Articles: sepsis.
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Multicenter Study Observational Study
Predicting early diagnosis of intensive care unit-acquired weakness in septic patients using critical ultrasound and biological markers.
Early diagnosis of intensive care unit-acquired weakness (ICUAW) is crucial for improving the outcomes of critically ill patients. Hence, this study was designed to identify predisposing factors for ICUAW and establish a predictive model for the early diagnosis of ICUAW. ⋯ Conclusively, a nomogram model is constructed for diagnosing ICUAW in septic patients, which is simple and rapid and allows for visual representation, with excellent diagnostic capability.
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Intensive care medicine · Jan 2025
Multicenter Study Observational StudyLeft ventricular diastolic dysfunction is prevalent but not associated with mortality in patients with septic shock.
Prognostic impact of left ventricular diastolic dysfunction (LVDD) in septic shock patients has not been determined using current diagnostic guidelines. We assessed the relation between LVDD during the first 3 days following intensive care unit (ICU) admission for septic shock and Day-28 mortality. ⋯ LVDD was highly prevalent in patients with septic shock but not associated with mortality. It appeared improving in one-third of survivors.
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Multicenter Study Observational Study
Steroid therapy for patients with septic shock: A multicenter observational study conducted in Japan.
Objective The Clinical Practice Guidelines for the Management of Sepsis and Septic Shock weakly recommend steroids for septic shock resistant to fluid resuscitation and vasopressors. This study aimed to describe the clinical practices for septic shock in the real world and to compare the association between the intermittent or continuous infusion of steroids and the prognosis. Methods This was a retrospective cohort study based on the AMOR-VENUS, in which Japanese intensive care unit (ICU) inpatients were enrolled between January and March 2018. ⋯ In the steroid group, hydrocortisone was used in 85.7%, the median daily dose was 192 mg, and the steroids were administered within 6 h of initiating vasopressor in 71.4%. The adjusted odds ratios of shock reversal on the 7th day and the ICU mortality for continuous versus intermittent infusion were 1.90 (95% confidence interval, 0.43-8.40) and 0.61 (0.10-3.85), respectively. Conclusion There was considerable variation in the criteria for the selection of patients and in the decision to use continuous or intermittent steroid infusion.
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Critical care medicine · Dec 2024
Multicenter StudyAssessment of Racial, Ethnic, and Sex-Based Disparities in Time-to-Antibiotics and Sepsis Outcomes in a Large Multihospital Cohort.
To characterize associations between race/ethnicity/sex, time-to-antibiotics, and mortality in patients with suspected sepsis or septic shock. ⋯ In a large cohort of patients with sepsis, time-to-antibiotics was longer for both women and Black patients even after detailed risk-adjustment. Women with septic shock had higher adjusted in-hospital mortality than men, but this association was not moderated by time-to-antibiotics.
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Multicenter Study
Culture-negative sepsis may be a different entity from culture-positive sepsis: a prospective nationwide multicenter cohort study.
The distinction between culture-positive sepsis and culture-negative sepsis regarding clinical characteristics and outcomes remains contentious. We aimed to elucidate these differences using large-scale nationwide data. ⋯ In patients with septic shock, culture-negativity was associated with increased mortality, despite the paradoxically higher appropriateness of empirical antibiotics than culture-positive patients. These contradictory findings suggest that the current criteria for determining the appropriateness of empirical antibiotic therapy may not be valid for culture-negative sepsis.