New Perspectives on the Management of Septic Shock in the Cancer Patient

Toney, John F.; Parker, Margaret M.

doi:10.1016/s0891-5520(05)70298-1

Cited by 5 publications

(2 citation statements)

References 84 publications

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“…Cardiac contractile dysfunction has been documented in both patients and experimental animal models of sepsis [8, 9, 10, 11, 12]. Available evidence suggests that septic cardiac dysfunction is not associated with histologic abnormalities [9, 13].…”

Section: Discussionmentioning

confidence: 99%

ECG Changes during Septic Shock

et al. 2002

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We have previously found that skeletal muscle becomes electrically inexcitable in septic patients. Work in an animal model suggests that a decrease in the available sodium current underlies the loss of electrical excitability. We examined ECGs from patients during periods of septic shock to determine whether there were any ECG abnormalities that might suggest a similar loss of excitability in cardiac tissue during sepsis. Fourteen out of 17 patients had low or significantly decreased QRS amplitudes during septic shock; 8 of 17 had long or increased QRS duration with or without bundle branch block. The mean decrease in QRS amplitude in septic patients was 41%, significantly higher than in controls where no consistent decrease in QRS amplitude was found (p < 0.01). In patients who recovered from septic shock, the QRS amplitude and the increased QRS duration both returned to normal. We conclude that there is a loss of QRS amplitude during septic shock that may be due to altered cardiac excitability.

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Section: Discussionmentioning

confidence: 99%

ECG Changes during Septic Shock

et al. 2002

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“…Overall, the prevalence of sepsis and the resulting mortality in animals as compared to human patients undergoing chemotherapy is much lower (sepsis 1-9% versus 45% and mortality 2-4% versus 30%). 26,28,[31][32][33][34][35][36] No death occurred during this study. Therefore, it is difficult to explain why animals in both groups and overall demonstrated benefit if receiving prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Trimethoprim‐Sulfadiazine during Chemotherapy in Dogs with Lymphoma and Osteosarcoma: A Double‐Blind, Placebo‐Controlled Study

Chretin

Rassnick

Shaw

et al. 2007

Veterinary Internal Medicne

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Background: The administration of chemotherapy is associated with risk for morbidity. Management of chemotherapyrelated morbidity in veterinary oncology has been primarily supportive.Hypothesis: The purpose of this study was to evaluate the effect of prophylactic antimicrobial use on chemotherapyassociated morbidity in dogs with lymphoma or osteosarcoma.Animals: Dogs presenting with histologically confirmed osteosarcoma or lymphoma were eligible. Methods: Patients were randomized to receive placebo or trimethoprim-sulfadiazine for 14 days after their first doxorubicin chemotherapy. Both owner and clinician were blinded with respect to treatment. Patient assessment included CBC, physical examination and performance, and toxicosis grading on days 7 and 14. Investigated outcomes were hospitalization, suspicion of infection, gastrointestinal toxicity, neutropenia, nonhematologic toxicity, and quality of life.Results: Seventy-three dogs were enrolled; 34 had osteosarcoma, and 39 had lymphoma. Dogs receiving trimethoprimsulfadiazine (n 5 36) had a significantly reduced hospitalization rate (P 5.03), nonhematologic toxicity (P 5 0.039), grade 2-4 nonhematologic toxicity (P , .0001), grade 2-4 gastrointestinal toxicity (P 5 .007). and altered performance (P 5 .015). By group, dogs with osteosarcoma (n 5 34) that received the antimicrobial experienced fewer occurrences of nonhematologic toxicity (P 5.02) and less severe nonhematologic toxicity (P 5 .038). Dogs with lymphoma (n 5 39) had significant reductions in the occurrence of hospitalization (P 5.035), severity of nonhematologic toxicity (P 5 .036), and alterations of performance (P 5 .015).Conclusions: The use of prophylactic trimethoprim-sulfadiazine has benefit in reducing morbidity in dogs with osteosarcoma or lymphoma during the first 14 days after treatment with doxorubicin.

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Sepsis

Shelton¹

1999

Seminars in Oncology Nursing

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New Perspectives on the Management of Septic Shock in the Cancer Patient

Cited by 5 publications

References 84 publications

ECG Changes during Septic Shock

ECG Changes during Septic Shock

Prophylactic Trimethoprim‐Sulfadiazine during Chemotherapy in Dogs with Lymphoma and Osteosarcoma: A Double‐Blind, Placebo‐Controlled Study

Sepsis

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