Clinical management of sepsis

Lam, S. Y.; Lau, Arthur Chun‐Wing; Lam, R Pk; Wu, Yan

doi:10.12809/hkmj165057

Cited by 8 publications

(8 citation statements)

References 48 publications

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“…These findings emphasize the importance of shock reversal with concomitant "decatecholamisation", to be performed as quickly as possible [89][90][91][92].…”

Section: Discussionmentioning

confidence: 62%

The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

et al. 2021

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Hemodynamic instability due to dysregulated host response is a life-threatening condition requiring vasopressors and vital organ support. Hemoadsorption with Cytosorb has proven to be effective in reducing cytokines and possibly in attenuating the devastating effects of the cytokine storm originating from the immune over-response to the initial insult. We reviewed the PubMed database to assess evidence of the impact of Cytosorb on norepinephrine needs in the critically ill. We further analyzed those studies including data on control cohorts in a comparative pooled analysis, defining a treatment effect as the standardized mean differences in relative reductions in vasopressor dosage at 24 h. The literature search returned 33 eligible studies. We found evidence of a significant reduction in norepinephrine requirement after treatment: median before, 0.55 (IQR: 0.39–0.90); after, 0.09 (0.00–0.25) μg/kg/min, p <0.001. The pooled effect size at 24 h was large, though characterized by high heterogeneity. In light of the importance of a quick resolution of hemodynamic instability in the critically ill, further research is encouraged to enrich knowledge on the potentials of the therapy.

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“…These findings emphasize the importance of shock reversal with concomitant "decatecholamisation", to be performed as quickly as possible [89][90][91][92].…”

Section: Discussionmentioning

confidence: 62%

The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

et al. 2021

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“…12 Although it is generally agreed that early initiation of therapy is key to surviving sepsis, controversies remain regarding the initial rate and choice of fluids, the role and choice of inotropes, the identification of infection sources with imaging and other techniques, the use of appropriate antibiotics, and the optimal microbiological workup. [13][14][15][16][17] The ED occupies a critical position in a patient's journey of sepsis care and plays an important role in the early identification and treatment of sepsis. 17 Despite frequent encounters with sepsis in EDs, few studies in Hong Kong have investigated sepsis care.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15][16][17] The ED occupies a critical position in a patient's journey of sepsis care and plays an important role in the early identification and treatment of sepsis. 17 Despite frequent encounters with sepsis in EDs, few studies in Hong Kong have investigated sepsis care. Yang et al 18 studied patients with sepsis and septic shock in a tertiary university teaching hospital and found no significant change in the in-hospital mortality rate after the implementation of sepsis guidelines (pre-implementation: 29.6% in 2009; post-implementation: 35.3% in 2010).…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional study on emergency department management of sepsis

Hung

Lam

et al. 2018

Hong Kong Med J

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“…O bundles recomendado para um resultado mais favorável, de acordo com o sepsis-3 (Singer et al, 2016), dispõe de algumas medidas importantes, entre elas o tratamento adequado que deve ser iniciado em até uma hora, a antibioticoterapia de amplo espectro o mais brevemente possível, ainda nesse pacote de medidas recomendadas citamos a ressuscitação volêmica associada a constante reavaliação (Lam et al, 2017).…”

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Internamentos por septicemia nas capitais brasileiras, no período de 1999 a 2016 e a sua relação com o Índice de Desenvolvimento Humano

Rosário

Martins

Schwab

et al. 2021

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Objetivos: demonstrar a série histórica de internamentos por sepse no Brasil, quais as capitais e regiões mais acometidas, bem como, se essas internações tiveram crescimento, em que proporção ocorreram e qual a relação com o Índice de Desenvolvimento Humano (IDH). Métodos: Foi realizado um estudo epidemiológico de série temporal com dados dos internamentos por septicemia nas capitais brasileiras de 1999 a 2016, obtidos do Sistema de Informações Hospitalares do Ministério da Saúde (SIH) e IDH das mesmas no período. Foram calculados os indicadores de internamentos para a metade de cada triênio do período obtido. Modelos de regressão linear e de Poisson foram realizados para verificar a tendência temporal e coeficientes de correlação de Pearson ou Spearman para correlação com o IDH. Resultados: houve aumento significativo de internamentos em algumas capitais, tais como: Boa Vista, Maceió, Porto Velho e Rio de Janeiro, e decréscimo em Campo Grande e Goiânia. A maior média de internamentos ocorreu em Porto Velho com 26.443,7 e a menor média em Teresina 171,3. Os coeficientes de correlação entre o total de internamentos e o IDH de cada capital registraram correlação positiva e significativa para Belo Horizonte, Boa Vista, São Paulo e Vitória. Conclusão: os internamentos por sepse tiveram mais acréscimos que decréscimos e a correlação com o IDH mostrou que quanto maior o IDH, maior fica o índice de internamentos, sugerindo que com taxas maiores desse IDH, torna-se possível fornecer uma estrutura adequada e um melhor desempenho no reconhecimento e desfecho da sepse.

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Clinical management of sepsis

Cited by 8 publications

References 48 publications

The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

Cross-sectional study on emergency department management of sepsis

Internamentos por septicemia nas capitais brasileiras, no período de 1999 a 2016 e a sua relação com o Índice de Desenvolvimento Humano

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