Epidemiology and prognostic factors in severe sepsis/septic shock. Evolution over six years

Azkárate, I.; Choperena, G.; Salas, E.; Sebastián, R.; Lara, Gabriel Alejandro ro Magdaleno; Elósegui, Ignacio Moriones; Barrutia, L.; Eguibar, Itziar; Salaberría, Ramón.

doi:10.1016/j.medine.2015.01.002

Cited by 20 publications

(14 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Various theses assert that septic shock should be managed by antimicrobial treatment, removing the source of infection, and maintaining hemodynamic support. 1 Septic shock has a high rate of fatality, so excessive treatment with medicine sometimes occurs with the aim of stabilizing patients. Norepinephrine is the preferred medicine to maintain hemodynamic support when volume infusion or dopamine treatment has failed.…”

Section: Discussionmentioning

confidence: 99%

“…However, this medicine sometimes causes ischemic necrosis by decreasing perfusion to end organs. 1 Several studies about the connection between ischemic necrosis and the use of norepinephrine have been reported. [2][3][4] However, no previous studies describe severe functional and aesthetic sequela of the upper lip and all fingers and toes after the use of norepinephrine.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Ischemic Necrosis of Upper Lip, and All Fingers and Toes After Norepinephrine Use

Shin

Roh

Lee

et al. 2016

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

A 68-year-old woman with necrosis of total finger, toe, and upper lip was requested by department of internal medicine. She was diagnosed with septic shock and treated with norepinephrine 10 days ago. Norepinephrine is an often-used medicine for normalizing blood pressure in septic shock patients. Norepinephrine stimulates adrenergic receptors, causing vasoconstriction and the rise of blood pressure. These peripheral vasoconstrictions sometimes lead to ischemic changes in end organs. In this case report, the authors describe ischemic necrosis of the upper lip and all fingers and toes after norepinephrine use in a patient in the intensive care unit.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Ischemic Necrosis of Upper Lip, and All Fingers and Toes After Norepinephrine Use

Shin

Roh

Lee

et al. 2016

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

show abstract

“…In addition, severe thrombocytopenia, rather than thrombocytopenia, is commonly known to have a poor prognosis. [18][19][20] Severe thrombocytopenia is associated with a high risk of organ bleeding. Normally, in patients who are not experiencing surgery, platelets higher than 20 Â 10 9 /l without a tendency of bleeding is permissible, whilst in the department of surgery, a platelet count higher than 50 Â 10 9 /l is required in order to avoid vital organ bleeding.…”

Section: Discussionmentioning

confidence: 99%

Leukemoid reaction with severe thrombocytopenia in a dying patient: a case report and literature review

Huang

2021

J Int Med Res

View full text Add to dashboard Cite

Leukemoid reaction complicated by thrombocytopenia is rare, usually seen in patients with malignant conditions, and is often associated with poor prognosis. Here, the case of a 28-year-old healthy female without exceptional past medical history, who suffered from severe vaginal infection, is reported. Although symptoms improved, the white blood cell (WBC) count continued to increase up to 78 460 cells/µl, however, the patient continued to improve and the outcome was good. The case revealed that an increasing WBC count may not change in synchrony with clinical symptoms. When faced with this scenario, procalcitonin measurements may play an important role in differentiating diagnosis and guiding treatment.

show abstract

“…Sepsis defined as infection-induced organ dysfunction is a common critical disease with high mortality and is the leading cause of death in intensive care unit [1,2]. Furthermore, the incidence of sepsis in ICU is increasing year by year, reaching more than 30% [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

The effect of recombinant human thrombopoietin (rhTPO) on sepsis patients with acute severe thrombocytopenia: a study protocol for a multicentre randomised controlled trial (RESCUE trial)

et al. 2019

View full text Add to dashboard Cite

Background: Sepsis is still a common critical disease with high morbidity and mortality in intensive care unit. Despite published guidelines for sepsis, development of antibiotic therapy and advanced organ support technologies, the mortality of sepsis patients is still 25% or more. It is necessary to distinguish the subtypes of sepsis, and the targeted therapy for the patients need to be explored. Platelets have various biological functions in hemostasis and thrombosis, host defense, inflammatory/immune responses and tissue repair/regeneration. Moreover, severe thrombocytopenia or sustained thrombocytopenia was closely associated with multiply organ dysfunction and higher mortality in sepsis patients. The clinical therapies for thrombocytopenia are platelet transfusion and platelet-elevating drugs. However, platelet transfusion has many defects in clinical practice in sepsis patients, and the impact of platelet-elevating drugs for sepsis patients is still unclear. RESCUE trial is aim to explore the effect of a platelet-elevating drug, recombinant human thrombopoietin (rhTPO), as an effective rescue therapy on sepsis patients with acute severe thrombocytopenia. Methods: It is a randomized, open-label, multi-center, controlled trial in 5 tertiary academic hospitals including medical, surgical or general ICUs. In this study, a total of 200 sepsis patients with severe thrombocytopenia will be randomly assigned in a 1:1 ratio to the control and rhTPO group. The patients will be followed up to 28 days after randomization. All patients in two groups receive the same treatment based on the guideline of Surviving Sepsis Campaign. Primary outcome is 28-day mortality. Secondary outcomes are the changes of PCs, blood transfusion, biomarkers of infection and organ function, days free from advanced organ support, drug-related adverse events, the length of ICU and hospital stay. Discussion: RESCUE trial is the first randomized controlled trial to explore the impact of rhTPO for severe thrombocytopenia in sepsis patients diagnosed by sepsis-3.0 standard. Furthermore, RESCUE trial results will be of significant clinical value on the targeted therapy and add clinical evidence that rhTPO is an effective rescue therapy for these sepsis patients.

show abstract

Epidemiology and prognostic factors in severe sepsis/septic shock. Evolution over six years

Cited by 20 publications

References 26 publications

Ischemic Necrosis of Upper Lip, and All Fingers and Toes After Norepinephrine Use

Ischemic Necrosis of Upper Lip, and All Fingers and Toes After Norepinephrine Use

Leukemoid reaction with severe thrombocytopenia in a dying patient: a case report and literature review

The effect of recombinant human thrombopoietin (rhTPO) on sepsis patients with acute severe thrombocytopenia: a study protocol for a multicentre randomised controlled trial (RESCUE trial)

Contact Info

Product

Resources

About