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.

scholarly journals Gambaran Sumber Terjadinya Infeksi pada Penderita Sepsis dan Syok Septik di ICU RSUP Prof. Dr. R. D. Kandou Manado Periode Agustus 2016 sampai dengan September 2017

e-CliniC ◽  
2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Juniarty J.P. Nainggolan ◽  
Lucky T. Kumaat ◽  
Mordekhai L. Laihad
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Decubitus Ulcer ◽  
Study Data ◽  
Common Source ◽  
Purposive Sampling ◽  
Life Threatening ◽  
Sources Of Infection ◽  
Sepsis And Septic Shock

Abstract: Sepsis is defined as life-threatening organ dysfunction caused by dysregulation of host response to infection meanwhile septic shock is defined as a subset of sepsis with severe circulatory and cellular metabolism abnormalities. The incidence of sepsis has been increasing for the past three decades, and becomes the most frequent cause of death among other common diseases in the Western countries such as myocardial infarction, stroke, and trauma. This study was aimed to find out the description of infection in sepsis and septic shock patients in Intensive Care Unit (ICU) of Prof. Dr. R. D. Kandou Hospital Manado. This was a rectrospective descriptrive study. Data were obtained from the medical record of sepsis patients in the period of August 2016 until September 2017. Samples were determined by using purposive sampling method. The results showed that the source of sepsis infection and septic shock was mostly caused by pneumonia as many as 50 samples, as follows: 21 patiens (31.3%) with HAP, 11 patients with CAP (16.4%), and 18 patients with VAP (26.9%). Other sources were 8 patients (11,9%) with urosepsis, 3 patients (4.5%) with cholangitis, 2 patients (3.0%) with abscess, 1 patient (1.5%) with diabetic foot, 1 patient (1.5%) with osteomyelitis , 1 patient with decubitus ulcer, and 1 patient (1.5%) with intraabdominal infection. Conclusion: The most common source of sepsis infection and septic shock was pneumonia infection; HAP was the leading one.Keywords: sources of infection, sepsis, shock septic Abstrak: Sepsis adalah ancaman kehidupan akibat disfungsi organ yang disebabkan oleh disregulasi respon terhadap infeksi. Syok septik adalah bagian dari sepsis dengan kelainan sirkulasi, seluler, atau metabolik yang cukup parah. Kejadian sepsis terus meningkat selama tiga dekade terakhir, dan menjadi penyebab kematian tertinggi dibandingkan penyakit-penyakit umum lainnya di negara Barat seperti miokard infark, stroke, dan trauma. Penelitian ini bertujuan untuk mengetahui gambaran sumber terjadinya infeksi pada penderita sepsis dan syok septik di Intensive Care Unit (ICU) RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif retrospektif menggunakan data rekam medik pasien sepsis di RSUP Prof. Dr. R. D. Kandou Manado periode Agustus 2016 - September 2017. Besar sampel ditentukan dengan metode purposive sampling. Dari hasil penelitian didapatkan bahwa sumber terjadinya infeksi sepsis dan syok septik paling banyak disebabkan pneumonia (50 orang) yaitu HAP 21 pasien (31,3%), CAP 11 pasien (16,4%), VAP 18 pasien (26,9%). Sumber lainnya ialah urosepsis 8 pasien (11,9%), kolangitis 3 pasien (4,5%), abses 2 pasien (3,0%) , kaki diabetes 1 pasien (1,5%), osteomielitis 1 pasien (1,5%), ulkus dekubitus 1pasien (1,5%), dan infeksi intraabdomen 1 pasien (1,5%). Simpulan: Sumber terjadinya infeksi sepsis dan syok septik terutama disebabkan pneumonia, yang terbanyak ialah HAP.Kata kunci: sumber infeksi, sepsis, syok septik

scholarly journals Tick-Borne-Associated Illnesses in the Pediatric Intensive Care Unit

2020 ◽  
Vol 15 (06) ◽  
pp. 269-275
Author(s):  
Kaila Lessner ◽  
Conrad Krawiec
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Early Recognition ◽  
Spotted Fever ◽  
Pediatric Intensive Care ◽  
Rocky Mountain ◽  
Rocky Mountain Spotted Fever ◽  
Life Threatening ◽  
Human Ehrlichiosis

AbstractWhen unrecognized and antibiotic delay occurs, Lyme disease, Rocky Mountain–spotted fever, babesiosis, and human ehrlichiosis and anaplasmosis can result in multiorgan system dysfunction and potentially death. This review focuses on the early recognition, evaluation, and stabilization of the rare life-threatening sequelae seen in tick-borne illnesses that require admission in the pediatric intensive care unit.

scholarly journals Collective aeromedical evacuations of SARS-CoV-2-related ARDS patients in a military tactical plane: a retrospective descriptive study

2021 ◽  
pp. bmjmilitary-2021-001876
Author(s):  
Thibault Martinez ◽  
K Simon ◽  
L Lely ◽  
C Nguyen Dac ◽  
M Lefevre ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Respiratory Distress Syndrome ◽  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Selection Criteria ◽  
Distress Syndrome ◽  
Descriptive Study ◽  
Military Aircraft ◽  
Life Threatening ◽  
The Military

After the appearance of the COVID-19 pandemic in France, MEROPE system was created to transform the military tactical ATLAS A400M aircraft into a flying intensive care unit. Collective aeromedical evacuations (aero-MEDEVAC) of patients suffering from SARS-CoV-2-related acute respiratory distress syndrome was performed from June to December 2020. A total of 22 patients were transported during seven missions. All aero-MEDEVAC was performed in safe conditions for patients and crew. No life-threatening conditions occurred during flight. Biohazard controls were applied according to French guidelines and prevented crew contamination. Thanks to rigorous selection criteria and continuous in-flight medical care, the safe transportation of these patients was possible. To the best of our knowledge, this is the first description of collective aero-MEDEVAC of these kinds of patients using a tactical military aircraft. We here describe the patient’s characteristics and the flight’s challenges.

Acquired hemophilia: a rare but life-threatening potential cause of bleeding in the intensive care unit

2011 ◽  
Vol 37 (8) ◽  
pp. 1240-1249 ◽  
Author(s):  
Aryeh Shander ◽  
Christopher E. Walsh ◽  
Caroline Cromwell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hemophilia A ◽  
Acquired Hemophilia A ◽  
Acquired Hemophilia ◽  
Life Threatening

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 Dermatological Manifestations in the Intensive Care Unit: A Practical Approach

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Mariona Badia ◽  
José Manuel Casanova ◽  
Lluís Serviá ◽  
Neus Montserrat ◽  
Jordi Codina ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cutaneous Lesion ◽  
Skin Lesions ◽  
Intensive Treatment ◽  
Main Diagnosis ◽  
Systemic Diseases ◽  
Cutaneous Manifestations ◽  
Critical Patients ◽  
The Moment

Dermatological problems are not usually related to intensive medicine because they are considered to have a low impact on the evolution of critical patients. Despite this, dermatological manifestations (DMs) are relatively frequent in critically ill patients. In rare cases, DMs will be the main diagnosis and will require intensive treatment due to acute skin failure. In contrast, DMs can be a reflection of underlying systemic diseases, and their identification may be key to their diagnosis. On other occasions, DMs are lesions that appear in the evolution of critical patients and are due to factors derived from the stay or intensive treatment. Lastly, DMs can accompany patients and must be taken into account in the comprehensive pathology management. Several factors must be considered when addressing DMs: on the one hand, the moment of appearance, morphology, location, and associated treatment and, on the other hand, aetiopathogenesis and classification of the cutaneous lesion. DMs can be classified into 4 groups: life-threatening DMs (uncommon but compromise the patient's life); DMs associated with systemic diseases where skin lesions accompany the pathology that requires admission to the intensive care unit (ICU); DMs secondary to the management of the critical patient that considers the cutaneous manifestations that appear in the evolution mainly of infectious or allergic origin; and DMs previously present in the patient and unrelated to the critical process. This review provides a characterization of DMs in ICU patients to establish a better identification and classification and to understand their interrelation with critical illnesses.

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