scholarly journals Basic and Advanced Echocardiographic Evaluation of Myocardial Dysfunction in Sepsis and Septic Shock

2018 ◽  
Vol 46 (1) ◽  
pp. 13-24 ◽  
Author(s):  
S. Vallabhajosyula ◽  
S. Pruthi ◽  
S. Shah ◽  
B. M. Wiley ◽  
S. V. Mankad ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Myocardial Dysfunction ◽  
Long Term Outcomes ◽  
Mortality And Morbidity ◽  
Echocardiographic Evaluation ◽  
Short And Long Term ◽  
Sepsis And Septic Shock

Sepsis continues to be a leading cause of mortality and morbidity in the intensive care unit. Cardiovascular dysfunction in sepsis is associated with worse short- and long-term outcomes. Sepsis-related myocardial dysfunction is noted in 20%–65% of these patients and manifests as isolated or combined left or right ventricular systolic or diastolic dysfunction Echocardiography is the most commonly used modality for the diagnosis of sepsis-related myocardial dysfunction. With the increasing use of ultrasonography in the intensive care unit, there is a renewed interest in sepsis-related myocardial dysfunction. This review summarises the current scope of literature focused on sepsis-related myocardial dysfunction and highlights the use of basic and advanced echocardiographic techniques for the diagnosis of sepsis-related myocardial dysfunction and the management of sepsis and septic shock.

scholarly journals Update of Sepsis in the Intensive Care Unit

2017 ◽  
Vol 9 (5) ◽  
pp. 441-455 ◽  
Author(s):  
Kelly Roveran Genga ◽  
James A. Russell
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Early Recognition ◽  
Hospital Readmissions ◽  
Kidney Injury ◽  
Predictive Biomarkers ◽  
Immune Dysfunction ◽  
Long Term Outcomes

Sepsis, the most common cause of admission to an intensive care unit (ICU), has had an increased incidence and prevalence over the last years with a simultaneous decrease in its short-term mortality. Sepsis survivors are more frequently discharged from hospital and often experience long-term outcomes such as late mortality, immune dysfunction, secondary infections, impaired quality of life, and unplanned readmissions. Early recognition and management of sepsis have challenged emergency care and critical care physicians and nurses. New sepsis definitions were produced and the Surviving Sepsis Campaign (SSC) 2016 was updated recently. Although hospital readmissions after sepsis are common, associated risk factors and how to manage patients who survive an episode of sepsis still need clarification. The immune dysfunction caused by sepsis/septic shock is complex, persistent, affects inflammatory and anti-inflammatory systems, and might be associated with long-term outcomes of sepsis. Several randomized controlled trials (RCT) that analyzed new (and old) interventions in sepsis/septic shock are discussed in this review in parallel with the SSC 2016 recommendations and other guidelines when relevant. RCTs addressing incidence, treatment, and prevention of important sepsis-associated organ dysfunction such as the acute respiratory distress syndrome, acute kidney injury, and brain dysfunction are highlighted. Finally, we briefly discuss the need for novel targets, predictive biomarkers, and new designs of RCTs in sepsis.

Short and long-term outcomes of Streptococcus pyogenes pneumonia managed in the intensive care unit

2017 ◽  
Vol 49 (10) ◽  
pp. 775-777 ◽  
Author(s):  
Marie Lecronier ◽  
Alexandre Elabbadi ◽  
Armand Mekontso Dessap ◽  
Nicolas de Prost
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Streptococcus Pyogenes ◽  
Long Term Outcomes ◽  
Short And Long Term

scholarly journals Short- and long-term outcomes in onco-hematological patients admitted to the intensive care unit with classic factors of poor prognosis

Oncotarget ◽  
2016 ◽  
Vol 7 (16) ◽  
pp. 22427-22438 ◽  
Author(s):  
Etienne Faucher ◽  
Martin Cour ◽  
Vincent Jahandiez ◽  
Adeline Grateau ◽  
Thomas Baudry ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Poor Prognosis ◽  
Long Term Outcomes ◽  
Hematological Patients ◽  
Short And Long Term

The Impact of Implementing a “Pain, Agitation, and Delirium Bundle” in a Pediatric Intensive Care Unit: Improved Delirium Diagnosis

2021 ◽  
Author(s):  
Lise D. Cloedt ◽  
Kenza Benbouzid ◽  
Annie Lavoie ◽  
Marie-Élaine Metras ◽  
Marie-Christine Lavoie ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Post Intervention ◽  
Number Of Patients ◽  
Implementation Period ◽  
Short And Long Term ◽  
The Impact

AbstractDelirium is associated with significant negative outcomes, yet it remains underdiagnosed in children. We describe the impact of implementing a pain, agitation, and delirium (PAD) bundle on the rate of delirium detection in a pediatric intensive care unit (PICU). This represents a single-center, pre-/post-intervention retrospective and prospective cohort study. The study was conducted at a PICU in a quaternary university-affiliated pediatric hospital. All patients consecutively admitted to the PICU in October and November 2017 and 2018. Purpose of the study was describe the impact of the implementation of a PAD bundle. The rate of delirium detection and the utilization of sedative and analgesics in the pre- and post-implementation phases were measured. A total of 176 and 138 patients were admitted during the pre- and post-implementation phases, respectively. Of them, 7 (4%) and 44 (31.9%) were diagnosed with delirium (p < 0.001). Delirium was diagnosed in the first 48 hours of PICU admission and lasted for a median of 2 days (interquartile range [IQR]: 2–4). Delirium diagnosis was higher in patients receiving invasive ventilation (p < 0.001). Compliance with the PAD bundle scoring was 79% for the delirium scale. Score results were discussed during medical rounds for 68% of the patients in the post-implementation period. The number of patients who received opioids and benzodiazepines and the cumulative doses were not statistically different between the two cohorts. More patients received dexmedetomidine and the cumulative daily dose was higher in the post-implementation period (p < 0.001). The implementation of a PAD bundle in a PICU was associated with an increased recognition of delirium diagnosis. Further studies are needed to evaluate the impact of this increased diagnostic rate on short- and long-term outcomes.

scholarly journals Use of Gentamicin for Sepsis and Septic Shock in Anaesthesia-Intensive Care Unit: A Clinical Practice Evaluation

2020 ◽  
Vol 48 (5) ◽  
pp. 399-405
Author(s):  
Cyril Pernod ◽  
◽  
Antoine Lamblin ◽  
Andrei Cividjian ◽  
Patrick Gerome ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Clinical Practice ◽  
Sepsis And Septic Shock
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