Surviving sepsis campaign: International guidelines for management of sepsis and septic shock in adults 2021 ‐ endorsement by the Scandinavian society of anaesthesiology and intensive care medicine

Rehn, Marius; Chew, Michelle; Olkkola, Klaus T.; Sigurðsson, Martin I; Yli‐Hankala, Arvi; Møller, Morten Hylander

doi:10.1111/aas.14045

Cited by 18 publications

(7 citation statements)

References 10 publications

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“…This concept has also been confirmed from the experimental results. The APACHE-II scoring system is a scoring method for assessing disease severity in critically ill patients [ 19 ]. Patients with severe sepsis may experience abnormal changes in physiological indicators at any time due to organ failure, such as electrolyte imbalance, severe acidosis, arrhythmia, and the APACHE-II score will also change accordingly.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Effect of Continuous Blood Purification Combined with Humanized Nursing in Patients with Severe Sepsis

Gan

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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This work aimed to explore the effect of humanized nursing on the patients’ recovery from severe sepsis based on continuous blood purification (CBP). 90 patients with severe sepsis were randomly and equally divided into a control group (basic intensive nursing + CBP) and a therapy group (humanized nursing + CBP). Before treatment and on the 7th and 14th days after treatment, indicators of patients were compared, including white blood cell (WBC), tumor necrosis factor (TNF-α), hepatic and renal function, C-reactive protein (CRP), brain natriuretic peptide (BNP), procalcitonin (PCT), and erythrocyte sedimentation rate (ESR). The mortality and nursing satisfaction were compared. After treatment, the saturation of pulse oxygen (SPO2) in the therapy group (85 ± 20 and 91 ± 9) was higher than that in the control group (78 ± 28 and 82 ± 18, respectively), and the lactic acid level (LAL) was greatly lower (2.8 ± 2.4 and 1.6 ± 0.9 vs. 4.3 ± 2.3 and 2.3 ± 2.7). The Acute Physiology and Chronic Health Evaluation II (APACHE-II) score after treatment was lower (13.67 ± 4.28 and 8.45 ± 5.12 vs. 17.34 ± 6.4 and 11.46 ± 4.23). The BNP, blood urea nitrogen (BUN), and CRP levels were decreased, and so did inflammatory indicators. The survival rate reached 71% and 47% in the therapy group and control group, respectively; and the nursing satisfaction was 97.80% and 26.67%, respectively. Humanized nursing combined with CBP could improve the therapeutic effect and speed up the recovery from severe sepsis.

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Section: Discussionmentioning

confidence: 99%

Therapeutic Effect of Continuous Blood Purification Combined with Humanized Nursing in Patients with Severe Sepsis

Gan

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Regarding clinical implication, our study was observational, and focused on ICU patients in which pneumonia was ruled out by chest imaging. Patients with pneumonia or those with sepsis-related organ failure should be treated with antibiotics without delay, as this may impact survival [ 32 ]. Considering the available evidence and the fact that the absence of respiratory sample on ICU day-1 was associated with a lower probability of being weaned from mechanical ventilation in our work, clinicians should make every effort to document and treat bacterial bronchitis, using all available tools (direct analysis of respiratory sample, biomarkers) to ascertain respiratory tract bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

Early antibiotic therapy is associated with a lower probability of successful liberation from mechanical ventilation in patients with severe acute exacerbation of chronic obstructive pulmonary disease

Deniel

Cour

Argaud

et al. 2022

Ann. Intensive Care

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Background While antibiotic therapy is advocated to improve outcomes in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) whenever mechanical ventilation is required, the evidence relies on small studies carried out before the era of widespread antibiotic resistance. Furthermore, the impact of systematic antibiotic therapy on successful weaning from mechanical ventilation was never investigated accounting for the competitive risk of death. The aim of the study was to assess whether early antibiotic therapy (eABT) increases successful mechanical ventilation weaning probability as compared to no eABT, in patients with AECOPD without pneumoniae, using multivariate competitive risk regression. Methods Retrospective analysis of patients admitted in 2 intensive care units (ICU) from 2012 to 2020 for AECOPD without pneumonia and requiring mechanical ventilation. eABT was defined as any anti-bacterial chemotherapy introduced during the first 24 h after ICU admission. The primary outcomes were the adjusted subdistribution hazard ratio (SHR) of the probability of being successfully weaned from mechanical ventilation (i.e. non-invasive and invasive ventilation) according to eABT status and accounting for the competitive risk of death. Results Three hundred and ninety-one patients were included, of whom 66% received eABT. eABT was associated with a lower probability of successful liberation from mechanical ventilation when accounting for the competing risk of death in multivariate analyses (SHR 0.71 [95% confidence interval, 0.57–0.89], p < 0.01), after adjustment with covariates of disease severity. This association was present in all subgroups except in patients under invasive mechanical ventilation on ICU day-1, in patients with ICU day-1 worst PaCO2 > 74 torr (median value) and in patients with a documented bacterial bronchitis at ICU admission. Ventilator-free days at day 28, ICU-free days at day 28 and invasive mechanical ventilation-free days at day 28, were significantly lower in the eABT group, while there was no significant difference in mortality at day 28 between patients who received eABT and those who did not. Conclusions eABT was independently associated with a lower probability of being successfully weaned from mechanical ventilation, suggesting that the clinician decision to overrule systematic administration of eABT was not associated with a detectable harm in AECOPD ICU patients without pneumonia.

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“…Sepsis,a severe, potentially fatal, organic dysfunction caused by infections or suspected infections,which has the characteristics of severe disease, rapid progression and low cure rate.Sepsis remains a major cause of morbidity and mortality worldwide, with increased burden in low-and middle-resource settings.The manifestations are various, such as fever, chills, palpitation, shortness of breath, shock,and mental symptoms,and so on.Sepsis can develop into SS [1][2] .As we all know, the application of antibiotics plays a crucial role in the treatment of sepsis.Current guidelines suggest that antibiotics administered within 1 hour of diagnosis can signi cantly improve patient outcomes [3] .According to a 2006 study of 2,731 adults with pyaemia showed that each 1h delay in antibiotic using resulted in a 7.6% increase in mortality.However,Taylor SP [4] et al found that there was no signi cant difference in the mortality of sepsis patients with a recognition delay of less than 6 hours or a drug administration delay of less than 1.5 hours through their study.Therefore, this study investigated the effect of rst-dose antibiotic delay intervals on the clinical e cacy of sepsis patients attending the emergency department. Methods 1.1Patient selection:A total of 452 patients with sepsis were retrospectively selected, which including 257 males and 195 females, from 2020.01 to 2022.12 in our hospital.We chose two diagnostic criteria for sepsis:digital signature of infection or suspected infection;digital signature of Sequential Organ Failure Assessmen,(SOFA), rises ≥ 2 points above the baseline.We de ned SS as persistent hypotension on the basis of sepsis,which need to maintain mean arterial pressure ≥ 8.67kPa or blood lactic acid ≥ 2 mmol/L on the basis of adequate blood volume supplementation with pressure raising drug.We de ned infected patients as those who were prescribed antibiotics within 12 hours of emergency triage and ordered to be used for blood or urine cultures and CRP, PCT, ,blood cells increased [5][6] .The primary outcome we considered in patients with sepsis was the in-hospital fatality rate.Exclusion criteria: Patients who do not meet the diagnosis of sepsis; Patients who with incomplete clinical data.…”

Section: Introductionmentioning

confidence: 99%

The relationship between first-dose antibiotic delay intervals and in-hospital mortality on patients with sepsis

Zhang

Huang

Bai

2023

Preprint

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Background To investigate the association between the time interval of antibiotic use and patient in-hospital mortality on sepsis patients, we quantified the time interval of first antibiotic administration in sepsis patients, namely diagnosis delay and administration delay, and explored the relationship between these delay times and patient prognosis.Methods A retrospective study of 452 patients with sepsis attending the emergency department from January 2020 to December 2022 was conducted to quantify the time interval of first antibiotic use, and use the Logistic analysis to evaluatethe the affect on prognosis and antibiotic use interval in these patients.Results Both delay in diagnosis and delay in administration of antibiotics were associated with in-hospital mortality, but there was no significant difference in diagnostic delay for less than 6 hours or administration delay for less than 3 hours when compared with the paired control group without delay.Conclusions Antibiotic delay in sepsis is associated with patient outcomes, but only for longer delays.There was no significant difference in in-hospital mortality between antibiotics use within 1 hour and 3 hours.

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Surviving sepsis campaign: International guidelines for management of sepsis and septic shock in adults 2021 ‐ endorsement by the Scandinavian society of anaesthesiology and intensive care medicine

Cited by 18 publications

References 10 publications

Therapeutic Effect of Continuous Blood Purification Combined with Humanized Nursing in Patients with Severe Sepsis

Therapeutic Effect of Continuous Blood Purification Combined with Humanized Nursing in Patients with Severe Sepsis

Early antibiotic therapy is associated with a lower probability of successful liberation from mechanical ventilation in patients with severe acute exacerbation of chronic obstructive pulmonary disease

The relationship between first-dose antibiotic delay intervals and in-hospital mortality on patients with sepsis

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