scholarly journals Administration of ascorbic acid in the treatment of septic shock

2021 ◽  
Vol 7 (3) ◽  
pp. 142
Author(s):  
Angeliki Stamouli ◽  
Christina Marvaki ◽  
George Vasilopoulos ◽  
Theodoros Kapadochos
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Ascorbic Acid ◽  
Intensive Care ◽  
Old Patients ◽  
First Semester ◽  
Beneficial Effects ◽  
Vital Functions ◽  
Administration Method ◽  
Review Manager

Introduction: Septic shock is a common condition encountered in the intensive care unit. Sepsis is the leading cause of death with mortality ranging from 35-50%. Several factors are involved in the increasing incidence of sepsis including age, immunosuppression and antibiotic resistance. Gram+ or Gram- infections are considered leading causes of sepsis. Septic shock prognosis is significantly affected by early treatment. The hospitalization of the patient in the intensive care unit is particularly important as it is essential to support vital functions due to the complications of the shock.Aim: To investigate the action of ascorbic acid in the treatment of septic shock and the benefits of its administration.  Method-Material: Randomized trials were searched in CENTRAL, EMBASE and PubMed databases. The total number of studies included was 6. The Cochrane Risk of Bias Tool Review Manager Revman 5.3 was used to control the studies. Τhe criteria for the inclusion of patients were: age more specifically over 18 years old, patients accepted to intensive care unit with septic shock, patients with septic shock who received ascorbic acid randomized studies and cohort studies and articles in English with a time limit from 2008 to the first semester of 2020.Results:  The results of the studies showed that patients with septicemia and septic shock have shown beneficial effects of ascorbic acid alone or in combination with corticosteroids and thiamine in the prevention of progressive organ dysfunction and in the reduction in mortality and severity of severe sepsis. Also, there was a reduced inflammatory response observed in septic shock and attenuated levels of circulatory injury biomarker.Conclusions: Ascorbic acid has beneficial properties in septic shock and various studies have highlighted the importance of the combination of ascorbic acid and other vitamins and trace elements.

scholarly journals Mortality-associated factors in old patients with severe sepsis or septic shock in the medical intensive care unit

Critical Care ◽  
2007 ◽  
Vol 11 (Suppl 3) ◽  
pp. P29
Author(s):  
R Bak ◽  
CS Salomão ◽  
RL Machado ◽  
GMM Oliveira ◽  
EB Lameu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Associated Factors ◽  
Medical Intensive Care Unit ◽  
Old Patients ◽  
Medical Intensive Care

Septic Shock Outcome and Factors Associated with Mortality in the Intensive Care Unit in Vietnam

2021 ◽  
Vol 104 (8) ◽  
pp. 1249-1254
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Mortality Rate ◽  
Mortality Risk ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Old Patients ◽  
Shock Outcome

Objective: To evaluate the mortality rate of septic shock patients and to learn about the associated risk factors for death. Materials and Methods: Septic shock is a life-threatening subset of sepsis with profound circulatory, cellular, and metabolic abnormalities. The authors conducted an analytical cross-sectional study on adult patients diagnosed with septic shock using Sepsis-3 criteria between May 2016 and May 2018 at an intensive care unit at a hospital in Vietnam. Data on patients’ outcomes and associated factors were collected through questionnaires and the patient medical records. To measure the association between independent variables and outcomes, odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression. Results: One hundred fifty patients with septic shock were enrolled in the present study. Septic shock occurred in 71.3% of the 60-years-old patients and 54% were men. The mean age was 68.5±15.52 years. The mortality rate was 62% and 17.3% of patients died within 24 hours after being diagnosed with septic shock. The median length of ICU stay was four days. The initial mean SOFA and APACHE II scores were significantly higher in the death group. Septic shock patients with comorbidities had a higher mortality risk compared to those without comorbidity (OR 2.9, 95% CI 1.116 to 7.700). Patients who developed septic shock in the hospital were at greater death risk (OR 7.8, 95% CI 3.3 to 18.2). Septic shock due to pneumonia had a higher mortality risk in comparison with those due to the other causes (OR 5.2, 95% CI 2.4 to 11.0). Conclusion: The mortality rate of patients with septic shock in Vietnam was considerably high. Many factors were identified as risks, such as nosocomial infection and respiratory tract diseases. Keywords: Septic shock; Outcome; Risk factors; Vietnam

scholarly journals Mortality rates in pediatric septic shock

2017 ◽  
Vol 56 (5) ◽  
pp. 304 ◽  
Author(s):  
Desy Rusmawatiningtyas ◽  
Nurnaningsih Nurnaningsih
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Mortality Rate ◽  
Fluid Overload ◽  
Pediatric Intensive Care ◽  
Developed Countries ◽  
Mortality Rates ◽  
Study Cohort ◽  
Survival Group

Background Septic shock remains a major cause of morbidity and mortality in children admitted to the intensive care unit. Recent investigations from developed countries have reported mortality rates of 20-30%. Few studies have reported mortality rates from pediatric septic shock in intensive care settings in developing countries with limited resources.  Objective  To determine the current mortality rates for pediatric patients with septic shock in a developing country.Methods A retrospective study was conducted in the Pediatric Intensive Care Unit (PICU) at DR. Sardjito General Hospital. Medical records and charts were reviewed and recorded for diagnoses of septic shock, from November 1st, 2011 to June 30th, 2014. Results  A database of all PICU admissions was assembled, and cases with diagnoses of septic shock were reviewed. The final data consisted of 136 patients diagnosed with septic shock. Septic shock was defined as a clinical suspicion of sepsis, manifested by hyperthermia or hypothermia, and accompanied by hypoperfusion  The overall mortality rate for the study cohort was 88.2%.  The median age of patients was 16 months, with 52.2% males. Median initial PRISM III and PELOD scores were 10 and 22, respectively. The median length of PICU stay was 4 days. A total of 48.5% of the subjects were in need of crystalloid and colloid fluid at a median amount of 40 mL/kg. The median time required to complete the initial resuscitation was 60 minutes. Mechanical ventilator support in the first 24 hours was required in 79.4% of the cases. Fluid overload of > 10% (FO>10%) was found in 58.8% of the subjects.Conclusion The mortality rate in pediatric septic shock in our hospital is very high. There is a higher incidence of fluid overload in the non-survival group .

scholarly journals Relationship between the presence of dedicated doctors in rapid response systems and patient outcome: a multicenter retrospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hyung-Jun Kim ◽  
Kyeongman Jeon ◽  
Byung Ju Kang ◽  
Jong-Joon Ahn ◽  
Sang-Bum Hong ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Propensity Score ◽  
Intensive Care Unit Admission ◽  
Hazard Ratio ◽  
Rapid Response ◽  
Admission Rates ◽  
Rapid Response Systems ◽  
Response Systems

Abstract Background Rapid response systems (RRSs) improve patients’ safety, but the role of dedicated doctors within these systems remains controversial. We aimed to evaluate patient survival rates and differences in types of interventions performed depending on the presence of dedicated doctors in the RRS. Methods Patients managed by the RRSs of 9 centers in South Korea from January 1, 2016, through December 31, 2017, were included retrospectively. We used propensity score-matched analysis to balance patients according to the presence of dedicated doctors in the RRS. The primary outcome was in-hospital survival. The secondary outcomes were the incidence of interventions performed. A sensitivity analysis was performed with the subgroup of patients diagnosed with sepsis or septic shock. Results After propensity score matching, 2981 patients were included per group according to the presence of dedicated doctors in the RRS. The presence of the dedicated doctors was not associated with patients’ overall likelihood of survival (hazard ratio for death 1.05, 95% confidence interval [CI] 0.93‒1.20). Interventions, such as arterial line insertion (odds ratio [OR] 25.33, 95% CI 15.12‒42.44) and kidney replacement therapy (OR 10.77, 95% CI 6.10‒19.01), were more commonly performed for patients detected using RRS with dedicated doctors. The presence of dedicated doctors in the RRS was associated with better survival of patients with sepsis or septic shock (hazard ratio for death 0.62, 95% CI 0.39‒0.98) and lower intensive care unit admission rates (OR 0.53, 95% CI 0.37‒0.75). Conclusions The presence of dedicated doctors within the RRS was not associated with better survival in the overall population but with better survival and lower intensive care unit admission rates for patients with sepsis or septic shock.

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

scholarly journals Beginning to See the Light: Lessons Learned From the Development of the Circadian System for Optimizing Light Conditions in the Neonatal Intensive Care Unit

2021 ◽  
Vol 15 ◽  
Author(s):  
Esther M. Hazelhoff ◽  
Jeroen Dudink ◽  
Johanna H. Meijer ◽  
Laura Kervezee
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Clinical Outcomes ◽  
Neonatal Intensive Care ◽  
Circadian System ◽  
Lessons Learned ◽  
Preterm Neonates ◽  
Negative Effects ◽  
Beneficial Effects

The circadian timing system optimizes health by temporally coordinating behavior and physiology. During mammalian gestation, fetal circadian rhythms are synchronized by the daily fluctuations in maternal body temperature, hormones and nutrients. Circadian disruption during pregnancy is associated with negative effects on developmental outcomes in the offspring, highlighting the importance of regular and robust 24-h rhythms over gestation. In the case of preterm birth (before 37 weeks of gestation), maternal cues no longer synchronize the neonate’s circadian system, which may adversely affect the neonate. There is increasing evidence that introducing robust light-dark cycles in the Neonatal Intensive Care Unit has beneficial effects on clinical outcomes in preterm infants, such as weight gain and hospitalization time, compared to infants exposed to constant light or constant near-darkness. However, the biological basis for these effects and the relationship with the functional and anatomical development of the circadian system is not fully understood. In this review, we provide a concise overview of the effects of light-dark cycles on clinical outcomes of preterm neonates in the NICU and its alignment with the development of the circadian system.

Septic Shock: Phenomenology

1971 ◽  
Vol 2 (4) ◽  
pp. 327-332
Author(s):  
Roy G. Fitzgerald
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Endotoxin Shock ◽  
Life Threatening ◽  
The Moment

This is an autobiographical account of an episode of life-threatening endotoxin shock experienced in the intensive care unit of a university-affiliated V.A. hospital. It was written within a day of the event by a psychiatrist interested in sharing with other physicians and nurses his harrowing time as a patient. He has added some afterthoughts as his perspective has broadened. The account presents the moment-to-moment events as he perceived them as well as his thoughts, feelings and fantasies. The ambiguities of being a psychiatrist-patient with its passivity-control, intellectual defenses, denial and fears of death are prominent in his thoughts.

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