Sepsis in internal wards: results of an Italian multicenter prospective study
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Sepsis is a frequent inflammatory disease with a high mortality and morbidity rate. Most of the data about epidemiology, management and prognosis of patients with sepsis came mainly from studies conducted within Intensive Care Units (ICUs). A consistent number of studies suggest that a proportion of patients with sepsis and severe sepsis are admitted to internal medicine units, and not transferred to an ICU. In this article, we presented the data of an Italian study, a multicenter study, evaluating consecutive patients, with an objective diagnosis of sepsis treated in internal medicine units.Sepsis is a frequent inflammatory disease with a high mortality and morbidity rate. Most of the data about epidemiology, management and prognosis of patients with sepsis came mainly from studies conducted within Intensive Care Units (ICUs). A consistent number of studies suggest that a proportion of patients with sepsis and severe sepsis are admitted to internal medicine units, and not transferred to an ICU. In this article, we presented the data of an Italian study, a multicenter study, evaluating consecutive patients, with an objective diagnosis of sepsis treated in internal medicine units.
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Organ dysfunction
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all original.I Indeed, this has been the conclusion of all previous studies, and that it is also observed in saliva can hardly be described as surprising.Thirdly, the only way in which it would be possible to prove any direct relation between the oestriol to progesterone ratio and the initiation of
Presentation (obstetrics)
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Sepsis is a potentially fatal condition and is becoming increasingly frequent, yet health professionals are often unable to recognise its symptoms. It is the body's exaggerated response to infection and, if left untreated, will lead to severe sepsis, multi-organ failure and death. Nurses play a vital role in identifying patients with sepsis and starting essential treatment. This article looks at how sepsis can be identified and effectively treated to improve survival.
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Several patients in the A&E and AMU departments are not managed optimally, which ultimately leads to increased morbidity and mortality. Many staff working in both departments were unaware of the existing trust sepsis pathway and Sepsis Six protocol for management of severe sepsis. To assess the
Surviving Sepsis Campaign
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Abstract Background: Sepsis was recently redefined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. With this redefinition (Sepsis-3), clinical and microbiological characteristics of patients with sepsis may differ from the patients fulfilling the previous described definition (Sepsis-2). Purpose: To describe differences in clinical and microbiological characteristics of sepsis episodes between Sepsis-3 and Sepsis-2. The secondary aim was to compare blood culture outcomes between episodes fulfilling Sepsis-3 and Sepsis-2 criteria, respectively. Methods: A prospective study design was used to include patients presenting with clinically suspected sepsis in the emergency department. Six blood culture bottles were collected from each patient. Blood cultures were described as having clinically relevant growth, contaminant growth, or no growth. Clinical and laboratory data were collected from medical records and the laboratory information system. Results: The analysis included 549 episodes. There were 387/549 (70.5%) Sepsis-3 and 443/549 (80.7%) Sepsis-2 episodes. In total, 369/549 (67.2%) episodes fulfilled both Sepsis-3 and Sepsis-2 criteria. Blood cultures were positive for clinically relevant growth in 140/387 (36.1%) and 155/443 (35.0%) episodes in Sepsis-3 and Sepsis-2, respectively. Other clinical and microbiological characteristics did not differ between Sepsis-3 and Sepsis-2. Conclusions: A high proportion of patients included through a sepsis alert system fulfilled both Sepsis-3 and Sepsis-2 criteria. The performance of blood cultures in detection of microorganisms was poor and were similar in Sepsis-3 and Sepsis-2 patients.
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The aim of this study was to evaluate the effect of the Surviving Sepsis Campaigns on mortality rates, before and after the second surviving sepsis publication, and to assess whether patients with sepsis being admitted to the ICU had a lower APACHE II score on admission. Patients with sepsis, who require ICU care, have an extremely poor prognosis. It has been shown that the mortality rates range from 20.7% (severe sepsis) to 45.7% (septic shock) [1]. The surviving sepsis campaign was initiated in 2002. The first, second and third publications were published in 2004, 2008 and 2012 respectively [2].
Surviving Sepsis Campaign
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Severe sepsis in children was a major subject and problem in the field of the Critical Care Medicine.Although effective antibiotics and supportive treatment for organ failure can be used to treat sepsis,mortality of septic children was high.Recently,continuous blood purification was widely used to treat sepsis,systemic inflammatory response syndrome and multiple organ dysfunction syndromes and has better effect.Continuous blood purification was considered as effective treatment for severe sepsis.
Organ dysfunction
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Since the definition of sepsis has been first proposed in 1991, the main content of the definition has been developed by infection + systemic inflammatory response syndrome as infection + organ dysfunction, and organ dysfunction is indicated by an increase in sequential organ failure assessment(SOFA) score.These are components of Sepsis-3 which was published in 2016.In Sepsis-3, the SOFA score in the identification and diagnosis of sepsis plays an important role, but Sepsis-3 was mainly used in adults, how to adjust it to children, some questions and details were proposed in this article.
Key words:
Sepsis; Diagnosis; Children,
SOFA score
Organ dysfunction
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