scholarly journals Sepsis in obstetrics and gynecology

2019 ◽  
Vol 2 (1) ◽  
pp. 13-21
Author(s):  
Yevhen Grizhimalsky
Keyword(s):  
Septic Shock ◽  
Inflammatory Diseases ◽  
Modern Medicine ◽  
Infectious Complications ◽  
Obstetrics And Gynecology ◽  
The Past ◽  
Care Protocol ◽  
Modern Knowledge ◽  
Definition Of ◽  
Sepsis And Septic Shock

Despite certain advances in modern medicine, the incidence of inflammatory diseases in women does not decrease, and infectious complications continue to occupy a leading place in the structure of obstetric and gynecological pathology. Moreover, the incidence of such dangerous complications as septic shock tends to increase. Over the past 25 years, the definition of sepsis and septic shock has changed three times; an international intensive care protocol is updated every four years with the participation of dozens of leading organizations and experts. Thus, the urgency of the problem is obvious and requires from doctors of all specialty’s modern knowledge on early detection and timely, early targeted therapy for sepsis and septic shock in obstetrics.

The Role of Histones and Heparin in Sepsis: A Review

2021 ◽  
pp. 088506662199232
Author(s):  
Xiaojuan Zhang ◽  
Xin Li
Keyword(s):  
Septic Shock ◽  
Multiple Organ ◽  
Clinical Settings ◽  
The Past ◽  
Life Saving ◽  
Extracellular Histones ◽  
Sepsis And Septic Shock ◽  
Development And Management ◽  
Made In

Septic shock with multiple organ failure is a devastating situation in clinical settings. Through the past decades, much progress has been made in the management of sepsis and its underlying pathogenesis, but a highly effective therapeutic has not been developed. Recently, macromolecules such as histones have been targeted in the treatment of sepsis. Histones primarily function as chromosomal organizers to pack DNA and regulate its transcription through epigenetic mechanisms. However, a growing body of research has shown that histone family members can also exert cellular toxicity once they relocate from the nucleus into the extracellular space. Heparin, a commonly used anti-coagulant, has been shown to possess life-saving capabilities for septic patients, but the potential interplay between heparin and extracellular histones has not been investigated. In this review, we summarize the pathogenic roles of extracellular histones and the therapeutic roles of heparin in the development and management of sepsis and septic shock.

Septic Shock

1992 ◽  
Vol 7 (2) ◽  
pp. 90-100 ◽  
Author(s):  
Margaret M. Parker ◽  
Mitchell P. Fink
Keyword(s):  
Septic Shock ◽  
Supportive Care ◽  
Antimicrobial Therapy ◽  
Clinical Manifestations ◽  
Sepsis Syndrome ◽  
Adjunctive Treatment ◽  
Cardiovascular Changes ◽  
The Past ◽  
Sepsis And Septic Shock ◽  
Very High

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 producing the sepsis syndrome.

Sepsis

2020 ◽  
Author(s):  
Steven P LaRosa ◽  
Steven M. Opal
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Organ Dysfunction ◽  
Fluid Resuscitation ◽  
Multiorgan Failure ◽  
Sepsis Management ◽  
The Past ◽  
Sepsis And Septic Shock

Sepsis, along with the multiorgan failure that often accompanies this condition, is a leading cause of mortality in the intensive care unit. Although modest improvements in the prognosis have been made over the past two decades and promising new therapies continue to be investigated, innovations in the management of septic shock are still required. This chapter discusses the definitions, epidemiology, and pathogenesis (including microbial factors, host-derived mediators, and organ dysfunction) relating to sepsis. Management of severe sepsis and septic shock is also described.  This review contains 5 figures, 11 tables, and 99 references. Keywords:Organ dysfunction, sepsis, septic shock, infection, bacteremia, fluid resuscitation, vasopressor

New definition of sepsis and septic shock: What does it give us?

2017 ◽  
Vol 41 (1) ◽  
pp. 38-40
Author(s):  
A. Rodríguez ◽  
I. Martín-Loeches ◽  
J.C. Yébenes
Keyword(s):  
Septic Shock ◽  
Definition Of ◽  
Sepsis And Septic Shock

Sepsis

2020 ◽  
Author(s):  
Steven P LaRosa ◽  
Steven M. Opal
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Organ Dysfunction ◽  
Fluid Resuscitation ◽  
Multiorgan Failure ◽  
Sepsis Management ◽  
The Past ◽  
Sepsis And Septic Shock

Sepsis, along with the multiorgan failure that often accompanies this condition, is a leading cause of mortality in the intensive care unit. Although modest improvements in the prognosis have been made over the past two decades and promising new therapies continue to be investigated, innovations in the management of septic shock are still required. This chapter discusses the definitions, epidemiology, and pathogenesis (including microbial factors, host-derived mediators, and organ dysfunction) relating to sepsis. Management of severe sepsis and septic shock is also described.  This review contains 5 figures, 11 tables, and 99 references. Keywords:Organ dysfunction, sepsis, septic shock, infection, bacteremia, fluid resuscitation, vasopressor

scholarly journals Epidemiology of pediatric sepsis in the pediatric intensive care unit of king Abdulaziz Medical City, Jeddah, Saudi Arabia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohamed O. Humoodi ◽  
Mona A. Aldabbagh ◽  
Maher M. Salem ◽  
Yousef M. Al Talhi ◽  
Sara M. Osman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Saudi Arabia ◽  
Intensive Care ◽  
Mortality Rate ◽  
Pediatric Intensive Care ◽  
Medical City ◽  
Definition Of ◽  
Pediatric Sepsis ◽  
Sepsis And Septic Shock

Abstract Background Pediatric sepsis remains a significant cause of morbidity and mortality worldwide. This study aimed to identify the incidence of sepsis and septic shock among patients admitted to the pediatric intensive care unit (PICU) of a tertiary center in Saudi Arabia.  Patients' demographics and risk factors associated with sepsis-related mortality were also investigated. Methods A retrospective cohort study was conducted in the PICU of King Abdulaziz Medical City, Jeddah (KAMC-J). KAMC-J is a tertiary care hospital in the western region of Saudi Arabia. A total of 2389 patients admitted to the PICU of KAMC-J between January 1, 2013 and December 31, 2017 were screened and evaluated for sepsis using The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Results Of the 2389 total admissions to the PICU, 113 patients (4.9%) met the definition of Sepsis-3; 50.4% of the 113 patients met the definition of septic shock. Most patients (66.3%) were less than 6 years old, and 52.2% were male. Eight-five patients (75.2%) had underlying comorbidities. The respiratory system was the most common primary site of infection (57.5%). Bacterial and viral infections were the most common infectious etiology with reported rates of 29.2 and 21.2%, respectively. The median duration of PICU stay was 8 days and the 28-day PICU mortality rate was 23.9%. A Pediatric Sequential Organ Failure Assessment (pSOFA) Score greater than four and a pre-existing percutaneous central venous catheter were associated with a significant increase in mortality, with adjusted odds ratios of 3.6 (95% confidence interval: 1.30–9.93) and 9.27 (95% confidence interval: 1.28–67.29), respectively. Conclusions The incidence of sepsis in our institution is comparable to that reported internationally; however, the mortality rate is higher than that of developed countries. Nationwide studies identifying sepsis epidemiology are needed to improve the outcome of pediatric sepsis. Following international guidelines for central-line insertion and maintenance is of paramount importance.

scholarly journals Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate

2021 ◽  
Vol 8 ◽  
Author(s):  
René López ◽  
Rodrigo Pérez-Araos ◽  
Fernanda Baus ◽  
Camila Moscoso ◽  
Álvaro Salazar ◽  
...  
Keyword(s):  
Septic Shock ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Lower Survival Rate ◽  
Lower Survival ◽  
And Performance ◽  
Lactate Levels ◽  
Definition Of ◽  
Sepsis And Septic Shock

The number of oncological patients (OP) admitted to intensive care units (ICU) for sepsis/septic shock has dramatically increased in recent years. The definition of septic shock has been modified, adding hyperlactatemia as a severity biomarker for mortality. However, it remains poorly reported in septic OP. We performed a retrospective analysis from a prospective database of sepsis/septic shock patients admitted to our ICU between September 2017 and September 2019 and followed until day 90. We identified 251 patients and 31.9% had active oncological comorbidity, mainly solid tumor (81.3%). Septic shock criteria were met for 112 (44.6%). Hyperlactatemia was observed in 136 (54.2%) patients and this was associated with a lower survival rate. Overall 90-day mortality was 15.1%. In OP vs. non-OP, hyperlactatemia was more frequent (65% vs. 49.1%, p = 0.013) and associated with lower survival (65.4% vs. 85.7%, p = 0.046). In OP, poor performance status was also associated with lower survival (HR 7.029 [1.998–24.731], p = 0.002) In an adjusted analysis, cancer was associated with lower 90-day survival (HR 2.690 [1.402–5.160], p = 0.003). In conclusion, septic OP remains a high mortality risk group in whom lactate levels and performance status could help with better risk stratification.

scholarly journals Recent advances in the pathophysiology and management of sepsis: a review

2021 ◽  
Vol 22 (2) ◽  
pp. 133-145
Author(s):  
B.A. Adegboro ◽  
J. Imran ◽  
S.A. Abayomi ◽  
E.O. Sanni ◽  
S.A. Biliaminu
Keyword(s):  
Septic Shock ◽  
Sofa Score ◽  
Clinical Status ◽  
Altered Mental Status ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Acute Increase ◽  
Haematological Changes ◽  
Definition Of ◽  
Sepsis And Septic Shock

Sepsis is a syndrome consisting of physiological, pathological and biochemical anomalies caused by infectious agents. It causes clinical organ dysfunction, which is identified by an acute increase in the Sequential (sepsis-related) Organ Failure Assessment (SOFA) score of two or more points. SOFA score is a score of three components that can be easily used at the bedside to track the clinical status of a patient while on admission, and these are altered respiratory rate of ≥ 22 breaths/minute, altered mental status, and systolic blood pressure of ≤ 100 mmHg. A patient with SOFA score of ≥ 2 has an attributable 2 - 25-fold increased risk of mortality compared to a patient with SOFA score of ˂ 2. This present review provides information on the new definition of sepsis and septic shock, aetiology, pathophysiology, biochemical, pathological and haematological changes, morbidity and mortality parameters, management, andprognostic factors in patients with sepsis. Key words: Sepsis, septic shock, SOFA score, pathophysiology, management bundles

New definition of sepsis and septic shock: What does it give us?

2017 ◽  
Vol 41 (1) ◽  
pp. 38-40 ◽  
Author(s):  
A. Rodríguez ◽  
I. Martín-Loeches ◽  
J.C. Yébenes
Keyword(s):  
Septic Shock ◽  
Definition Of ◽  
Sepsis And Septic Shock
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