Articles: sepsis.
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Recent developments in the pathophysiology and treatment of sepsis have clearly shown the confusion produced by the imprecise terminology used to define the various facets of the sepsis process. The criteria required to diagnose bacteremia, sepsis, sepsis syndrome or septic shock vary from one author to the other. This inaccuracy accounts for the inability to compare the results of therapeutic investigation from different groups. The aim of this article is to point out the necessity of standardized terminology and to propose definitions which might be appropriate.
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Critical care medicine · May 1992
Comparative StudyRight ventricular dysfunction in septic patients.
To compare right ventricular ejection fraction in trauma and septic patients during the hyperdynamic circulatory phase of these states. ⋯ Hemodynamic measurements comparing septic and trauma patients showed increased cardiac output in both groups and no differences in the pulmonary resistance. Right ventricular ejection fraction in the septic patients was significantly reduced compared with the trauma patients. Therefore, we concluded that right ventricular contractility may be decreased in septic patients.
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Acta Anaesthesiol Scand · Apr 1992
Case ReportsAn outbreak of Klebsiella oxytoca septicemias associated with the use of invasive blood pressure monitoring equipment.
Seven cases of septicemia with piperacillin-resistant Klebsiella oxytoca (PRKO) occurred at 2-monthly intervals in a thoracic surgery intensive care unit. All PRKO isolates were serotyped, and phenotyped with a biochemical typing system. ⋯ PRKO of the epidemic phenotype was recovered from several non-patient transducer domes. The outbreak ended when transducer heads were disinfected and the use of non-patient domes was abolished.
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Although hepatocellular dysfunction occurs early in sepsis despite fluid resuscitation, it is unknown if an increased volume of resuscitation protects hepatocellular function. To study this, rats were subjected to sepsis by cecal ligation and puncture (CLP). These and sham-treated rats then received either 3 or 6 mL/100 g BW normal saline subcutaneously. ⋯ These results confirm the notion that the depression in hepatocellular function in early sepsis is not the result of any reduction of hepatic perfusion. The dissociation of increased hepatic blood flow from depressed hepatocellular function remains despite the larger volume of resuscitation. The hepatocellular dysfunction that occurs even in early sepsis cannot be corrected simply by increasing the volume of crystalloid resuscitation.