scholarly journals Faculty Opinions recommendation of Septic shock presentation in adolescents with COVID-19.

2020 ◽  
Author(s):  
Anirban Basu ◽  
Surajit Chakraborty
Keyword(s):  
Septic Shock ◽  
Shock Presentation

scholarly journals Septic shock presentation in adolescents with COVID-19

2020 ◽  
Vol 4 (7) ◽  
pp. e21-e23 ◽  
Author(s):  
Cecilia Dallan ◽  
Fabrizio Romano ◽  
Johan Siebert ◽  
Sofia Politi ◽  
Laurence Lacroix ◽  
...  
Keyword(s):  
Septic Shock ◽  
Shock Presentation

scholarly journals 1694. Predictors of Septic Shock in Adult Patients with Candidemia: A Single-Center Experience Over 13 Years

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S620-S620
Author(s):  
Jin Woong Suh ◽  
Jeong Yeon Kim ◽  
You Seung Chung ◽  
Hojin Lee ◽  
Sun Bean Kim ◽  
...  
Keyword(s):  
Septic Shock ◽  
Central Venous Catheter ◽  
Candida Species ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Venous Catheter ◽  
Adult Patients ◽  
Central Venous ◽  
Shock Presentation ◽  
Factors Associated

Abstract Background Although the incidence of candidemia has been increased recently, factors associated with septic shock in adult patients with candidemia have not been well defined. We performed a study to identify septic shock risk factors. Methods This retrospective study was conducted among adult patients ≥19 years of age with candidemia who were diagnosed from 2006 to 2018 at a single tertiary care medical center. Clinical data were collected. Patients were excluded if they were noted to have concomitant bacteremia or to have received antifungal treatment <5 days. Results After application of the exclusion criteria, 46 patients (25.1%) were classified as having septic shock presentation out of 183 patients. Between the septic shock and non-septic shock patients, there were no differences regarding comorbidities. Variables associated with septic shock in the univariate analysis were non-remission of candidemia [23/46 (67.6%) vs. 100/137 (83.3%) P = 0.044], central venous catheter [41/46 (89.1%) vs. 98/137 (67.9) P = 0.005], hemodialysis [12/46 (26.1%) vs. 15/137 (10.9%) P = 0.012], neutropenia [10/46 (21.7%) vs. 14/137 (10.2%) P = 0.045], and previous hospitalization to the intensive care unit (ICU) [24/46 (52.2%) vs. 47/137 (34.3%) P = 0.031]. The group of other Candida species consisting of [C. guilliermondii, C. haemulonii, C. famata, C. lusitaniae, and unknown] was more common in the septic shock patients (10.9%) than in the non-septic shock patients (1.5%), P = 0.004. The mortality of patients with septic shock was significantly higher than that of patients without septic shock [37/46 (80.4%) vs. 59/137 (43.1%) P < 0.001]. Multivariate analysis showed central venous catheter (odds ratio [OR] 4.00, 95% confidence interval [CI] 1.12 – 14.30, P = 0.033) and abnormal aspartate aminotransferase [AST] (OR 2.76, 95% CI 1.06 – 7.16, P = 0.024) were significantly associated with septic shock. Presence of other Candida species (OR 6.78, 95% CI 0.87 – 53.03, P = 0.068) showed borderline significance. Conclusion Our findings suggest that venous catheter and abnormal AST were significant factors associated with septic shock in adult patients with candidemia. Also, candidemia caused by other Candida species may need to be monitored closely for the development of septic shock presentation. Disclosures All authors: No reported disclosures.

DOES PATIENT ORIGIN AT TIME OF SEPTIC SHOCK PRESENTATION ALTER OUTCOMES?

CHEST Journal ◽  
2007 ◽  
Vol 132 (4) ◽  
pp. 560A
Author(s):  
Zhen Wang ◽  
Christa Schorr ◽  
Stephen W. Trzeciak ◽  
R. Phillip Dellinger ◽  
Joseph E. Parrillo
Keyword(s):  
Septic Shock ◽  
Shock Presentation

Low-Dose Steroids Cut Mortality in Septic Shock

2006 ◽  
Vol 36 (19) ◽  
pp. 24
Author(s):  
BRUCE JANCIN
Keyword(s):  
Septic Shock ◽  
Low Dose

Septic shock patient and ultrasound in the emergency room

2016 ◽  
Vol 37 (S 01) ◽  
Author(s):  
M Algaba Montes ◽  
AÁ Oviedo García ◽  
M Patricio Bordomás
Keyword(s):  
Septic Shock ◽  
Emergency Room ◽  
Septic Shock Patient

Combination of Antibiotic Treatment with the Thrombin Inhibitor Recombinant Hirudin for the Therapy of Experimental Klebsiella pneumoniae Sepsis

1994 ◽  
Vol 71 (06) ◽  
pp. 768-772 ◽  
Author(s):  
Gerhard Dickneite ◽  
Jörg Czech
Keyword(s):  
Septic Shock ◽  
Klebsiella Pneumoniae ◽  
Organ Failure ◽  
Therapeutic Effect ◽  
Disseminated Intravascular Coagulation ◽  
Post Infection ◽  
Thrombin Inhibitor ◽  
Bolus Administration ◽  
Bacterial Burden ◽  
Recombinant Hirudin

SummaryRats which were infected with the gramnegative pathogen Klebsiella pneumoniae develop disseminated intravascular coagulation (DIC), multi-organ failure (MOF) and finally die in a septic shock. We investigated the therapeutic effect of antibiotic (tobramycin) treatment combined with the infusion of the highly specific thrombin inhibitor rec. hirudin. Although administration of 2 mg/kg tobramycin alone leads to a decrease of the bacterial burden, DIC could not be prevented. Infusion of rec. hirudin (0.25 mg/kg x h) for 4 h (start of treatment 1 h post infection), in addition to a bolus administration of tobramycin, led to an amelioration of DIC parameters as fibrinogen, thrombin-antithrombin complex (TAT) and platelets. Serum transaminase levels (GOT, GPT) as a marker of MOF were significantly improved by rec. hirudin, the T50 value increased from 17 h in the tobramycin group to 42 h in the tobramycin + rec. hirudin giuup, muilality rates were 90% or 60%, respectively. Combination of heparin (10011/kg x h) and tobramycin was not effective on survival.

Evidence for impaired 21-hydroxylase activity in patients with septic shock

2004 ◽  
Vol 112 (S 1) ◽  
Author(s):  
MWA Angstwurm ◽  
A Rashidi-Kia ◽  
M Bidlingmeier ◽  
J Schopohl ◽  
R Gaertner
Keyword(s):  
Septic Shock ◽  
Hydroxylase Activity

Effect of fluid bolus triggers and their combination on fluid responsiveness in optimization phase of severe sepsis and septic shock resuscitation

MedPharmRes ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 27-32
Author(s):  
Bien Le ◽  
Dai Huynh ◽  
Mai Tuan ◽  
Minh Phan ◽  
Thao Pham ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Fluid Responsiveness ◽  
Statistical Significance ◽  
Venous Pressure ◽  
Fluid Bolus ◽  
Low Blood Pressure ◽  
Low Central Venous Pressure ◽  
Sepsis And Septic Shock

Objectives: to evaluate the fluid responsiveness according to fluid bolus triggers and their combination in severe sepsis and septic shock. Design: observational study. Patients and Methods: patients with severe sepsis and septic shock who already received fluid after rescue phase of resuscitation. Fluid bolus (FB) was prescribed upon perceived hypovolemic manifestations: low central venous pressure (CVP), low blood pressure, tachycardia, low urine output (UOP), hyperlactatemia. FB was performed by Ringer lactate 500 ml/30 min and responsiveness was defined by increasing in stroke volume (SV) ≥15%. Results: 84 patients were enrolled, among them 30 responded to FB (35.7%). Demographic and hemodynamic profile before fluid bolus were similar between responders and non-responders, except CVP was lower in responders (7.3 ± 3.4 mmHg vs 9.2 ± 3.6 mmHg) (p 0.018). Fluid response in low CVP, low blood pressure, tachycardia, low UOP, hyperlactatemia were 48.6%, 47.4%, 38.5%, 37.0%, 36.8% making the odd ratio (OR) of these triggers were 2.81 (1.09-7.27), 1.60 (0.54-4.78), 1.89 (0.58-6.18), 1.15 (0.41-3.27) and 1.27 (0.46-3.53) respectively. Although CVP < 8 mmHg had a higher response rate, the association was not consistent at lower cut-offs. The combination of these triggers appeared to raise fluid response but did not reach statistical significance: 26.7% (1 trigger), 31.0% (2 triggers), 35.7% (3 triggers), 55.6% (4 triggers), 100% (5 triggers). Conclusions: fluid responsiveness was low in optimization phase of resuscitation. No fluid bolus trigger was superior to the others in term of providing a higher responsiveness, their combination did not improve fluid responsiveness as well.

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