Perioperative care of the septic patient presents unique challenges for the nurse. Understanding the physiology of sepsis is important for the nurse to anticipate the physiologic changes associated with the disorder and to prioritize the patient's needs. Ensuring adequate intravenous access by peripheral or central venous access as well as anticipating potential invasive monitoring lines allows the nurse to quickly administer antibiotic therapy, initiate fluid resuscitation, and prepare for potential vasopressor use.
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http://dx.doi.org/10.1016/j.cnc.2018.05.008 | DOI Listing |
BMJ Open
January 2025
Department of Surgery, Alberta Health Services, Calgary, Alberta, Canada.
Introduction: To improve surgical quality and safety, health systems must prioritise equitable care for surgical patients. Racialised patients experience worse postoperative outcomes when compared with non-racialised surgical patients in settler colonial nation-states. Identifying preventable adverse outcomes for equity-deserving patient populations is an important starting point to begin to address these gaps in care.
View Article and Find Full Text PDFCrit Care Sci
January 2025
Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile - Santiago, Chile.
Background: ANDROMEDA-SHOCK 2 is an international, multicenter, randomized controlled trial comparing hemodynamic phenotype-based, capillary refill time-targeted resuscitation in early septic shock to standard care resuscitation to test the hypothesis that the former is associated with lower morbidity and mortality in terms of hierarchal analysis of outcomes.
Objective: To report the statistical plan for the ANDROMEDA--SHOCK 2 randomized clinical trial.
Methods: We briefly describe the trial design, patients, methods of randomization, interventions, outcomes, and sample size.
mBio
January 2025
Department of Microbiology, Genetics, & Immunology, Michigan State University, East Lansing, Michigan, USA.
The emergence and global spread of carbapenem-resistant complex species present a pressing public health challenge. Carbapenem-resistant spp. cause a wide variety of infections, including septic shock fatalities in newborns and immunocompromised adults.
View Article and Find Full Text PDFBurns Trauma
January 2025
Department of Critical Care Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Gulou District, Nanjing, Jiangsu 210008, China.
Background: Non-thyroidal illness syndrome is commonly observed in critically ill patients, characterized by the inactivation of systemic thyroid hormones (TH), which aggravates metabolic dysfunction. Recent evidence indicates that enhanced TH inactivation is mediated by the reactivation of type 3 deiodinase (Dio3) at the tissue level, culminating in a perturbed local metabolic equilibrium. This study assessed whether targeted inhibition of Dio3 can maintain tissue metabolic homeostasis under septic conditions and explored the mechanism behind Dio3 reactivation.
View Article and Find Full Text PDFIDCases
January 2025
Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Sarawak, Malaysia.
We report a first case of ceftazidime-resistant pediatric melioidosis involving a previously healthy seven-year-old boy who presented with right lobar pneumonia complicated with a 5-cm lung abscess. Ceftazidime was initiated on Day-6 of admission when (ceftazidime-susceptible, minimum inhibitory concentration [MIC] 1.0 mcg/mL) was isolated from blood.
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