Effective treatment of sepsis: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Major Research Findings

Sepsis is a life-threatening condition caused by the body's overwhelming and life-threatening response to infection. Timely administration of antibiotics and source control are crucial for sepsis treatment. However, the impact of these treatments on clinical outcomes remains uncertain.

Several studies have indicated the importance of timeliness in sepsis treatment. One study found that delayed antibiotic administration was associated with increased 28-day mortality in sepsis patients. 23 Moreover, delayed antibiotic administration was also shown to increase the risk of progression from severe sepsis to septic shock. 23

Another study demonstrated that using a procalcitonin (PCT)-guided algorithm for antibiotic cessation resulted in a significantly shorter duration of antibiotic therapy and a significant decrease in mortality. 22 These findings suggest the potential effectiveness of using PCT as a tool to guide antibiotic cessation decisions in sepsis treatment.

The effectiveness of steroids in sepsis treatment remains controversial. One study investigated the efficacy of early dexamethasone administration in patients with septic shock but did not find any clear benefits. 5 Another study examined the effectiveness of hydrocortisone administration in patients with septic shock, but again, no clear benefits were observed. 20

Treatment Summary

Sepsis treatment requires prompt administration of antibiotics and removal of the source of infection. 23 A procalcitonin (PCT)-guided algorithm for antibiotic cessation can potentially shorten antibiotic therapy duration and reduce mortality. 22 The effectiveness of steroids in sepsis treatment remains unclear. 5 20

Benefits and Risks

Benefits Summary

Prompt administration of antibiotics and removal of the source of infection in sepsis treatment contribute to reduced mortality. 23 Employing a procalcitonin (PCT)-guided algorithm can potentially shorten antibiotic therapy duration and decrease mortality. 22

Risks Summary

Delayed antibiotic administration has been associated with increased 28-day mortality in sepsis patients. 23 Furthermore, delayed antibiotic administration has also been shown to elevate the risk of progression from severe sepsis to septic shock. 23 The effectiveness of steroids in sepsis treatment remains unclear. 5 20

Comparison Between Studies

Commonalities

Many studies emphasize the crucial role of timeliness in sepsis treatment. 23

Differences

Conclusions regarding treatment methods and effectiveness vary across different studies. For instance, the effectiveness of steroids is not consistent in various studies. 5 20

Consistency and Inconsistencies in Findings

Research findings on sepsis treatment exhibit both consistency and inconsistencies. For example, the effectiveness of steroids is not consistent across different studies. 5 20 These discrepancies might be attributed to differences in study design and patient populations.

Considerations for Real-World Application

Sepsis treatment necessitates prompt antibiotic administration and removal of the infection source. 23 Employing a procalcitonin (PCT)-guided algorithm can potentially shorten antibiotic therapy duration and decrease mortality. 22 However, these treatment methods may not be effective for all patients. It is essential to follow medical advice and receive appropriate treatment.

Limitations of Current Research

Research on sepsis treatment remains insufficient. Further studies are necessary to gain a more comprehensive understanding of the subject.

Future Research Directions

More research is needed to further investigate sepsis treatment. Particularly, studies focusing on the effectiveness of steroids and the efficacy of a procalcitonin (PCT)-guided algorithm for antibiotic cessation are crucial.

Conclusion

Sepsis is a life-threatening condition, and prompt treatment is vital. Delayed antibiotic administration is associated with increased mortality in sepsis patients. 23 A procalcitonin (PCT)-guided algorithm can potentially shorten antibiotic therapy duration and decrease mortality. 22 The effectiveness of steroids in sepsis treatment remains unclear. 5 20 More research is necessary to understand sepsis treatment thoroughly.

Treatment List

Sepsis treatment methods include the following:

  • Prompt administration of antibiotics
  • Removal of the source of infection
  • Procalcitonin (PCT)-guided algorithm for antibiotic cessation
  • Steroid administration
Literature analysis of 25 papers
Positive Content
22
Neutral Content
3
Negative Content
0
Article Type
10
10
12
9
25
1.

Adjunctive therapy in sepsis: a critical analysis of the clinical trial programme.

Author: CohenJ

Improved sepsis treatment

This study discusses the challenges of developing novel drugs for treating sepsis, highlighting the need for more focused clinical trials with stricter protocols to ensure a homogeneous patient population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

2.

Antibiotic regimens for suspected early neonatal sepsis.

Author: MtitimilaE I, CookeR W I

Reduced mortality
Insufficient evidence

There is no evidence from randomized trials to suggest that any antibiotic regimen is better than another in the treatment of presumed early neonatal sepsis. More studies are needed to determine the most effective antibiotic regimen.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Antibiotic regimens for suspected late onset sepsis in newborn infants.

Author: GordonA, JefferyH E

Sepsis treatment

This study examines the optimal antibiotic regimen for initial treatment of suspected late onset neonatal sepsis, a significant cause of morbidity and mortality.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Can procalcitonin help us in timing of re-intervention in septic patients after multiple trauma or major surgery?

Author: SvobodaPetr, KantorováIona, ScheerPeter, RadvanovaJana, RadvanMartin

Reduced organ dysfunction

Using procalcitonin as an additional marker to separate local infection from generalized infection in patients with surgical sepsis showed a tendency to decrease multiple organ dysfunction syndrome.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Early dexamethasone treatment for septic shock patients: a prospective randomized clinical trial.

Author: CicarelliDomingos Dias, VieiraJoaquim Edson, BenseñorFábio Ely Martins

Septic shock treatment

Early administration of dexamethasone for patients with septic shock was investigated to halt the progression towards MODS and death.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

The Procalcitonin And Survival Study (PASS) - a randomised multi-center investigator-initiated trial to investigate whether daily measurements biomarker Procalcitonin and pro-active diagnostic and therapeutic responses to abnormal Procalcitonin levels, can improve survival in intensive care unit patients. Calculated sample size (target population): 1000 patients.

Author: JensenJens-Ulrik, LundgrenBettina, HeinLars, MohrThomas, PetersenPernille L, AndersenLasse H, LauritsenAnne O, HougaardSine, MantoniTeit, BømlerBonnie, ThornbergKlaus J, ThormarKatrin, LøkenJesper, SteensenMorten, CarlPeder, PetersenJ Asger, TousiHamid, Søe-JensenPeter, BestleMorten, HestadSøren, AndersenMads H, FjeldborgPaul, LarsenKim M, RossauCharlotte, ThomsenCarsten B, OstergaardChristian, KjaerJesper, GrarupJesper, LundgrenJens D

Sepsis treatment

Specific and rapid markers of bacterial infection are being sought for use in critically ill patients with sepsis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Corticosteroids in the treatment of severe sepsis and septic shock in adults: a systematic review.

Author: AnnaneDjillali, BellissantEric, BollaertPierre-Edouard, BriegelJosef, ConfalonieriMarco, De GaudioRaffaele, KehDidier, KupferYizhak, OppertMichael, MeduriG Umberto

Reduced ICU stay
Shock reversal
Hyperglycemia
Hypernatremia

This study found that prolonged low-dose corticosteroid therapy may have a beneficial drug effect on short-term mortality in patients with severe sepsis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Meropenem vs standard of care for treatment of late onset sepsis in children of less than 90 days of age: study protocol for a randomised controlled trial.

Author: LutsarIrja, TrafojerUrsula M T, HeathPaul T, MetsvahtTuuli, StandingJoseph, EspositoSusanna, de CabreVincent Meiffredy, OeserClarissa, AboulkerJean-Pierre,

Antibacterial coverage
LOS treatment

This study is comparing the efficacy of meropenem with a predefined standard of care (ampicillin + gentamicin or cefotaxime + gentamicin) in the treatment of late-onset neonatal sepsis (LOS) in 550 neonates and infants less than 90 days old. The primary endpoint is clinical response at 2 days after the end of study therapy.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Effect of empirical treatment with moxifloxacin and meropenem vs meropenem on sepsis-related organ dysfunction in patients with severe sepsis: a randomized trial.

Author: BrunkhorstFrank M, OppertMichael, MarxGernot, BloosFrank, LudewigKatrin, PutensenChristian, NierhausAxel, JaschinskiUlrich, Meier-HellmannAndreas, WeylandAndreas, GründlingMatthias, MoererOnnen, RiessenReimer, SeibelArmin, RagallerMaximilian, BüchlerMarkus W, JohnStefan, BachFriedhelm, SpiesClaudia, ReillLorenz, FritzHarald, KiehntopfMichael, KuhntEvelyn, BogatschHolger, EngelChristoph, LoefflerMarkus, KollefMarin H, ReinhartKonrad, WelteTobias,

Reduced mortality rates
No difference in organ failure

Treatment with combined meropenem and moxifloxacin compared with meropenem alone did not result in less organ failure in adult patients with severe sepsis. There was no statistically significant difference in the rates of 28-day and 90-day mortality between the two groups.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Diagnostic methods in sepsis: the need of speed.

Author: CoelhoFernando Rodrigues, MartinsJoilson Oliveira

Improved sepsis diagnosis

This study discusses the challenges of treating sepsis, a common and serious condition, highlighting current diagnostic methods and promising new tests for sepsis detection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

A pilot randomised controlled trial in intensive care patients comparing 7 days' treatment with empirical antibiotics with 2 days' treatment for hospital-acquired infection of unknown origin.

Author: ScawnN, SaulD, PathakD, MatataB, KempI, StablesR, LaneS, HaycoxA, HoutenR

A pilot randomized trial investigated the effectiveness of 48 hours of broad-spectrum antibiotic treatment for suspected sepsis of unknown origin in the cardiac intensive care unit (ICU). The study also explored the predictive power of newer sepsis biomarkers.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Procalcitonin-guided therapy in intensive care unit patients with severe sepsis and septic shock--a systematic review and meta-analysis.

Author: PrknoAnna, WackerChristina, BrunkhorstFrank M, SchlattmannPeter

Reduced antibiotic use

Procalcitonin (PCT) algorithms for antibiotic treatment decisions have been studied in adult patients in primary care, emergency departments, and intensive care units (ICUs), suggesting potential benefits in reducing antibiotic exposure without increasing mortality rates. However, research on the efficacy and safety of this approach in critically ill patients with severe sepsis and septic shock is lacking.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

13.

Diagnostic accuracy and effectiveness of automated electronic sepsis alert systems: A systematic review.

Author: MakamAnil N, NguyenOanh K, AuerbachAndrew D

Improved care processes
False positive alerts
No mortality improvement
Poor PPV

Automated sepsis alerts derived from electronic health data may improve care processes, but they tend to have poor positive predictive value and do not improve mortality or length of stay.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

14.

Does Infection Site Matter? A Systematic Review of Infection Site Mortality in Sepsis.

Author: MotzkusChristine A, LuckmannRoger

This review examines the impact of infection site on hospital mortality in patients with sepsis. The study emphasizes the importance of considering the source of infection when treating sepsis, as different sites may have varying impacts on mortality.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

15.

Sepsis: the LightCycler SeptiFast Test MGRADE®, SepsiTest™ and IRIDICA BAC BSI assay for rapidly identifying bloodstream bacteria and fungi - a systematic review and economic evaluation.

Author: StevensonMatt, PandorAbdullah, Martyn-St JamesMarrissa, RafiaRachid, UttleyLesley, StevensJohn, SandersonJean, WongRuth, PerkinsGavin D, McMullanRonan, DarkPaul

Reduced morbidity
Reduced mortality
Limited evidence

There is currently insufficient evidence to determine the clinical effectiveness and cost-effectiveness of rapid diagnostic tests for sepsis compared with standard practice.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

Impact of Prehospital Care on Outcomes in Sepsis: A Systematic Review.

Author: SmythMichael A, Brace-McDonnellSamantha J, PerkinsGavin D

Sepsis treatment

Sepsis is a serious response to infection. Treatment guidelines emphasize starting treatment as early as possible. This study examines whether early intervention by ambulance crews before hospital arrival improves outcomes for sepsis patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

17.

Empirical Micafungin Treatment and Survival Without Invasive Fungal Infection in Adults With ICU-Acquired Sepsis, Candida Colonization, and Multiple Organ Failure: The EMPIRICUS Randomized Clinical Trial.

Author: TimsitJean-Francois, AzoulayElie, SchwebelCarole, CharlesPierre Emmanuel, CornetMuriel, SouweineBertrand, KloucheKada, JaberSamir, TrouilletJean-Louis, BruneelFabrice, ArgaudLaurent, CoussonJoel, MezianiFerhat, GrusonDidier, ParisAdeline, DarmonMichael, Garrouste-OrgeasMaité, NavellouJean-Christophe, FoucrierArnaud, AllaouchicheBernard, DasVincent, GangneuxJean-Pierre, RucklyStéphane, MaubonDaniele, JullienVincent, WolffMichel,

Reduced new IFI rate

Empirical treatment with micafungin, compared with placebo, did not increase fungal infection-free survival at day 28 in nonneutropenic critically ill patients with ICU-acquired sepsis. Micafungin did decrease the rate of new invasive fungal infection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Liberal versus conservative fluid therapy in adults and children with sepsis or septic shock.

Author: LiDanyang, LiXueyang, CuiWei, ShenHuahao, ZhuHong, XiaYi

Fluid therapy
Sepsis treatment

Sepsis and septic shock are serious complications of infection that can be life-threatening. While fluids are a key part of initial treatment, the best approach – giving large amounts of fluid (liberal) or smaller amounts (conservative) – is still debated in terms of its impact on patient outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

19.

Continuous versus intermittent infusions of antibiotics for the treatment of infectious diseases: Meta-analysis and systematic review.

Author: ChenChang-Hua, ChenYu-Min, ChangYu-Jun, WangShu-Hui, ChangChih-Yen, YenHua-Cheng

Improved efficacy

Continuous infusion of intravenous antibiotics compared to intermittent infusions may have different effects on clinical outcomes in patients with infection. However, the evidence is inconclusive, and larger studies are needed to determine the optimal administration route.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

20.

Impact on Efficacy and Safety of Hydrocortisone in Sepsis and Septic Shock - A Systematic Literature Review and Meta-analysis.

Author: AletrebyWaleed Tharwat, AlharthyAbdulrahman Mishaal, MadiAhmed Fouad, SolimanIbrahim Refaat, HamidoHend Mohammed, RamadanOmar Elsayed, AlzayerWasim, HuwaitBasim Mohammed, AlodatMohammed Ali, MumtazShahzad Ahmed, MahmoodNasir Nasim, Al KurdiMahmoud Hussien, FarragHazem Abdulgaffar, KarakitsosDimitrios

Sepsis management

Sepsis and septic shock are serious conditions that cause significant illness and death, placing a large burden on healthcare systems. While steroids have potential benefits, their effectiveness in treating sepsis or septic shock is still being investigated.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

21.

Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis: The VICTAS Randomized Clinical Trial.

Author: SevranskyJonathan E, RothmanRichard E, HagerDavid N, BernardGordon R, BrownSamuel M, BuchmanTimothy G, BusseLaurence W, CoopersmithCraig M, DeWildeChristine, ElyE Wesley, EyzaguirreLindsay M, FowlerAlpha A, GaieskiDavid F, GongMichelle N, HallAlex, HinsonJeremiah S, HooperMichael H, KelenGabor D, KhanAkram, LevineMark A, LewisRoger J, LindsellChris J, MarlinJessica S, McGlothlinAnna, MooreBrooks L, NugentKatherine L, NwosuSamuel, PolitoCarmen C, RiceTodd W, RickettsErin P, RudolphCaroline C, SanfilippoFred, VieleKert, MartinGreg S, WrightDavid W,

This multicenter, randomized, double-blind, placebo-controlled trial investigated the effect of a combination of vitamin C, thiamine, and hydrocortisone on ventilator- and vasopressor-free days in patients with sepsis. The study found no significant difference between the intervention and placebo groups for the primary outcome. While the trial was terminated early for administrative reasons, the findings suggest that this treatment combination may not be effective in improving these outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Clinical impact of procalcitonin-based algorithms for duration of antibiotic treatment in critically ill adult patients with sepsis: a meta-analysis of randomized clinical trials.

Author: Gutiérrez-PizarrayaAntonio, León-GarcíaMaría Del Carmen, De Juan-IdígorasReyes, Garnacho-MonteroJ

Decreased mortality
Reduced antibiotic therapy
None mentioned

This systematic review found that a procalcitonin-guided strategy for antibiotic cessation in critically ill adults with sepsis was associated with a significantly shorter duration of antimicrobial therapy and a significant decrease in mortality.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

23.

Adverse effects of delayed antimicrobial treatment and surgical source control in adults with sepsis: results of a planned secondary analysis of a cluster-randomized controlled trial.

Author: RüddelHendrik, Thomas-RüddelDaniel O, ReinhartKonrad, BachFriedhelm, GerlachHerwig, LindnerMatthias, MarshallJohn C, SimonPhilipp, WeissManfred, BloosFrank, SchwarzkopfDaniel,

Early antimicrobial treatment
Prevention of shock progression
Delayed treatment
Septic shock

This nationwide registry-based study investigated the prevalence and clinical course of autoimmune thyroid disorders in patients with autoimmune Addison disease (AAD). Autoimmune thyroid disease was diagnosed in 48% of AAD patients, with 42% having autoimmune hypothyroidism. The true prevalence of hypothyroidism in AAD is lower than previously reported. Long-term remission rates in Graves disease (GD) patients with AAD were comparable to recent reports in patients without AAD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

24.

Clinical and biochemical endpoints and predictors of response to plasma exchange in septic shock: results from a randomized controlled trial.

Author: StahlKlaus, WandPhilipp, SeeligerBenjamin, Wendel-GarciaPedro David, SchmidtJulius J, SchmidtBernhard M W, SauerAndrea, LehmannFelix, BuddeUlrich, BuschMarkus, WiesnerOlaf, WelteTobias, HallerHermann, WedemeyerHeiner, PutensenChristian, HoeperMarius M, BodeChristian, DavidSascha

Hemodynamic stabilization
Mediator removal
Protective factor repletion

This study evaluated the effects of therapeutic plasma exchange (TPE) on patients with refractory septic shock. 24 patients received either standard of care (SOC) or SOC plus one single TPE. TPE was associated with a significant reduction in norepinephrine doses, decreased lactate levels, and a reduction in inflammatory biomarkers. Baseline lactate concentration was identified as a potential predictor of response to TPE.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

25.

Benefits of esmolol in adults with sepsis and septic shock: An updated meta-analysis of randomized controlled trials.

Author: ZhangJing, ChenChun, LiuYi, YangYi, YangXiaolei, YangJin

Controlled heart rate
Improved cardiac function
Reduced mortality

This meta-analysis evaluated the efficacy of esmolol for sepsis and septic shock. Esmolol significantly decreased 28-day mortality, heart rate, tumor necrosis factor-a, and troponin I levels. It did not significantly affect other parameters like length of intensive care unit stay or lung injury.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

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