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1

Sudaryadi, Sudaryadi, Eddy Harijanto, and Indro Mulyono. "Comparison of Hydrocortisone with Combined Hydrocortisone, Ascorbic Acid, and Thiamine as an Adjuvant Therapy on Septic Shock Patients on Mortality: A Systematic Review and Meta-analysis." Open Access Macedonian Journal of Medical Sciences 11, F (2023): 171–79. http://dx.doi.org/10.3889/oamjms.2023.9952.

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BACKGROUND: Septic shock is still considered a global health problem because it is the main cause of morbidity and mortality in critical patients. Various clinical studies have proven that intravenous administration of high dose ascorbic acid and corticosteroid helps slow the inflammation cascade. These studies help lower the global sepsis and septic shock burden with cost-effective methods and minimum side effects. We systematically reviewed the comparison between hydrocortisone and hydrocortisone-ascorbic acid-thiamine (HAT) combined therapy as an adjuvant in the mortality rate of septic sho
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Yuniar, Irene, Vembricha Nindya Manusita, and Sonya Leonardy Low. "Corticosteroids for pediatric septic shock patients." Paediatrica Indonesiana 59, no. 2 (2019): 67–71. http://dx.doi.org/10.14238/pi59.2.2019.67-71.

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Background Septic shock remains a major cause of mortality and admission to the pediatric intensive care unit (PICU) in children. Management includes adequate fluid resuscitation, followed by catecholamine infusion, if needed. Corticosteroid therapy is advised for catecholamine-refractory shock, although this practice is controversial, as it was not beneficial in other studies.
 Objective To assess corticosteroid use in pediatric septic shock patients in Cipto Mangunkusumo Hospital.
 Methods This cross-sectional study included all patients aged 1 month-18 years with a diagnosis of se
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Litwak, Jane, Nam Cho, H. Nguyen, Kayvan Moussavi, and Thomas Bushell. "Vitamin C, Hydrocortisone, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Analysis of Real-World Application." Journal of Clinical Medicine 8, no. 4 (2019): 478. http://dx.doi.org/10.3390/jcm8040478.

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A recent study suggested mortality benefits using vitamin C, hydrocortisone, and thiamine combination therapy (triple therapy) in addition to standard care in patients with severe sepsis and septic shock. In order to further evaluate the effects of triple therapy in real-world clinical practice, we conducted a retrospective observational cohort study at an academic tertiary care hospital. A total of 94 patients (47 in triple therapy group and 47 in standard care group) were included in the analysis. Baseline characteristics in both groups were well-matched. No significant difference in the pri
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Parker, Margaret M., and Mitchell P. Fink. "Septic Shock." Journal of Intensive Care Medicine 7, no. 2 (1992): 90–100. http://dx.doi.org/10.1177/088506669200700206.

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The incidence of sepsis and septic shock has been increasing dramatically over the past 10 years. Despite advances in antimicrobial therapy, the mortality of septic shock remains very high. We review the clinical manifestations of sepsis and septic shock and describe the cardiovascular manifestations. Pathophysiology of the cardiovascular changes is discussed, and mediators believed to be involved in the pathogenesis are reviewed. Management of septic shock is also discussed, including antimicrobial therapy, supportive care, and adjunctive treatment aimed at affecting the mediators involved in
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Sutrisno, Wibowo, and Volodymyr Dzhyvak. "Assessing corticosteroid utilization and mortality risk in septic shock: insights from network meta-analysis." Deka in Medicine 1, no. 1 (2024): e791. http://dx.doi.org/10.69863/dim.v1i1.5.

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BACKGROUND: Despite current guidelines recommending corticosteroid administration in septic shock management, there is ongoing controversy regarding their impact on mortality rates and the most effective corticosteroid type. OBJECTIVES: To assess corticosteroid use and mortality risk in septic shock via network meta-analysis. METHODS: A comprehensive network meta-analysis was undertaken by retrieving articles from PubMed, Embase, and Scopus databases. Pertinent data encompassing baseline characteristics of articles, definitions of sepsis, types of corticosteroids employed, and mortality rates
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Kirov, M. Yu, V. V. Kuzkov, D. N. Protsenko, et al. "Septic shock in adults: guidelines of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists”." Annals of Critical Care, no. 4 (October 30, 2023): 7–42. http://dx.doi.org/10.21320/1818-474x-2023-4-7-42.

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The paper represents the clinical guidelines for septic shock in adults, approved by the All-Russian public organization “Federation of anesthesiologists and reanimatologists” in 2023. Septic shock is a widespread condition with a high mortality rate. The recommendations cover the issues of etiology, pathogenesis, clinical signs and symptoms, methods of laboratory and instrumental diagnosis of septic shock. The clinical guidelines present initial therapy for septic shock, including approaches to vasopressor and inotropic therapy, recommendations for choosing antibacterial drugs, fluid and adju
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Lamichhane, Sabitri, Nayan Manandhar, Shailendra Dhakal, and Yagya Laxmi Shakya. "Management and Outcome of Severe Sepsis and Septic Shock Patients." Journal of Nepal Health Research Council 16, no. 2 (2018): 165–71. http://dx.doi.org/10.33314/jnhrc.v16i2.985.

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Background: Severe sepsis and septic shock are major causes of morbidity and mortality worldwide and need immediate medical attention. Early recognition, fluid resuscitation and early antimicrobials are the mainstays of sepsis therapy. This study analyzed the management strategies of severe sepsis and septic shock and evaluated its impact.Methods: A prospective study was conducted on patients admitted through emergency department of Tribhuvan University Teaching Hospital of Nepal, who were diagnosed with severe sepsis and septic shock.Results: A total of 85 patients were diagnosed as severe se
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Epstein, Danny, Karawan Badarni, and Yaron Bar-Lavie. "Impact of Haemoadsorption Therapy on Short Term Mortality and Vasopressor Dependency in Severe Septic Shock with Acute Kidney Injury: A Retrospective Cohort Study." Antibiotics 13, no. 12 (2024): 1233. https://doi.org/10.3390/antibiotics13121233.

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Background/Objectives: Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response to infection, remains a major challenge in ICUs. This study evaluated whether combining haemoadsorption therapy with continuous renal replacement therapy (CRRT) reduces ICU and short-term mortality in patients with severe septic shock and acute kidney injury (AKI) requiring CRRT. Methods: A single-centre retrospective cohort study was conducted at Rambam Health Care Campus, Haifa, Israel, from January 2018 to February 2024. Data were collected from ICU patients with severe septic shock an
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Chae, Bora, Yo Sep Shin, Seok-In Hong, et al. "Extracellular Water to Total Body Water Ratio in Septic Shock Patients Receiving Protocol-Driven Resuscitation Bundle Therapy." Journal of Clinical Medicine 10, no. 13 (2021): 2917. http://dx.doi.org/10.3390/jcm10132917.

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(1) Bio-electrical impedance analysis (BIA) is a rapid, simple, and noninvasive tool for evaluating the metabolic status and for assessing volume status in critically ill patients. Little is known, however, the prognostic value of body composition analysis in septic shock patients. This study assessed the association between parameters by body composition analysis and mortality in patients with septic shock in the emergency department (ED). (2) Data were prospectively collected on adult patients with septic shock who underwent protocol-driven resuscitation bundle therapy between December 2019
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10

Rugg, Christopher, Riko Klose, Rouven Hornung, et al. "Hemoadsorption with CytoSorb in Septic Shock Reduces Catecholamine Requirements and In-Hospital Mortality: A Single-Center Retrospective ‘Genetic’ Matched Analysis." Biomedicines 8, no. 12 (2020): 539. http://dx.doi.org/10.3390/biomedicines8120539.

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Septic shock is a major burden to healthcare with mortality rates remaining high. Blood purification techniques aim to reduce cytokine levels and resultant organ failure. Regarding septic shock, hemoadsorption via CytoSorb seems promising, but the main effects on organ failure and mortality remain unclear. In this retrospective single-center study, septic shock patients receiving CytoSorb in addition to renal replacement therapy (n = 42) were analyzed and compared to matched controls (n = 42). A generalized propensity-score and Mahalanobis distance matching method (‘genetic’ matching) was appl
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Valerio-Rojas, Juan C., Insara J. Jaffer, Daryl J. Kor, Ognjen Gajic, and Rodrigo Cartin-Ceba. "Outcomes of Severe Sepsis and Septic Shock Patients on Chronic Antiplatelet Treatment: A Historical Cohort Study." Critical Care Research and Practice 2013 (2013): 1–9. http://dx.doi.org/10.1155/2013/782573.

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Background. Sepsis is characterized by dysfunctional activation of platelets, and antiplatelet therapy could improve the outcomes of septic patients.Methods. We performed a retrospective cohort study of severe sepsis or septic shock adult patients. Outcomes of patients on antiplatelet therapy were compared to those that were not taking antiplatelet therapy by univariate analysis followed by a propensity score analysis based on the probability of receiving antiplatelet therapy.Results. Of 651 patients included in the study 272 (42.8%) were on antiplatelet therapy before the development of sever
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12

Castelli, Valeria, Enric Sastre-Escolà, Pedro Puerta-Alcalde, et al. "The Etiology, Antibiotic Therapy and Outcomes of Bacteremic Skin and Soft-Tissue Infections in Onco-Hematological Patients." Antibiotics 12, no. 12 (2023): 1722. http://dx.doi.org/10.3390/antibiotics12121722.

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Objectives: to assess the current epidemiology, antibiotic therapy and outcomes of onco- hematological patients with bacteremic skin and soft-tissue infections (SSTIs), and to identify the risk factors for Gram-negative bacilli (GNB) infection and for early and overall mortality. Methods: episodes of bacteremic SSTIs occurring in cancer patients at two hospitals were prospectively recorded and retrospectively analyzed. Results: Of 164 episodes of bacteremic SSTIs, 53% occurred in patients with solid tumors and 47% with hematological malignancies. GNB represented 45.5% of all episodes, led by P
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Chen, Shih-Hsiang, Tsung-Yen Chang, Yi-Lun Wang, et al. "Outcome of Tocilizumab Treatment in Febrile Neutropenic Children with Severe Sepsis/Septic Shock in a Single-Center Retrospective Case Series." Cancers 16, no. 8 (2024): 1512. http://dx.doi.org/10.3390/cancers16081512.

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Purpose: To assess the efficacy of an IL-6 blockade with tocilizumab on treatment outcome of severe sepsis/septic shock in children with febrile neutropenia. Methods: We performed a retrospective study of febrile neutropenic patients younger than 18 years old who developed severe sepsis/septic shock at a single medical center between November 2022 and October 2023. Results: Seven patients with febrile neutropenia complicated with severe sepsis/septic shock were identified. Four of seven patients received tocilizumab in addition to standard of care. The median IL-6 level before administration o
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Kleuzovich, A. A., V. V. Kazyonnov, A. N. Kudryavtsev, A. V. Geyze, G. P. Plotnikov, and А. A. Alekseyev. "Selection of Target Mean Arterial Pressure in Severely Burned Patients with Septic Shock." General Reanimatology 18, no. 6 (2022): 12–21. http://dx.doi.org/10.15360/1813-9779-2022-6-12-21.

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The timely diagnosis of both sepsis and septic shock can be challenging in severely burned patients. Monitoring methods providing early diagnosis of organ dysfunction development are of great importance. Assessment of the glomerular filtration rate with central hemodynamic parameters can be considered as a component of comprehensive monitoring of effectiveness of septic shock therapy.Aim: to determine the relationship between the target mean arterial pressure and glomerular filtration rate parameters in the treatment of severely burned patients with septic shock.Material and methods. 158 sever
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Kogelmann, Klaus, Tobias Hübner, Franz Schwameis, Matthias Drüner, Morten Scheller, and Dominik Jarczak. "First Evaluation of a New Dynamic Scoring System Intended to Support Prescription of Adjuvant CytoSorb Hemoadsorption Therapy in Patients with Septic Shock." Journal of Clinical Medicine 10, no. 13 (2021): 2939. http://dx.doi.org/10.3390/jcm10132939.

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Introduction: Despite advances in critical care medicine, adjunctive approaches in sepsis therapy have failed to prove their efficacy. Notwithstanding promising results using hemoadsorption (CytoSorb), questions remain concerning timing and dosing. We created a dynamic scoring system (DSS) to assess patients with early septic shock and performed a first evaluation of the system in this patient population. Methods: Data from 502 patients with septic shock according to Sepsis-3 criteria were retrospectively analyzed. Score parameters were documented at the time of diagnosis (T0) and 6 h later (T
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Shapoval, С. D. "Septic shock: treatment and modern interpretation of the issue." Ukrainian Journal of Clinical Surgery 91, no. 3 (2024): 38–46. http://dx.doi.org/10.26779/2786-832x.2024.3.38.

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Objective. To analyse the results of treatment of patients with septic shock, which was carried out in accordance with the decisions of the International Conference on Conciliation and the protocols of the Sepsis–3 guideline. Materials and methods. We observed 283 patients with sepsis who were treated in the purulent–septic centre of Zaporizhzhia City Hospital No. 3 during 1991–2024: Group 1 – 193 (68.2%) patients with sepsis treated according to the decisions of the International Conference on Sepsis and Septic Shock (2012, 2004) in 1991–2015, and Group 2 – 90 (31.8%) patients treated accordi
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Shirtliff, Mark E., and Jon T. Mader. "Acute Septic Arthritis." Clinical Microbiology Reviews 15, no. 4 (2002): 527–44. http://dx.doi.org/10.1128/cmr.15.4.527-544.2002.

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SUMMARY Acute septic arthritis may develop as a result of hematogenous seeding, direct introduction, or extension from a contiguous focus of infection. The pathogenesis of acute septic arthritis is multifactorial and depends on the interaction of the host immune response and the adherence factors, toxins, and immunoavoidance strategies of the invading pathogen. Neisseria gonorrhoeae and Staphylococcus aureus are used in discussing the host-pathogen interaction in the pathogenesis of acute septic arthritis. While diagnosis rests on isolation of the bacterial species from synovial fluid samples,
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Chapman, Marianne, Michael Davies, Marni Nenke, et al. "ODP584 Corticosteroid-binding Globulin Deficiency Independently Predicts Mortality and is Associated with Norepinephrine Requirements in Septic Shock." Journal of the Endocrine Society 6, Supplement_1 (2022): A75. http://dx.doi.org/10.1210/jendso/bvac150.155.

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Abstract Context: Hydrocortisone administration in septic shock remains controversial. Corticosteroid-binding globulin (CBG) transports cortisol to inflammatory sites and is depleted in septic shock. Objective To determine if severely deficient plasma CBG <200 nmol/L (Ref range 269-641 nmol/L) independently predicts septic shock mortality. Methods A prospective observational study in patients with septic shock. Patients were categorised into two groups: mean plasma CBG concentrations <200 nmol/L and ≥200 nmol/L (day 1/2), with additional categorisation by nadir CBG. Primary outco
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Kethireddy, Shravan, and Anand Kumar. "Mortality due to septic shock following early, appropriate antibiotic therapy." Critical Care Medicine 40, no. 7 (2012): 2228–29. http://dx.doi.org/10.1097/ccm.0b013e318256bb99.

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Lu, Yao, Han Zhang, Fang Teng, Wen-Jun Xia, Gui-Xiang Sun, and Ai-Qing Wen. "Early Goal-Directed Therapy in Severe Sepsis and Septic Shock: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials." Journal of Intensive Care Medicine 33, no. 5 (2016): 296–309. http://dx.doi.org/10.1177/0885066616671710.

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Introduction: The Surviving Sepsis Campaign guidelines recommend early goal-directed therapy (EGDT) for the resuscitation of patients with sepsis; however, the recent evidences quickly evolve and convey conflicting results. We performed a meta-analysis to evaluate the effect of EGDT on mortality in adults with severe sepsis and septic shock. Methods: We searched electronic databases to identify randomized controlled trials that compared EGDT with usual care or lactate-guided therapy in adults with severe sepsis and septic shock. Predefined primary outcome was all-cause mortality at final follo
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Piche, Mackenzie, Maureen Campion, and Alina Adeel. "1167. Got Micafungin? The Incidence of Fungemia in Patients with Septic Shock." Open Forum Infectious Diseases 7, Supplement_1 (2020): S609. http://dx.doi.org/10.1093/ofid/ofaa439.1353.

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Abstract Background Timely administration of antibiotics in patients presenting with sepsis decreases mortality, however evidence evaluating empiric antifungal coverage has been inconclusive. Recent data have shown no mortality benefit of empiric antifungal therapy in patients with ICU-acquired sepsis. Despite the lack of data, the Surviving Sepsis Campaign recommends empiric coverage for all suspected pathogens, including fungi. The purpose of this study is to determine the frequency of concomitant septic shock and fungemia at UMass Memorial Medical Center, a large tertiary care center. Metho
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Kong, Lin, Qing Wu, and Bo Liu. "The impact of selenium administration on severe sepsis or septic shock: a meta-analysis of randomized controlled trials." African Health Sciences 21, no. 1 (2021): 277–85. http://dx.doi.org/10.4314/ahs.v21i1.36.

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Introduction: The efficacy of selenium administration to treat severe sepsis or septic shock remains controversial. We con- duct a systematic review and meta-analysis to explore the impact of selenium administration on severe sepsis or septic shock.
 Methods: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through May 2020 for randomized controlled trials (RCTs) assessing the effect of selenium administration on severe sepsis or septic shock. Me- ta-analysis is performed using the random-effect model.
 Results: Five RCTs involving 1482 patients are inc
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Krugova, L. V., D. S. Zinatullina, I. G. Trukhanova, and Yu G. Kutyreva. "Septic embolism of small branches of the pulmonaryartery in the postoperative period in a postpartum woman (clinical observation)." Medical alphabet, no. 23 (November 4, 2024): 44–48. http://dx.doi.org/10.33667/2078-5631-2024-23-44-48.

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Septic complications in obstetric practice are the most important cause of maternal mortality and pregnancy complications; they account for about 15 % of the structure of maternal mortality in the world. It is likely that the incidence of sepsis during pregnancy is estimated inaccurately, which is due to both the provision of an insufficient number of reports and the not always correct interpretation of the clinical picture of the disease. A rare complication of a septic condition in the postpartum period in the form of embolism of small branches of the pulmonary artery indicates a variety of
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Al-Khaldi, Manal Rashid. "Systematic Review: Impact of Vitamin C, Hydrocortisone, and Thiamine Therapy on Sepsis and Septic Shock Patients." American Journal of Medical Science and Innovation 2, no. 2 (2023): 61–72. http://dx.doi.org/10.54536/ajmsi.v2i2.1938.

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Systematic Inflammatory Response Syndrome and Sepsis are inflammatory responses to many health manifestations. Sepsis mortality is high despite global treatment standards, with metabolic resuscitation being a novel approach for managing Sepsis. The purpose of this systematic review is to assess the effectiveness of the critical care combination comprising hydrocortisone, Vitamin C, and thiamine in potentially mitigating Sepsis, reducing mortality associated with septic shock, and alleviating organ failure. In order to execute this scoping review, recent research based on the effect of vitamin
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Jung, Boris, Stephanie Nougaret, Gérald Chanques, et al. "The Absence of Adrenal Gland Enlargement during Septic Shock Predicts Mortality." Anesthesiology 115, no. 2 (2011): 334–43. http://dx.doi.org/10.1097/aln.0b013e318225cfd7.

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Background : Assessment and management of septic shock associated adrenal function remain controversial. The aim of this study was to explore the prognostic value of adrenal gland volume in adults with septic shock. Methods : A short cosyntropin test and determination of adrenal volume by computed tomography were performed within 48 h of shock in patients with septic shock (n = 184) and in 2 control groups: 40 ambulatory patients and 15 nonseptic critically ill patients. The primary endpoint was intensive care unit mortality. Results : At intensive care unit discharge, 59 patients with septic
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Pradhan, Ginius, Khaldoon Shaheen, Mary Muoneke, and Basel Altaqi. "Pulmonary Septic Emboli due to Azygos Vein Septic Thrombosis." Case Reports in Medicine 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/904057.

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The triad of extrapulmonary infection, contiguous septic vein thrombosis, and septic pulmonary embolism is a rare complex but associated with significant morbidity and mortality. Septic azygos vein thrombosis is extremely rare and potentially serious since it may also cause pulmonary emboli and sudden death. We report a case of a 32-year-old woman with history of IV drug abuse who presented with epidural abscess and methicillin-resistantS. aureus(MRSA) bacteremia. Later she developed signs of septic pulmonary embolism secondary to septic azygos vein thrombosis. With early diagnosis, appropriat
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de, Jong PH. "Septic Arthritis: The drainage controversy." Rheumatica Acta: Open Access 2, no. 1 (2018): 001–5. https://doi.org/10.17352/raoa.000008.

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Objective: Septic arthritis is a relatively rare disease, which is associated with a high morbidity and mortality. Treatment consists of prolonged antibiotic therapy and removal of intra-articular inflammatory debris. However, there is much controversy about the most effective drainage method. Therefore, we compared the clinical efficacy of (daily) needle aspiration with surgical drainage in adult patients with septic arthritis.
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Li, Xiao-jin, Ru-rong Wang, Yan Kang, et al. "Effects of Safflower Yellow on the Treatment of Severe Sepsis and Septic Shock: A Randomized Controlled Clinical Trial." Evidence-Based Complementary and Alternative Medicine 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/3948795.

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Objective.To evaluate the clinical effect of safflower yellow on the treatment of severe sepsis and septic shock.Methods.85 patients with severe sepsis and septic shock were randomly selected to receive either therapy according to the international guidelines for management of severe sepsis and septic shock (Surviving Sepsis Campaign 2012) (control group,n= 45) or conventional therapy plus safflower yellow (study group,n= 40). The 28-day mortality and 28-day Kaplan-Meier survival curves were compared as primary outcomes.Results.The 28-day mortality from all causes and in-hospital mortality wer
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Yerke, Jason, Kyle Strnad, and Seth R. Bauer. "Corticosteroids for Septic Shock: Another Chapter in the Saga." Hospital Pharmacy 55, no. 2 (2019): 135–42. http://dx.doi.org/10.1177/0018578719829416.

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The use of corticosteroids in the management of septic shock has been a highly debated topic for quite some time. Corticosteroids have the ability to combat hyperinflammatory and exaggerated vasodilatory responses, as well as to sensitize adrenergic receptors to decrease the duration of shock. While helpful clinically, this has not translated to consistent mortality benefits. Conflicting results from 2 landmark trials published in 2002 and 2008 have led to varying clinical practices, and a clearly defined role of corticosteroids in septic shock is lacking. A decade later, an influx of new data
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Corcione, Silvia, Simone Mornese Pinna, Antonio Vena, et al. "Pseudomonas aeruginosa bloodstream infections in internal medicine wards: A large Italian multicenter retrospective study." PLOS One 20, no. 5 (2025): e0317540. https://doi.org/10.1371/journal.pone.0317540.

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Introduction This large, multicenter, Italian retrospective study aimed to describe clinical characteristics and risk factors associated with 30-day mortality in patients with Pseudomonas aeruginosa bloodstream infections (PA-BSI) admitted to internal medicine wards (IMW). To enhance clinical decision-making, we also developed and internally validated a bedside prognostic model to predict the 30-day mortality risk. Methods We conducted a retrospective, multicenter cohort study across 14 public hospitals in Italy, analyzing all adult patients admitted to IMW with PA-BSI between 2021 and 2022. R
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Oliva, Alessandra, Alessandro Bianchi, Alessandro Russo, et al. "Effect of N-Acetylcysteine Administration on 30-Day Mortality in Critically Ill Patients with Septic Shock Caused by Carbapenem-Resistant Klebsiella pneumoniae and Acinetobacter baumannii: A Retrospective Case-Control Study." Antibiotics 10, no. 3 (2021): 271. http://dx.doi.org/10.3390/antibiotics10030271.

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Carbapenem-resistant Klebsiella pneumoniae (CR-Kp) and Acinetobacter baumannii (CR-Ab) represent important cause of severe infections in intensive care unit (ICU) patients. N-Acetylcysteine (NAC) is a mucolytic agent with antioxidant and anti-inflammatory properties, showing also in-vitro antibacterial activity. Aim was to evaluate the effect on 30-day mortality of the addition of intravenous NAC to antibiotics in ICU patients with CR-Kp or CR-Ab septic shock. A retrospective, observational case:control study (1:2) in patients with septic shock caused by CR-Kp or CR-Ab hospitalized in two diff
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Rulli, Immacolata, Angelo Mattia Carcione, Federica D’Amico, Giuseppa Quartarone, Roberto Chimenz, and Eloisa Gitto. "Corticosteroids in Pediatric Septic Shock: A Narrative Review." Journal of Personalized Medicine 14, no. 12 (2024): 1155. https://doi.org/10.3390/jpm14121155.

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Objective: A controversial aspect of pediatric septic shock management is corticosteroid therapy. Current guidelines do not recommend its use in forms responsive to fluids and inotropes but leave the decision to physicians in forms refractory to the first steps of therapy. Data Sources: Review of literature from January 2013 to December 2023 from online libraries Pubmed, Medline, Cochrane Library, and Scopus. Study Selection: The keywords “septic shock”, “steroids” and “children” were used. Data Extraction: Of 399 articles, 63 were selected. Data Synthesis: Regarding mortality, although the 20
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Hopkinson, Dennis A., Jean Paul Mvukiyehe, Sudha P. Jayaraman, et al. "Sepsis in two hospitals in Rwanda: A retrospective cohort study of presentation, management, outcomes, and predictors of mortality." PLOS ONE 16, no. 5 (2021): e0251321. http://dx.doi.org/10.1371/journal.pone.0251321.

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Purpose Few studies have assessed the presentation, management, and outcomes of sepsis in low-income countries (LICs). We sought to characterize these aspects of sepsis and to assess mortality predictors in sepsis in two referral hospitals in Rwanda. Materials and methods This was a retrospective cohort study in two public academic referral hospitals in Rwanda. Data was abstracted from paper medical records of adult patients who met our criteria for sepsis. Results Of the 181 subjects who met eligibility criteria, 111 (61.3%) met our criteria for sepsis without shock and 70 (38.7%) met our cri
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Tancharoen, Lalita, Prat Pairattanakorn, Visanu Thamlikitkul, and Nasikarn Angkasekwinai. "Epidemiology and Burden of Sepsis at Thailand’s Largest University-Based National Tertiary Referral Center during 2019." Antibiotics 11, no. 7 (2022): 899. http://dx.doi.org/10.3390/antibiotics11070899.

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Data specific to the epidemiology and burden of sepsis in low- and middle-income countries are limited. This study aimed to determine the epidemiology and burden of adult patients with sepsis at Siriraj Hospital during 2019. Randomly selected adult patients who had blood cultures performed at our center during January–December 2019 were enrolled. A Quick Sepsis-related Organ Failure Assessment (qSOFA) score was used to determine the presence of sepsis. Demographic data and clinical outcome data were collected, and the annual incidence of sepsis or septic shock and death was estimated. Of the 9
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Plotkin, L. L. "Refractory Septic Shock (Part 2)." Messenger of ANESTHESIOLOGY AND RESUSCITATION 18, no. 3 (2021): 79–86. http://dx.doi.org/10.21292/2078-5658-2021-18-3-79-86.

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Refractory shock is the shock that does not respond to vasopressor therapy. Refractory shock with a short-term mortality rate of more than 50% is diagnosed in 6-7% of critically ill patients. There is an objective need to Investigate methods of intensive therapy for refractory septic shock.The objective of the study: to analyze literature data on the intensive care of refractory septic shock.Results. The second part of the article analyzes 37 studies, both Russian and foreign ones devoted to the intensive care of refractory shock. At present, based on the analysis of the publication, it is imp
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Law, Adam. "Should ascorbic acid be a primary therapy for sepsis in prehospital settings?" Journal of Paramedic Practice 13, no. 1 (2021): 33–38. http://dx.doi.org/10.12968/jpar.2021.13.1.33.

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Background: Prehospital emergency medical services (EMS) are believed to be responsible for the initial treatment of 68 000 septic patients annually in the UK, 88% of whom have severely low ascorbic acid levels, which can lead to organ dysfunction, increasing the likelihood of mortality. Objective: This review aims to determine if early therapeutic use of ascorbic acid (vitamin C) could reduce the deterioration of septic patients and therefore overall mortality. Method: A literature review was conducted using the mySearch, PubMed and Cochrane Library databases. Each was systematically searched
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Law, Adam. "Should ascorbic acid be a primary therapy for sepsis in prehospital settings?" Journal of Paramedic Practice 13, no. 1 (2021): 33–38. http://dx.doi.org/10.12968/jpar.2021.13.1.33.

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Background: Prehospital emergency medical services (EMS) are believed to be responsible for the initial treatment of 68 000 septic patients annually in the UK, 88% of whom have severely low ascorbic acid levels, which can lead to organ dysfunction, increasing the likelihood of mortality. Objective: This review aims to determine if early therapeutic use of ascorbic acid (vitamin C) could reduce the deterioration of septic patients and therefore overall mortality. Method: A literature review was conducted using the mySearch, PubMed and Cochrane Library databases. Each was systematically searched
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Carlos Sanchez, E., Michael R. Pinsky, Sharmili Sinha, Rajesh Chandra Mishra, Ahsina Jahan Lopa, and Ranajit Chatterjee. "Fluids and Early Vasopressors in the Management of Septic Shock: Do We Have the Right Answers Yet?" Journal of Critical Care Medicine 9, no. 3 (2023): 138–47. http://dx.doi.org/10.2478/jccm-2023-0022.

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Abstract Septic shock is a common condition associated with hypotension and organ dysfunction. It is associated with high mortality rates of up to 60% despite the best recommended resuscitation strategies in international guidelines. Patients with septic shock generally have a Mean Arterial Pressure below 65 mmHg and hypotension is the most important determinant of mortality among this group of patients. The extent and duration of hypotension are important. The two initial options that we have are 1) administration of intravenous (IV) fluids and 2) vasopressors, The current recommendation of t
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Thavorn, Kednapa, Sasha van Katwyk, Murray Krahn, et al. "Value of mesenchymal stem cell therapy for patients with septic shock: an early health economic evaluation." International Journal of Technology Assessment in Health Care 36, no. 5 (2020): 525–32. http://dx.doi.org/10.1017/s0266462320000781.

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Background.This study estimates the maximum price at which mesenchymal stem cell (MSC) therapy is deemed cost-effective for septic shock patients and identifies parameters that are most important in making treatment decisions.MethodsWe developed a probabilistic Markov model according to the sepsis care trajectory to simulate costs and quality-adjusted life years (QALYs) of septic shock patients receiving either MSC therapy or usual care over their lifetime. We calculated the therapeutic headroom by multiplying the gains attributable to MSCs with willingness-to-pay (WTP) threshold and derived t
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Song, Binglin, Xiangde Zheng, Kangrui Fu, and Chun Liu. "Early use of low-dose hydrocortisone can reduce in-hospital mortality in patients with septic shock: A systematic review and meta-analysis." Medicine 103, no. 48 (2024): e40635. http://dx.doi.org/10.1097/md.0000000000040635.

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Background: This study aimed to assess the impact of the timing of low-dose hydrocortisone adjuvant therapy initiation on clinical outcomes in patients with septic shock by a systematic review and meta-analysis. Methods: We conducted a comprehensive search of all randomized controlled trials (RCTs) and cohort studies available in the PubMed, Web of Science, and Embase databases. The search included articles published from the founding of these databases until August 1, 2024. The purpose of the search was to compare the results of initiating low-dose hydrocortisone (HC) adjuvant therapy at diff
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Corrêa, Thiago Domingos, Leonardo Lima Rocha, Camila Menezes Souza Pessoa, Eliézer Silva, and Murillo Santucci Cesar de Assuncao. "Fluid therapy for septic shock resuscitation: which fluid should be used?" Einstein (São Paulo) 13, no. 3 (2015): 462–68. http://dx.doi.org/10.1590/s1679-45082015rw3273.

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Early resuscitation of septic shock patients reduces the sepsis-related morbidity and mortality. The main goals of septic shock resuscitation include volemic expansion, maintenance of adequate tissue perfusion and oxygen delivery, guided by central venous pressure, mean arterial pressure, mixed or central venous oxygen saturation and arterial lactate levels. An aggressive fluid resuscitation, possibly in association with vasopressors, inotropes and red blood cell concentrate transfusion may be necessary to achieve those hemodynamic goals. Nonetheless, even though fluid administration is one of
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Kulikov, Alexander V., E. M. Shifman, D. N. Protsenko, et al. "Septic shock in obstetrics: guidelines of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists”." Annals of Critical Care, no. 2 (April 28, 2023): 7–44. http://dx.doi.org/10.21320/1818-474x-2023-2-7-44.

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The article reflects the main provisions of the clinical guidelines on septic shock in obstetrics, approved by the All-Russian public organization “Federation of Anesthesiologists-Resuscitators” in 2022. The relevance of the problem is associated with high mortality and morbidity rates from sepsis and septic shock in obstetrics. The main issues of etiology, pathogenesis, clinical picture, methods of laboratory and instrumental diagnostics, features of using the qSOFA, SOFA, MOEWS, SOS, MEWC, IMEWS scales for sepsis verification are consistently presented. The article presents the starting inte
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Plotkin, L. L., and V. A. Artamonov. "Septic shock in the intensive care unit of a multidisciplinary hospital." Messenger of ANESTHESIOLOGY AND RESUSCITATION 21, no. 6 (2024): 51–56. https://doi.org/10.24884/2078-5658-2024-21-6-51-56.

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The objective of the study was to assess the prevalence, etiology, and outcomes of intensive care in patients with septic shock in the ICU of a multidisciplinary hospital.Materials and methods. A single-center, retrospective, cohort study was conducted involving 398 patients with septic shock who were hospitalized in the ICU over a one-year period. Diagnosis of septic shock, as well as a complex of intensive care, were carried out according to the criteria proposed by the recommendations of the Surviving sepsis campaign (2021). Antibacterial therapy was prescribed based on the Guidelines «Diag
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Wolk, Donna M., and J. Kristie Johnson. "Rapid Diagnostics for Blood Cultures: Supporting Decisions for Antimicrobial Therapy and Value-Based Care." Journal of Applied Laboratory Medicine 3, no. 4 (2019): 686–97. http://dx.doi.org/10.1373/jalm.2018.028159.

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Abstract Bacteremia and sepsis are critically important syndromes with high mortality, morbidity, and associated costs. Bloodstream infections and sepsis are among the top causes of mortality in the US, with >600 deaths each day. Most septic patients can be found in emergency medicine departments or critical care units, settings in which rapid administration of targeted antibiotic therapy can reduce mortality. Unfortunately, routine blood cultures are not rapid enough to aid in the decision of therapeutic intervention at the onset of bacteremia. As a result, empiric, broad-spectrum trea
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Aygün, Fatih, Fatih Varol, Cansu Durak, et al. "Evaluation of Continuous Renal Replacement Therapy and Therapeutic Plasma Exchange, in Severe Sepsis or Septic Shock in Critically Ill Children." Medicina 55, no. 7 (2019): 350. http://dx.doi.org/10.3390/medicina55070350.

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Background and objective: Severe sepsis and septic shock are life-threatening organ dysfunctions and causes of death in critically ill patients. The therapeutic goal of the management of sepsis is restoring balance to the immune system and fluid balance. Continuous renal replacement therapy (CRRT) is recommended in septic patients, and it may improve outcomes in patients with severe sepsis or septic shock. Therapeutic plasma exchange (TPE) is another extracorporeal procedure that can improve organ function by decreasing inflammatory and anti-fibrinolytic mediators and correcting haemostasis by
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Maekawa, Hiroshi, and Kousuke Negishi. "Extended Sessions of Polymyxin-B Immobilized Fiber Column Hemoperfusion Ameliorate Renal Outcome and Mortality in Septic Shock with Acute Kidney Injury." Blood Purification 46, no. 2 (2018): 81–89. http://dx.doi.org/10.1159/000488639.

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Background/Aims: Polymyxin-B (PMX) treatment has been reported to decrease mortality in patients with septic shock and acute kidney injury (AKI). In this study, we aimed to evaluate whether extended sessions of PMX (Ext-PMX) immobilized fiber column hemoperfusion ameliorate clinical outcomes in patients complicated with septic shock and AKI without surgical control. Methods: Twenty-two patients with nonsurgical septic shock and AKI who received PMX were included. They were divided according to the duration of PMX treatment: Ext-PMX and standard PMX (Std-PMX). Results: The mean blood pressure i
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Chang, Wei, Jian-Feng Xie, Jing-Yuan Xu, and Yi Yang. "Effect of levosimendan on mortality in severe sepsis and septic shock: a meta-analysis of randomised trials." BMJ Open 8, no. 3 (2018): e019338. http://dx.doi.org/10.1136/bmjopen-2017-019338.

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ObjectiveWe aim to synthesise up-to-date randomised trials to investigate the effects of levosimendan on mortality and clinical outcomes in severe sepsis and septic shock.MethodsA collection of databases including PubMed, EMBASE, Cochrane Central Register and Web of Science were searched updated to August 2017. Randomised trials were included when they pertain to the use of levosimendan in severe sepsis or septic shock compared with any category of inotropes, or as an adjunct to standard therapy with mortality reported. The primary outcome was mortality, and the secondary outcomes were clinica
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Lyu, Qing-Quan, Qi-Hong Chen, Rui-Qiang Zheng, Jiang-Quan Yu, and Xiao-Hua Gu. "Effect of Low-Dose Hydrocortisone Therapy in Adult Patients With Septic Shock: A Meta-Analysis With Trial Sequential Analysis of Randomized Controlled Trials." Journal of Intensive Care Medicine 35, no. 10 (2018): 971–83. http://dx.doi.org/10.1177/0885066618803062.

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Background: The efficacy of low-dose hydrocortisone therapy in the management of septic shock remains controversial in critical care for many years. Hence, we performed this meta-analysis of randomized controlled trials (RCTs) with trial sequential analysis (TSA) to evaluate its effect on clinical outcome among adult patients with septic shock. Methods: We identified relevant RCTs published from inception to March 7, 2018 comparing low-dose hydrocortisone with placebo or no intervention in adults admitted to the intensive care unit (ICU) for septic shock. Meta-analyses were performed for the p
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Yuan, Shiqi, Chong Chen, Fengshuo Xu, et al. "Antithrombotic Therapy Improves ICU Mortality of Septic Patients with Peripheral Vascular Disease." International Journal of Clinical Practice 2022 (March 16, 2022): 1–6. http://dx.doi.org/10.1155/2022/1288535.

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Objective. The effectiveness of antithrombotic drugs for treating sepsis is controversial. Here, we explore the association between antithrombotic therapy and intensive care unit (ICU) mortality for septic patients with peripheral vascular disease. Methods. This retrospective cohort study uses data from the Medical Information Mart for Intensive Care (MIMIC)-III database. Kaplan–Meier survival analyses were used to examine mortality among different groups. Cox regression and marginal structural Cox models (MSCMs) were used to adjust for confounding factors. Main Results. The final cohort from
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Al Ansoriani, Marogi. "PRIMARY OUTCOME MEASURES IN PEDIATRIC SEPTIC SHOCK TRIALS : A SYSTEMATIC REVIEW." Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425) 9, no. 10 (2023): 88–96. http://dx.doi.org/10.53555/h2w52p26.

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Background: Septic is a significant global health concern for children, with about 1.2 million cases each year and varying mortality rates up to 50%. Clinical research in pediatric septic shock faces challenges in choosing appropriate outcome measures beyond mortality due to diverse mortality rates and patient populations. As a result, there's a need for comprehensive research to determine the optimal primary outcome measure for intervention trials in pediatric septic shock cases. Purpose: This study was aimed for an extensive investigation aimed at identifying the primary outcome measure for
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