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JAMA Internal Medicine Dec 2020
Topics: Humans; Inpatients; Patient Care Bundles; Sepsis; Shock, Septic
PubMed: 32865547
DOI: 10.1001/jamainternmed.2020.2756 -
Archivos Argentinos de Pediatria Aug 2014New and important concepts have emerged for the advanced management of the child with septic shock in the recent decades. Attending physicians in the Pediatric intensive... (Review)
Review
New and important concepts have emerged for the advanced management of the child with septic shock in the recent decades. Attending physicians in the Pediatric intensive care unit must be fully aware of them to improve patient care in the critical care unit. It should be considered the use of immune therapy only in selected groups of patients. Continuous renal replacement therapies are well tolerated and their early use prevents deleterious fluid overload. Removal of inflammatory mediators by using high volume hemofiltration may play a role in hyperdynamic septic patients. The use of plasmapheresis is recommended in patients with thrombocytopenia-associated multiple organ failure. Extracorporeal support use should be considered in those with refractory septic shock despite goals directed therapy. The immunoparalysis has been associated with nosocomial infections and late mortality. The information from genetic markers may allow early intervention and preventive genomics-based medicine.
Topics: Child; Genomics; Humans; Immunologic Deficiency Syndromes; Intensive Care Units; Shock, Septic
PubMed: 24955908
DOI: 10.5546/aap.2014.358 -
Cancer Nursing Aug 1989Septic shock is an infrequent but not uncommon oncologic emergency. An understanding of the risk factors, pathophysiology, and current issues in the management of septic... (Review)
Review
Septic shock is an infrequent but not uncommon oncologic emergency. An understanding of the risk factors, pathophysiology, and current issues in the management of septic shock can contribute to better patient care through early recognition and prompt and knowledgeable intervention. This article reviews the epidemiology, predisposing risk factors, causative organisms, and pathophysiology of septic shock. Medical and nursing interventions illustrate the necessary teamwork involved in managing this life-threatening problem. Investigational approaches are discussed as well as the importance of identifying at-risk patients and initiating preventative measures.
Topics: Emergencies; Female; Humans; Middle Aged; Neoplasms; Nursing Assessment; Risk Factors; Shock, Septic
PubMed: 2670198
DOI: No ID Found -
Pediatric Clinics of North America Feb 1987Although septic shock may be initiated by invading microbes, it is the metabolic and immunologic host responses that determine the true pathophysiology of this common... (Review)
Review
Although septic shock may be initiated by invading microbes, it is the metabolic and immunologic host responses that determine the true pathophysiology of this common critical care illness. Currently, septic shock therapeutics emphasize empiric and symptomatic treatment. Biochemical elucidation of the septic process will ultimately result in specific interventions for this ominous intensive care syndrome.
Topics: Capillary Permeability; Child; Critical Care; Endotoxins; Humans; Respiratory Distress Syndrome; Resuscitation; Shock, Septic
PubMed: 3543821
DOI: 10.1016/s0031-3955(16)36186-7 -
Clinics in Perinatology Dec 1986Septic shock in the obstetric population remains an uncommon yet potentially lethal complication of infection. Effective therapy mandates early recognition and... (Review)
Review
Septic shock in the obstetric population remains an uncommon yet potentially lethal complication of infection. Effective therapy mandates early recognition and aggressive intervention. Although numerous similarities exist in comparison to the nonobstetric patient, differences in potential pathogens and alterations in physiologic parameters should be kept in mind. In addition, the antepartum subject carries with her another potentially viable human being who deserves consideration. Optimal therapy should be directed at reestablishing an effective intravascular volume, maintaining adequate oxygen delivery to peripheral and central tissues, and the initiation of appropriate broad-spectrum antimicrobial agents to eradicate the causative pathogens.
Topics: Anti-Bacterial Agents; Blood Volume; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Respiratory Distress Syndrome; Shock, Septic
PubMed: 3539448
DOI: No ID Found -
Critical Care Clinics Jul 2003In the last 5 years, the understanding of the epidemiology and pathogenesis of pediatric sepsis, septic shock, and multiple organ failure has expanded greatly. There has... (Review)
Review
In the last 5 years, the understanding of the epidemiology and pathogenesis of pediatric sepsis, septic shock, and multiple organ failure has expanded greatly. There has also been a substantial increase in the number of successful randomized trials in which success has been measured as reduction in mortality in adults, children, and newborns. This article discusses these advances, updating the 1997 article on septic shock written by the author and by Dr. Robert E. Cunnion and following the format of the 1997 article.
Topics: Critical Care; Hemodynamics; Humans; Multiple Organ Failure; Pediatrics; Resuscitation; Risk Factors; Shock, Septic
PubMed: 12848313
DOI: 10.1016/s0749-0704(03)00013-7 -
Journal of Nippon Medical School =... Apr 2010The mortality rate of septic shock remains high. The guidelines of the Surviving Sepsis Campaign were published in 2004 and were revised in 2008. Steroid therapy is... (Review)
Review
The mortality rate of septic shock remains high. The guidelines of the Surviving Sepsis Campaign were published in 2004 and were revised in 2008. Steroid therapy is prominent in the guidelines but remains controversial. In this review, steroid therapy for septic shock is discussed with various landmark papers.
Topics: Adrenal Cortex Hormones; Evidence-Based Medicine; Health Promotion; History, 20th Century; History, 21st Century; Humans; Practice Guidelines as Topic; Shock, Septic; Treatment Outcome
PubMed: 20453417
DOI: 10.1272/jnms.77.67 -
Critical Care Clinics Apr 1988Septic shock may occur in otherwise normal individuals but is frequently a fatal sequel to infection in the elderly, the diabetic, or the debilitated patient. Mortality... (Review)
Review
Septic shock may occur in otherwise normal individuals but is frequently a fatal sequel to infection in the elderly, the diabetic, or the debilitated patient. Mortality rates range from 40 to 95 per cent depending both on host factors and on the speed of initiation of appropriate therapy. The complexities of shock pathophysiology and biochemistry are elusive, but certain hemodynamic derangements are clearly described and create obvious therapeutic imperatives. Correction of the supply-dependent phase of oxygen consumption is the cornerstone of supportive therapy. Survival is primarily dependent on the rapid delivery of the appropriate antibiotics, surgical drainage and debridement of any infected tissues or abscesses, and aggressive volume resuscitation at the very time early sepsis is diagnosed. Septic shock is a medical emergency.
Topics: Anti-Bacterial Agents; Critical Care; Glucocorticoids; Hemodynamics; Humans; Oxygen Consumption; Shock, Septic
PubMed: 3048584
DOI: No ID Found -
Clinics in Chest Medicine Jun 1996Cardiac dysfunction is common in sepsis and septic shock. An understanding of this pathophysiology is crucial in treatment of this disorder. This article reviews the... (Review)
Review
Cardiac dysfunction is common in sepsis and septic shock. An understanding of this pathophysiology is crucial in treatment of this disorder. This article reviews the numerous studies of septic shock in humans that focus on cardiovascular physiology, briefly addresses the possible etiology, and concludes with therapeutic implications.
Topics: Humans; Prognosis; Shock, Septic; Ventricular Dysfunction, Left; Ventricular Dysfunction, Right
PubMed: 8792063
DOI: 10.1016/s0272-5231(05)70311-7 -
The American Journal of Emergency... Aug 2023
Topics: Humans; Shock, Septic; Sepsis; Prognosis
PubMed: 37270359
DOI: 10.1016/j.ajem.2023.05.033