Year in review in Intensive Care Medicine 2014: III. Severe infections, septic shock, healthcare-associated infections, highly resistant bacteria, invasive fungal infections, severe viral infections, Ebola virus disease and paediatrics

Timsit, Jean‐François; Perner, Anders; Bakker, Jan; Bassetti, Matteo; Benoît, Dominique; Cecconi, Maurizio; Curtis, J. Randall; Doig, Gordon S.; Herridge, Margaret S.; Jaber, Samir; Joannidis, Michael; Papazian, Laurent; Peters, Mark; Singer, Pierre; Smith, Martin; Soares, Márcio; Torres, Antoni; Vieillard‐Baron, Antoine; Citerio, Giuseppe; Azoulay, Élie

doi:10.1007/s00134-015-3755-8

Cited by 21 publications

(10 citation statements)

References 78 publications

(56 reference statements)

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“…Sepsis is a life-threatening condition caused by an injurious host response to infection with an estimated incidence of over 19 million cases per year worldwide [ 1 , 2 ]. Sepsis plays a prominent role in patients admitted to intensive care units (ICUs) where it is highly associated with morbidity and mortality [ 3 ]. During sepsis, triggering of inflammatory and coagulation cascades, together with endothelial damage, invariably leads to activation of platelets [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Chronic antiplatelet therapy is not associated with alterations in the presentation, outcome, or host response biomarkers during sepsis: a propensity-matched analysis

et al. 2016

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PurposeSepsis is a major health burden worldwide. Preclinical investigations in animals and retrospective studies in patients have suggested that inhibition of platelets may improve the outcome of sepsis. In this study we investigated whether chronic antiplatelet therapy impacts on the presentation and outcome of sepsis, and the host response.MethodsWe performed a prospective observational study in 972 patients admitted with sepsis to the mixed intensive care units (ICUs) of two hospitals in the Netherlands between January 2011 and July 2013. Of them, 267 patients (27.5 %) were on antiplatelet therapy (95.9 % acetylsalicylic acid) before admission. To account for differential likelihoods of receiving antiplatelet therapy, a propensity score was constructed, including variables associated with use of antiplatelet therapy. Cox proportional hazards regression was used to estimate the association of antiplatelet therapy with mortality.ResultsAntiplatelet therapy was not associated with sepsis severity at presentation, the primary source of infection, causative pathogens, the development of organ failure or shock during ICU stay, or mortality up to 90 days after admission, in either unmatched or propensity-matched analyses. Antiplatelet therapy did not modify the values of 19 biomarkers providing insight into hallmark host responses to sepsis, including activation of the coagulation system, the vascular endothelium, the cytokine network, and renal function, during the first 4 days after ICU admission.ConclusionsPre-existing antiplatelet therapy is not associated with alterations in the presentation or outcome of sepsis, or the host response.Electronic supplementary materialThe online version of this article (doi:10.1007/s00134-015-4171-9) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Chronic antiplatelet therapy is not associated with alterations in the presentation, outcome, or host response biomarkers during sepsis: a propensity-matched analysis

et al. 2016

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“…Extensive transmission is reported through infected bodily fluids from patients or dead corpses, affecting family members, social workers, healthcare providers, and missionaries [9]. Secondary cases have challenged many countries admitting repatriated patients, raising important concerns about healthcare providers' safety [10,11]. Delayed transmission through sexual contact with survivors has been attributed to viral persistence in semen [9,11].…”

Section: Us Centers For Disease Control and Prevention (Cdc)mentioning

confidence: 99%

Planet’s population on the move, infections on the rise

Poulakou

Plachouras

2016

Intensive Care Med

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“…Bacteria, fungi and viruses or a combination of them cause these diseases (1). Sepsis and septic shock are the largest cause of mortality worldwide in the Intensive Care Units (ICU), MOF (2) constituting a high cost to in health systems (3).…”

Section: Introductionmentioning

confidence: 99%

A Randomized clinical trial of antioxidant therapy in patients with septic shock. Reference study to propose adjuvant therapy in patients with critical organic damage by COVID-19

Aisa-Álvarez

Pérez-Torres

Camarena-Alejo

et al. 2020

Preprint

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Background: Oxidative stress (OS) participates in the pathophysiology of patients with septic shock having multiple organ failure (MOF), ischemia-reperfusion injury and acute respiratory failure syndrome (ARDS). Antioxidants have been proposed in their therapy.Objective: To evaluate the effect of antioxidant treatment in patients with septic shock with MOF and levels OS after treatment.Research question: Will the administration of specific antioxidant therapy decrease deregulatory factors of oxidative stress and organ failure in patients with septic shock?Study design and Methods: Double-blind, placebo-controlled randomized clinical trial run in 2 ICU in Mexico City between May 2018 and January 2020. The random allocation sequence was generated using computer methods. Patients older than 18 years of either sex, with septic shock were included, were excluded when informed consent could not be obtained, they received chronic or recent use of steroids, statins, or antioxidants or if they had contraindications to the use of antioxidants. All antioxidants were administered by mouth or nasogastric tube during 5 days and were added to standard.Results: 97 patients were included with median age of 66 years. 20 were treated with MT and 18 with Vit C and they showed post-treatment decreased SOFA scores [p=0.007 and p<0.001 respectively]. Also, total antioxidant capacity (TAC) was improved by NAC. All patients had decreased basal levels of Vit C and patients that received Vit C had decreased levels of the NO3−/NO2− (p=0.02) and RCP levels [p=0.045]. Procalcitonin (PCT) levels were reduced by Vit E, [p=0.047], NAC; [p=0.001] and MT [p=0.045]. LPO was reduced in patients that received MT p=0.042 Conclusion: In septic shock, antioxidant therapy associated with standard intensive care unit therapy reduces MOF, the oxidative and inflammatory state. These results could be a reference to use adjuvant antioxidant therapy in patients with septic shock in COVID19.Trial Registration: ClinicalTrials.gov Identifier: NCT 03557229

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Year in review in Intensive Care Medicine 2014: III. Severe infections, septic shock, healthcare-associated infections, highly resistant bacteria, invasive fungal infections, severe viral infections, Ebola virus disease and paediatrics

Cited by 21 publications

References 78 publications

Chronic antiplatelet therapy is not associated with alterations in the presentation, outcome, or host response biomarkers during sepsis: a propensity-matched analysis

Chronic antiplatelet therapy is not associated with alterations in the presentation, outcome, or host response biomarkers during sepsis: a propensity-matched analysis

Planet’s population on the move, infections on the rise

A Randomized clinical trial of antioxidant therapy in patients with septic shock. Reference study to propose adjuvant therapy in patients with critical organic damage by COVID-19

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