scholarly journals Necrotizing soft-tissue infections in pediatric intensive care: a prospective multicenter case-series study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Stéphane Dauger ◽  
◽  
Renaud Blondé ◽  
Olivier Brissaud ◽  
Marie-Odile Marcoux ◽  
...  
Keyword(s):  
Intensive Care ◽  
Soft Tissue ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Soft Tissue Infections ◽  
Case Series Study ◽  
Necrotizing Soft Tissue Infections ◽  
Series Study

scholarly journals Necrotizing Soft Tissue Infections in Intensive Care

2021 ◽  
pp. 088506662110101
Author(s):  
Alexandru Ogica ◽  
Christoph Burdelski ◽  
Holger Rohde ◽  
Stefan Kluge ◽  
Geraldine de Heer
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
Soft Tissue ◽  
Sofa Score ◽  
Laboratory Data ◽  
Serum Lactate ◽  
Soft Tissue Infections ◽  
Necrotizing Soft Tissue Infections ◽  
The Mean ◽  
Organ Dysfunctions

Background: Necrotizing soft tissue infections (NSTIs) are typically characterized by extensive soft tissue destruction with systemic signs of toxicity, ranging from sepsis to septic shock. Our aim was to analyze the clinical characteristics, microbiological results, laboratory data, therapies, and outcome of patients with NSTIs admitted to an intensive care unit (ICU). Methods: A monocentric observational study of patients admitted to the ICU of a university hospital between January 2009 and December 2017. The demographic characteristics, comorbidities, clinical features, microbiology and laboratory results, organ dysfunctions, therapies, and outcome were retrospectively analyzed. Results: There were 59 patients and 70% males. The mean age (± SD) was 55 ± 18; type II (monomicrobial) NSTI was present in 36 patients (61%); the most common isolated pathogen was Streptococcus pyogenes in 28 patients (48%). Septic shock was diagnosed in 41 patients (70%). The most common organ dysfunctions were circulatory and renal in 42 (71%) and 38 patients (64%). The mean value (± SD) of serum lactate at admission to the ICU was 4.22 ± 5.42 mmol/l, the median SOFA score and SAPS II were 7 (IQR 4 - 10) and 46 (IQR 30.5 - 53). ICU mortality rate was 25%. Both SOFA score and serum lactate demonstrated a good prognostic value regarding ICU outcome (OR 1.29, 95%CI 1.07-1.57, P < 0.007 and OR 1.53, 95%CI 1.19-1.98, P < 0.001). A cut-off value for serum lactate of 6.55 mmol/L positively predicted mortality with 67% sensitivity and 97% specificity. Conclusion: NSTIs carry a high risk of septic shock and multiple organ dysfunction syndrome and thus are still associated with high mortality. In our study, the value of serum lactate at admission to the ICU correlated well with mortality. This easy-to-measure parameter could play a role in the decision-making process regarding prognosis and continuation of care.

COVID-19 situation in Baden-Württemberg, Germany: Preliminary case series study during the first wave

2021 ◽  
Vol 1 (1) ◽  
pp. 6-11
Author(s):  
Dzmitry Katovich ◽  
Claudia Grun ◽  
Hanna Katovich ◽  
Bastian Hauer ◽  
Thomas Iber ◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Symptoms ◽  
Fatal Outcome ◽  
Laboratory Data ◽  
Case Series ◽  
Severe Illness ◽  
Case Series Study ◽  
Regional Factors ◽  
Series Study

The present case series study presents the preliminary data of 347 of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) positively tested patients in the Mittelbaden hospital, Baden-Baden Bühl, Germany, during the period from March to June 2020. Among the 347 patients, 55% were males. The mean age-wise was 52.5±20.2 years in the overall cohort and 78.9±11.1 years in fatal outcome cases. A total of 120/347 patients (34.6%) required hospitalization, but only 36/347 (10.37%) cases required intensive care. The overall fatality rate was 6.6% (23/347), of which 12 patients were from the intensive care unit. The most frequent clinical symptoms observed were cough (62.5%), hyperthermia (47.8%), rhinorrhea (25.1%), sore throat (23.1%), dyspnea (22.8%), and headache (19.3%). Laboratory data analysis showed no specific findings, but severe laboratory disturbances could predict critical illness. A higher risk of severe illness or lethal outcome in elderly patients with several comorbidities was the most frequent. The fight against COVID-19 infection in Germany seems to be more successful during the first wave than in other countries. The improvement of the healthcare system against infectious outbreaks depends directly on the analysis of regional factors.

Imaging assessment and treatment of soft‐tissue venous malformations: Retrospective case series study of 126 cases

2020 ◽  
Vol 33 (6) ◽  
Author(s):  
Li‐Ming Sun ◽  
Meng‐Nan Xu ◽  
Yuan Xu ◽  
Min Wang ◽  
Si‐Ming Yuan
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
Venous Malformations ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Case Series Study ◽  
Assessment And Treatment ◽  
Series Study

Secondary bone/soft tissue sarcoma in childhood cancer survivors: a nationwide hospital-based case-series study in Japan

2018 ◽  
Vol 48 (9) ◽  
pp. 806-814 ◽  
Author(s):  
Yasushi Ishida ◽  
Miho Maeda ◽  
Souichi Adachi ◽  
Takeshi Rikiishi ◽  
Maho Sato ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Case Series ◽  
Childhood Cancer Survivors ◽  
Case Series Study ◽  
Series Study

Management of necrotizing soft tissue infections in the intensive care unit: results of an international survey

2015 ◽  
Vol 41 (8) ◽  
pp. 1506-1508 ◽  
Author(s):  
Nicolas de Prost ◽  
◽  
Emilie Sbidian ◽  
Olivier Chosidow ◽  
Christian Brun-Buisson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Soft Tissue ◽  
Soft Tissue Infections ◽  
International Survey ◽  
Necrotizing Soft Tissue Infections

Understanding necrotizing soft tissue infections in the intensive care unit

2020 ◽  
Vol 46 (9) ◽  
pp. 1739-1742 ◽  
Author(s):  
Tomas Urbina ◽  
Martin Bruun Madsen ◽  
Nicolas de Prost
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Soft Tissue ◽  
Soft Tissue Infections ◽  
Necrotizing Soft Tissue Infections

Intracranial Epidural Hematoma in Newborn Infants: Clinical Study of 15 Cases

Neurosurgery ◽  
2005 ◽  
Vol 57 (5) ◽  
pp. 924-929 ◽  
Author(s):  
Rachel Heyman ◽  
Anne Heckly ◽  
Joseph Magagi ◽  
Patrick Pladys ◽  
Abderrahmane Hamlat
Keyword(s):  
Medical Records ◽  
Epidural Hematoma ◽  
Newborn Infants ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Nulliparous Women ◽  
Case Series Study ◽  
History Of ◽  
Time Latency ◽  
Series Study

Abstract OBJECTIVE: Epidural hematoma (EDH) in newborn infants is rare. We have described the history of 15 newborns with EDH to provide a better understanding of this pathology. METHODS: This is a descriptive case series study using a retrospective review of the medical records of newborns who were admitted to the Pediatric Intensive Care Unit and Neurosurgery Department with the diagnosis of birth EDH over a 24-year period (1979–2002). RESULTS: There was no sex predominance, and most of the mothers were young, nulliparous women. The time latency from birth to the first signs varied from 0 to 24 hours. Clinical presentation was nonspecific: seizures and hypotonia were the main symptoms. The parietal area was the most frequent location. Surgical drainage was required in nine patients, and no deaths were reported. CONCLUSION: This report highlights the clinicoradiological characteristics of newborn EDH, which occurs more frequently in newborns that experienced difficult delivery from a nulliparous mother. Surgery is not a rule; some patients can be managed with conservative treatment. The outcome is generally good.

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