The initial resuscitation of septic shock

Cinel, İsmail; Kasapoğlu, Umut Sabri; Gül, Fethi; Dellinger, R Phillip

doi:10.1016/j.jcrc.2020.02.004

Cited by 35 publications

(22 citation statements)

References 125 publications

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“…The results have been contradictory as to its usefulness. Studies have shown that qSOFA is more specific but less sensitive than having two of four SIRS criteria for early identification of infection induced organ dysfunction [40][41][42][43]. Neither SIRS nor qSOFA are ideal screening tools for sepsis and the bedside clinician needs to understand the limitations of each.…”

Section: Rationalementioning

confidence: 99%

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021

et al. 2021

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Section: Rationalementioning

confidence: 99%

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021

et al. 2021

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“…Moreover, we also emphasize the importance of UO in the hemodynamic management of septic shock. Hemodynamic support for patients with septic shock is crucial ( 29 ), including the use of large amounts of fluids in combination with vasopressors, and in some cases with inotropic agents. The hemodynamic targets for resuscitation of septic shock often rely on macro-hemodynamic parameters, including heart rate, mean arterial pressure, and central venous pressure.…”

Section: Discussionmentioning

confidence: 99%

Urine Output Is Associated With In-hospital Mortality in Intensive Care Patients With Septic Shock: A Propensity Score Matching Analysis

Qiao

Mei

2021

Front. Med.

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Background: The relationship between urine output (UO) and in-hospital mortality in intensive care patients with septic shock is currently inconclusive.Methods: The baseline data, UO, and in-hospital prognosis of intensive care patients with septic shock were retrieved from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. By drawing receiver operating characteristic (ROC) curves and comparing the areas under the ROC curves (AUC) to determine the predictive value of UO for in-hospital mortality, and by drawing the Kaplan-Meier curves to compare the difference in in-hospital mortality between different groups of UO.Results: Before and after the propensity score matching (PSM) analysis, UO was always a risk factor for in-hospital mortality in patients with septic shock. The AUC of UO was comparable to the Sequential Organ Failure Assessment (SOFA) scoring system, while the AUC of combining UO and SOFA was greater than that of SOFA. The median survival time of the high-UO group (UO > 0.39 ml/kg/h, before PSM; UO > 0.38 ml/kg/h, after PSM) was longer than that of the low-UO group. Compared with the high-UO group, the hazard ratios (HR) of the low-UO group were 2.6857 (before PSM) and 1.7879 (after PSM).Conclusions: UO is an independent risk factor for septic shock. Low levels of UO significantly increase the in-hospital mortality of intensive care patients with septic shock. The predictive value of UO is comparable to the SOFA scoring system, and the combined predictive value of the two surpasses SOFA alone.

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“…The recent Rapid Treatment of Carnitine in Septic Shock (RACE) experiment examined the hypothesis that L-carnitine administration could minimize cumulative organ failure in septic shock patients. Another trial aiming to treat sepsis with the help of vitamin C and other fluids found that patients who received this innovative medication had a lower fatality rate [ 28 ].…”

Section: Reviewmentioning

confidence: 99%

Sepsis Management, Controversies, and Advancement in Nanotechnology: A Systematic Review

Choudhary¹

2022

Cureus

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Sepsis is a potentially dangerous infection that requires prompt identification and treatment. Emergency medicine physicians must grasp the clinical signs and laboratory results of direct and indirect organ failure, the source of infection management, and the criteria for treating sepsis and septic shock. The pathogenesis of sepsis is connected to inflammation and an excess of reactive oxygen and nitrogen species, which activate the pathogen-associated molecular pattern (PAMP)-pattern recognition receptor (PRR) and damageassociated molecular pattern (DAMP)-PRR signaling pathways. The development of rapid, sensitive, and precise techniques for sepsis diagnosis might be aided by nanotechnology, a part of nanomedicine. Nanoparticles (NPs) such as magnetic NPs, gold NPs, fluorescent (silica and quantum dots), and lipid-based NPs have all been discussed to contribute to the detection of sepsis-related microbial infections. Because of the intrinsic and unique features of these nano-sized systems, researchers are evaluating nanotechnologybased alternatives for sepsis control. Recent advances in nanotechnology-based technologies for sepsis detection and management are discussed in this study.Databases (PubMed, Medline, PMC, Google Scholar) were used to source various studies that were carried out on sepsis in terms of assessment, types, diagnosis, and treatment controversies, with more attention being given with a focus on the most recent data, principles, and management guidelines. Priority was also given to studies published within the last 11 years, using keywords such as "sepsis guidelines," "sepsis clinical," "septic risk factors," "sepsis and nano technology," "nano particles," "sepsis controversies," and "nano diagnostic" in the search. After a filtration process, the eight most relevant studies were selected to be included in this review. The filtration process included the use of both inclusion and exclusion criteria. The excluded studies were pediatric populations, obstetrical populations, and nanotechnology advancements dealing with other fields not relating to sepsis. The selected studies were also undertaken through a quality appraisal process using corresponding assessment tools. The selected articles were all highly informative about sepsis and the processes of diagnosis and treatment that are currently in use as well as those that are still being developed or implemented. Furthermore, we look at how nanomedicine in the application of nanomaterials can be employed to efficiently manage sepsis.

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The initial resuscitation of septic shock

Cited by 35 publications

References 125 publications

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021

Urine Output Is Associated With In-hospital Mortality in Intensive Care Patients With Septic Shock: A Propensity Score Matching Analysis

Sepsis Management, Controversies, and Advancement in Nanotechnology: A Systematic Review

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