2017
DOI: 10.1097/ccm.0000000000002262
|View full text |Cite
|
Sign up to set email alerts
|

Increased Time to Initial Antimicrobial Administration Is Associated With Progression to Septic Shock in Severe Sepsis Patients

Abstract: Objective To determine if time to initial antimicrobial is associated with progression of severe sepsis to septic shock. Design Retrospective cohort Setting 656 bed urban academic medical center Patients Emergency department patients ≥18 years of age with severe sepsis and/or septic shock and antimicrobial administration within 24 hours. Patients with shock on presentation were excluded. Interventions N/A. Measurements and Main Results We identified 3,929 severe sepsis patients, with overall mortalit… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...
2
1
1
1

Citation Types

5
103
0
5

Year Published

2019
2019
2023
2023

Publication Types

Select...
5
1
1

Relationship

0
7

Authors

Journals

citations
Cited by 153 publications
(113 citation statements)
references
References 23 publications
5
103
0
5
Order By: Relevance
“…The chaotic administration of these therapies decreases the probability of benefit; the ICU could be considered the ideal place for protocols intended to more adequately organize therapies . Good practice requires prompt resuscitation, early antibiotic administration, protective mechanical ventilation, and early nutrition, preferably enteral. Evaluating nutrition risk and body composition can define nutrition therapy strategy.…”
Section: Discussionmentioning
confidence: 99%
See 2 more Smart Citations
“…The chaotic administration of these therapies decreases the probability of benefit; the ICU could be considered the ideal place for protocols intended to more adequately organize therapies . Good practice requires prompt resuscitation, early antibiotic administration, protective mechanical ventilation, and early nutrition, preferably enteral. Evaluating nutrition risk and body composition can define nutrition therapy strategy.…”
Section: Discussionmentioning
confidence: 99%
“…These uncertainties should not deter nutrition therapy in critically ill patients, that is, devaluing it because of presumed inefficiency in reducing mortality could be an equivalent sin. In critical illness, there are few therapies that unequivocally reduce mortality, including early resuscitation and the use of broad‐spectrum antibiotics . Nutrition therapy should be seen more as a support for other therapies and an additional resource among a set of measures to decrease suffering and improve quality of life in survivors.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Data from clinical studies support early antibiotics as a critical intervention for improving mortality from sepsis and development of end-organ dysfunction. Mortality from sepsis is 5 times higher when the initial antibiotic choice is inappropriate (48), and increased time to antibiotic administration is associated with progression to septic shock (49). Activation of the innate immune response following infection is regulated by various cellular pathways, including autophagy, a highly conserved pathway involved in clearing damaged proteins and organelles from cells.…”
Section: Molecular Pathways Of Lung Injurymentioning
confidence: 99%
“…Despite these efforts to better define sepsis, accurate diagnosis of sepsis remains a major clinical challenge. At the same time, delay of antibiotic treatment initiation in patients at stake to develop severe sepsis and septic shock by only few hours is associated with increased mortality (Ferrer et al, 2014;Whiles et al, 2017;Peltan et al, 2017). Considerable improvement of sepsis treatment thus lies in expediting its diagnosis, i.e., by designing reliable tools for early identification of patients developing sepsis.…”
Section: Introductionmentioning
confidence: 99%