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PubMed Journals Articles About "Clinical Trial Of The Optimal Endpoint Of Early Sepsis Resuscitation" RSS

23:17 EDT 21st July 2018 | BioPortfolio

Clinical Trial Of The Optimal Endpoint Of Early Sepsis Resuscitation PubMed articles on BioPortfolio. Our PubMed references draw on over 21 million records from the medical literature. Here you can see the latest Clinical Trial Of The Optimal Endpoint Of Early Sepsis Resuscitation articles that have been published worldwide.

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Showing "Clinical Trial Optimal Endpoint Early Sepsis Resuscitation" PubMed Articles 1–25 of 43,000+

Fluid Resuscitation and Management in Patients with Sepsis and Septic Shock.

Sepsis and septic shock are common diseases with high mortality rates. Although volume therapy has been a central component of sepsis therapy for decades, the choice of optimal fluid and fluid intake is unclear. This paper summarizes findings on pathophysiology, clinical trial results, and current recommendations for optimal volume and fluid management in sepsis.


Early Machine-Human Interface around Sepsis Severity Identification: From Diagnosis to Improved Management?

To investigate the statistical measures of the performance of 2 interventions: a) early sepsis identification by a computerized sepsis "sniffer" algorithm (CSSA) in the emergency department (ED) and b) human decision to activate a multidisciplinary early resuscitation sepsis and shock response team (SSRT).

Liberal Versus Restrictive Intravenous Fluid Therapy for Early Septic Shock: Rationale for a Randomized Trial.

Prompt intravenous fluid therapy is a fundamental treatment for patients with septic shock. However, the optimal approach for administering intravenous fluid in septic shock resuscitation is unknown. Two competing strategies are emerging: a liberal fluids approach, consisting of a larger volume of initial fluid (50 to 75 mL/kg [4 to 6 L in an 80-kg adult] during the first 6 hours) and later use of vasopressors, versus a restrictive fluids approach, consisting of a smaller volume of initial fluid (≤30 mL/k...


Metabolomics in Sepsis and Its Impact on Public Health.

Sepsis, with its often devastating consequences for patients and their families, remains a major public health concern that poses an increasing financial burden. Early resuscitation together with the elucidation of the biological pathways and pathophysiological mechanisms with the use of "-omics" technologies have started changing the clinical and research landscape in sepsis. Metabolomics (i.e., the study of the metabolome), an "-omics" technology further down in the "-omics" cascade between the genome and...

Pediatric Sepsis Update: How are Children Different?

Although there are some commonalities between pediatric and adult sepsis, there are important differences in pathophysiology, clinical presentation, and therapeutic approaches. The recognition and diagnosis of sepsis is a significant challenge in pediatric patients as vital sign aberrations and examination findings are often subtle as compared to those observed in adults. Gaps in knowledge that have been studied in depth in adult sepsis are still being investigated in pediatric patients such as best practic...

Early Goal-Directed Therapy: The History and Ongoing Impact on Management of Severe Sepsis and Septic Shock.

The use of early goal-directed therapy (EGDT) for the management of severe sepsis and septic shock, a practice put forth by Dr. Rivers et al. in 2001, ushered in a new era of targeted sepsis therapy. After its publication, several further studies helped validate the protocolized approach to sepsis management, ultimately leading to its incorporation into the Surviving Sepsis Campaign guidelines. Since that time, however, a trio of large multi-center randomized controlled trials have taken place to evaluate t...

Implementation of the Neonatal Sepsis Calculator in an Australian Tertiary Perinatal Centre.

Early-onset sepsis (EOS) is a potentially fatal condition that affects about 0.3-0.8/1,000 infants born at ≥35 weeks' gestation in developed countries. Current EOS management algorithms result in 8-15% of infants receiving antibiotics for suspected sepsis. The Neonatal Sepsis Calculator provides evidence-based estimates of individual sepsis risk, but data on its clinical application is limited.

Effect of a machine learning-based severe sepsis prediction algorithm on patient survival and hospital length of stay: a randomised clinical trial.

Several methods have been developed to electronically monitor patients for severe sepsis, but few provide predictive capabilities to enable early intervention; furthermore, no severe sepsis prediction systems have been previously validated in a randomised study. We tested the use of a machine learning-based severe sepsis prediction system for reductions in average length of stay and in-hospital mortality rate.

Clinical trial design for local therapies for brain metastases: a guideline by the Response Assessment in Neuro-Oncology Brain Metastases working group.

The goals of therapeutic and biomarker development form the foundation of clinical trial design, and change considerably from early-phase to late-phase trials. From these goals, decisions on specific clinical trial design elements, such as endpoint selection and statistical approaches, are formed. Whereas early-phase trials might focus on finding a therapeutic signal to make decisions on further development, late-phase trials focus on the confirmation of therapeutic impact by considering clinically meaningf...

An Interpretable Machine Learning Model for Accurate Prediction of Sepsis in the ICU.

Sepsis is among the leading causes of morbidity, mortality, and cost overruns in critically ill patients. Early intervention with antibiotics improves survival in septic patients. However, no clinically validated system exists for real-time prediction of sepsis onset. We aimed to develop and validate an Artificial Intelligence Sepsis Expert algorithm for early prediction of sepsis.

Fluid resuscitation with lactated Ringer's solution vs normal saline in acute pancreatitis: A triple-blind, randomized, controlled trial.

Little is known regarding the optimal type of fluid resuscitation in acute pancreatitis (AP).

Sepsis Diagnostics in the Era of "Omics" Technologies.

Sepsis is a multifactorial clinical syndrome with an extremely dynamic clinical course and with high diverse clinical phenotype. Early diagnosis is crucial for the final clinical outcome. Previous studies have not identified a biomarker for the diagnosis of sepsis which would have sufficient sensitivity and specificity. Identification of the infectious agents or the use of molecular biology, next gene sequencing, has not brought significant benefit for the patient in terms of early diagnosis. Therefore, we ...

Challenging Dogma: The Value of Bolus Fluids in the Early Resuscitation of Hyperdynamic Sepsis.

Diagnosis and management of sepsis.

Sepsis is a common condition with high morbidity and mortality. Although many patients may require critical care, this article considers the features of sepsis that are of most relevance to acute general physicians. Recently updated definitions of sepsis and septic shock have been proposed which better identify patients who are likely to have a poor outcome, and therefore give an opportunity to escalate care. Despite these advances, there is still no molecular signature able to diagnose sepsis. Pathogenesis...

Inotropic Therapy for Sepsis.

Sepsis, severe sepsis, and septic shock represent a dynamic clinical syndrome involving a systemic inflammatory response, circulatory changes, and end-organ dysfunction from an infection. Early aggressive management to restore perfusion and/or improve hypotension is critical to improving outcomes. Although the basic management principles of early goal-directed therapy for sepsis have not undergone significant changes, there has been a recent shift in recommendations related to the timing and type of inotrop...

Adaptive and Platform Trials in Remote Damage Control Resuscitation.

The traditional approach to clinical trial design requires assuming precise values for multiple unknown parameters, resulting is a trial design that is unlikely to perform well if one or more of those assumptions turn out to be incorrect. During conduct of the trial, trial characteristics are often held fixed, even if incoming data suggest that one or more design assumptions were incorrect. This leads to an increased risk of a failed trial. In contrast, an adaptive clinical trial is designed to take advanta...

Incidence of early-onset sepsis in infants born to women with clinical chorioamnionitis.

To determine the frequency of sepsis and other adverse neonatal outcomes in women with a clinical diagnosis of chorioamnionitis.

Optimal patient selection for anticoagulant therapy in sepsis: an evidence-based proposal from Japan.

Selecting an appropriate target population is essential to maximize survival benefits of anticoagulant therapy against sepsis. Our meta-analysis of three populations with sepsis and nationwide observational study in Japan showed that anticoagulants improved mortality only in sepsis-induced disseminated intravascular coagulation (DIC) but not in non-DIC. This divergent effect was physiologically explained by host-protective immune responses of local thrombosis, which are mandatory in the early stage of sepsi...

New Diagnostic Possibilities for Neonatal Sepsis.

Progress in neonatal care has decrease morbidity and mortality due to neonatal sepsis (NS). Although diagnosis of sepsis continues to rely on blood culture, this method is too slow and limited by false-negative results. There are numerous sepsis biomarkers that have been evaluated for the early diagnosis of NS, but, to date, there is no single ideal biomarker, though novel biomarkers are becoming more sophisticated and specific in their clinical applications. This review provides an overview of the current ...

Rates and Factors Associated With Placebo Response in Trials of Pharmacotherapies for Nonalcoholic Steatohepatitis: Systematic Review and Meta-analysis.

Understanding the extent of the placebo effect in randomized controlled trials of studying nonalcoholic steatohepatitis (NASH) is important for optimal trial design, including sample size calculations and treatment endpoint definition.

Early-phase Innate Immune Suppression in Murine Severe Sepsis Is Restored with Systemic Interferon-β.

Sepsis is a leading cause of death in the intensive care unit. Immune modulatory therapy targeting sepsis-associated proinflammatory responses has not shown survival benefit. Here, the authors evaluated innate immunity at the early stage of murine mild or severe peritoneal sepsis induced by cecal ligation and puncture, and the effect of systemic interferon-β, a potent inflammatory mediator, on severe sepsis as well as its mechanism of action.

Integrated Biosensor for Rapid and Point-Of-Care Sepsis Diagnosis.

Sepsis is an often fatal condition that arises when the immune response to an infection causes widespread systemic organ injury. A critical unmet need in combating sepsis is the lack of accurate early biomarkers that produce actionable results in busy clinical settings. Here, we report the development of a point-of-care platform for rapid sepsis detection. Termed IBS (integrated biosensor for sepsis), our approach leverages i) the newly-found pathophysiological role of cytokine interleukin-3 (IL-3) in early...

Pyruvate-enriched resuscitation for shock.

This commentary addresses the recent retraction of an article which reported favorable outcomes in septic patients treated with intravenous pyruvate. The retracted report was cited in the authors' recent minireview on the cellular mechanisms and clinical application of pyruvate to improve cardiac performance. Because the retracted article reports pyruvate-enhanced resuscitation of critically ill patients, the authors wish to inform the readership, especially critical care providers, that this particular cli...

A systematic investigation on animal models of cyclosporine A combined with Escherichia coli to simulate the immunosuppressive status of sepsis patients before onset.

Immunosuppression is an important mechanism for the development of sepsis pathology, and is the key to the high mortality of sepsis. However, patients appear to be immunocompromised before sepsis onset due to lack of enough attention. Present sepsis models cannot fully mimic the onset of sepsis in patients. Hence, effective treatments in animal experiments could not be transformed into clinical application. In the present study, we improved the animal model of sepsis and used cyclosporine A immunosuppressiv...

Antithrombin concentrate use in disseminated intravascular coagulation of sepsis: meta-analyses revisited.

Recently, two meta-analyses examined the effect of antithrombin on mortality in patients with sepsis and disseminated intravascular coagulation (DIC) with diverging results. In the meta-analysis observing no significant survival effect of antithrombin, the results of a large trial were included under the assumption that all 2,314 participants of the trial had sepsis and DIC, which according to post hoc analyses is not the case. To the other meta-analysis reporting beneficial effect, the same trial contribut...


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