outcomes in a Community Hospital With Emphasis on the 3 Hour Bundle

CHEST Journal ◽  
2015 ◽  
Vol 148 (4) ◽  
pp. 349A
Author(s):  
Mohamed Osman ◽  
Souad Enakuaa ◽  
Jane Ramos ◽  
Kim Kresevic ◽  
Iris Rukshin ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Clinical Outcomes ◽  
Community Hospital ◽  
Sepsis And Septic Shock ◽  
The Impact

scholarly journals The Impact of Timing of Antibiotics on Outcomes in Severe Sepsis and Septic Shock

2015 ◽  
Vol 43 (9) ◽  
pp. 1907-1915 ◽  
Author(s):  
Sarah A. Sterling ◽  
W. Ryan Miller ◽  
Jason Pryor ◽  
Michael A. Puskarich ◽  
Alan E. Jones
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Sepsis And Septic Shock ◽  
The Impact

Impact of Serum Phosphate in Mechanically Ventilated Patients With Severe Sepsis and Septic Shock

2018 ◽  
Vol 35 (5) ◽  
pp. 485-493 ◽  
Author(s):  
Christopher J. Miller ◽  
Bruce A. Doepker ◽  
Andrew N. Springer ◽  
Matthew C. Exline ◽  
Gary Phillips ◽  
...  
Keyword(s):  
Septic Shock ◽  
Mechanical Ventilation ◽  
Severe Sepsis ◽  
Clinical Outcomes ◽  
Serum Phosphate ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Sepsis And Septic Shock ◽  
The Impact ◽  
Ventilated Patients

Background: Hypo- and hyperphosphatemia are common in severe sepsis and septic shock. Published outcome data in patients with phosphate derangements primarily focus on hypophosphatemia and the general critically ill population. This study aimed to determine the impact of serum phosphate on clinical outcomes in patients with severe sepsis and septic shock. Methods: A retrospective cohort analysis of adult mechanically ventilated patients with severe sepsis or septic shock was performed. Patients were randomly selected from an internal intensive care unit (ICU) database at an academic medical center in the United States and screened for inclusion and exclusion criteria. Time-weighted phosphate was calculated using all phosphate measurements obtained during ICU admission. The associations between time-weighted phosphate and duration of mechanical ventilation, 28-day mortality, and ICU and hospital length of stay were evaluated using linear or logistic regression as appropriate. Results: One-hundred ninety-seven patients were evaluated: 33 were categorized as hypophosphatemia, 123 as normophosphatemia, and 41 as hyperphosphatemia. Patients with time-weighted hyperphosphatemia had a higher Simplified Acute Physiology Score III score and incidence of septic shock. Significantly higher rates of 28-day mortality were observed among those with time-weighted phosphate levels above 3.5 mg/dL. However, both time-weighted hypo- and hyperphosphatemia were associated with decreased duration of mechanical ventilation. For every 0.5 mg/dL increase in time-weighted phosphate referent values from 4.0 to 6.0, the duration of mechanical ventilation decreased by 8% to 26%. For every 0.5 mg/dL decrease in time-weighted phosphate referent values from 3.0 to 1.0, significant decreases in duration of mechanical ventilation ranged from 14% to 41%. Conclusion: Time-weighted hyperphosphatemia may be associated with increased mortality in mechanically ventilated patients with severe sepsis or septic shock. However, time-weighted hypo- and hyperphosphatemia were associated with decreased duration of mechanical ventilation. Future studies should further describe the impact of hypo- and hyperphosphatemia on clinical outcomes among critically ill patients with severe sepsis or septic shock.

scholarly journals The impact of smoking on patient outcomes in severe sepsis and septic shock

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Fahad Alroumi ◽  
Ahmed Abdul Azim ◽  
Rachel Kergo ◽  
Yuxiu Lei ◽  
James Dargin
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Patient Outcomes ◽  
Sepsis And Septic Shock ◽  
The Impact

scholarly journals Immunosuppression, rather than inflammation, is a salient feature of sepsis in an Indian cohort

2019 ◽  
Author(s):  
Samanwoy Mukhopadhyay ◽  
Pravat K Thatoi ◽  
Bidyut K Das ◽  
Saroj K Mohapatra
Keyword(s):  
Gene Expression ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Large Scale ◽  
Salient Feature ◽  
Biological Processes ◽  
Blood Gene Expression ◽  
Large Scale Change ◽  
Sepsis And Septic Shock ◽  
First Time

1AbstractSepsis remains a lethal ailment with imprecise treatment and ill-understood biology. A clinical transcriptomic analysis of sepsis patients was performed for the first time in India and revealed large-scale change in blood gene expression in patients of severe sepsis and septic shock admitted to ICU. Three biological processes were quantified using scores derived from the corresponding transcriptional modules. Comparison of the module scores revealed that genes associated with immune response were more suppressed compared to the inflammation-associated genes. These findings will have great implication in the treatment and prognosis of severe sepsis/septic shock if it can be translated into a bedside tool.

Classification of sepsis, severe sepsis and septic shock: the impact of minor variations in data capture and definition of SIRS criteria

2012 ◽  
Vol 38 (5) ◽  
pp. 811-819 ◽  
Author(s):  
Peter M. C. Klein Klouwenberg ◽  
David S. Y. Ong ◽  
Marc J. M. Bonten ◽  
Olaf L. Cremer
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Data Capture ◽  
Definition Of ◽  
Sepsis And Septic Shock ◽  
The Impact ◽  
Sirs Criteria
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