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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A three-day-old female infant was transferred to the Pediatric Intensive Care Unit with chief presenting problems of progressive change of cyanosis and respiratory distress. Physical examination revealed tachypnea, acrocyanosis, hepatomegaly, undetectable pulse of extremities and oozing over the place of venous puncture. Chest roentgenograms revealed slight cardiomegaly; other X-rays were within normal limits. Complete electrocardiograms showed right axis deviation and right ventricular hypertrophy. Because of an impression of neonatal sepsis, the patient was put in an incubator with oxygen and antibiotics were given. Persistent anuria appeared associated with sighs of cardiac and renal failure; the ventilator was applied; dopamine and lasix were also given. Unfortunately, the cyanosis worsened progressive. Despite several attempts at resuscitations, the infant expired eight hours later. Pathology disclosed the heart size as normal; hypoplasia of ascending aorta as 0.4 cm in diameter; a PDA with 1 cm in diameter; a diminutive bean-sized left ventricle; hypertrophy of right ventricle and atresias of aortic and mitral valves. There was no evidence of septicemia.
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PMID:[Hypoplastic left heart syndrome due to aortic and mitral atresias: report of one case]. 263 9

A series of 76 pyonephrotic kidneys in 73 patients were drained by percutaneous nephrostomy (PN) tube and examined to evaluate the contribution of this technique to the treatment of pyonephrosis. In 71 patients, clinical symptoms disappeared 24-48 h after the procedure. Two patients died from sepsis subsequent to anuria and underlying malignancy. Once the acute phase had remitted, interventional procedures were carried out in 39 cases, and constituted the definitive therapy in 36. In 32 cases, elective surgery was the definitive therapy, including the 3 cases not resolved after interventional procedures. Three patients in whom the obstruction cleared spontaneously following PN needed no additional treatment. Major complications included 6 cases of sepsis, all of which resolved satisfactorily with proper medical therapy.
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PMID:Percutaneous nephrostomy in pyonephrosis. 266 49

The present study reports our experience in 45 patients submitted to percutaneous nephrostomy. We describe the indications of this procedure and highlight its efficacy in making etiologic diagnosis and recovering renal function. Similarly, we underscore its efficacy in the treatment of sepsis, anuria, and dissolution of uric acid calculi. The low incidence rate of complications and no mortality from this procedure, and its diagnostic and therapeutic efficacy make it a common procedure in day-to-day urological practice.
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PMID:[Diagnostic and therapeutic value of puncture nephrostomy. Review of 45 cases]. 273 78

A 3-year-old girl is reported on who underwent laparotomy for ileocaecal intussusception elsewhere one week following severe gastroenteritis. Immediately after surgery, she developed haemolytic-uraemic syndrome with haemolytic anaemia, thrombocytopenia, increase of urea and creatinine and anuria as well as subsequent peritonitis, enterocolitis and sepsis. Following relaparotomy with establishment of ileostomy, peritoneal dialysis for several days was carried out for treatment of the haemolytic-uraemic syndrome. This case demonstrates that the haemolytic-uraemic syndrome can be treated effectively by peritoneal dialysis despite fresh bowel anastomoses, and that simultaneously occurring peritonitis can be managed by intraperitoneal administration of antibiotics via dialysis fluid.
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PMID:[Peritoneal dialysis in hemolytic-uremic syndrome following ileocecal resection for invagination in postoperative peritonitis]. 275 Mar 44

Over a 6 years period, 51 autopsies have been performed in infants dead after severe sepsis. One third of them had renal damages, consisting mainly in haemorrhagic infiltration. Pathological and clinical data are not always well correlated, but some parameters may enhance a poorer renal prognosis, such as the duration of shock and anuria, or exchange transfusion. The clinical presentation of the infection and the encountered germs are the same in both groups, with or without renal damage. A better management of intensive haemodynamic cares in these neonates increases their survival rate and raises the problem of chronic renal failure or hypertension in this situation. It seems very useful to state precisely the surveillance and protection of the renal function in such patients.
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PMID:[Anatomical study of the kidneys of newborn infants dying after a septic state]. 372 9

A 72-year-old woman with a single kidney and renal calculi was admitted as an emergency with sepsis and anuria. Renal drainage was established by percutaneous nephrostomy (PTN) as an emergency procedure. A nephrostogram showed multiple lucent stones and a single opaque calculus in the renal pelvis. The definitive treatment of the mixed calculi was carried out through the PTN. The lucent stones were dissolved by alkaline irrigation and the opaque stone removed by a biliary basket via the dilated tract. The safety and simplicity of PTN as an emergency procedure and its use for definitive treatment with the avoidance of surgery are stressed.
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PMID:Salvage of an obstructed single kidney by combined percutaneous nephrostomy, percutaneous stone extraction and alkalinisation. 682 43

Of 167 patients with major burns, fatal respiratory distress developed in ten. Fluid overload caused fatal respiratory failure within 48 hours of admission in five patients with anuria, whereas late deaths were due to fluid overload and pulmonary sepsis. Three of the four patients who had a tracheostomy died of pulmonary sepsis, whereas all ten patients who had endotracheal intubation survived, p less than 0.05. Preventable causes of fatal respiratory distress were found in all ten patients. The use of colloid infusions during burn shock resuscitation and serial monitoring of pulmonary extravascular water was suggested for prophylaxis of fluid overload and respiratory distress syndrome. Aspiration pneumonia prophylaxis and avoidance of an early tracheostomy were suggested for prophylaxis of pulmonary sepsis. It is suggested that the concept of idiopathic burn lung syndrome be abandoned, and instead, a vigorous etiologic search to be instituted in order to prevent, to identify and to treat correctable causes of respiratory failure.
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PMID:Fatal respiratory distress in burned patients. 724 47

Multiorgan failure (MOF) due to intoxication, trauma or sepsis in the progressive late stages always include acute renal failure (ARF). The prognosis of these patients is poor despite adequate dialysis. This study included 27 consecutive patients (20 men and 7 women, age range 15-77 years) with a rapid progress of MOF including ARF, who were treated by plasma exchange as an attempt to reverse the progress of MOF. Twenty-three of the patients suffered from a septic shock. Oliguria or anuria was present in all, dialysis was performed in 16 of them, and mechanical respiratory aid in 17. Plasma exchange was performed 1-10 times and almost exclusively by centrifuge technique, using albumin and/or liquid stored plasma (in a few cases fresh frozen plasma) as colloidal replacement fluid. Twenty-two patients survived (81%) and 5 patients died. The reasons of death were cerebral haemorrhagia, brain abscess, myocardial sudden death, relapsing sepsis from multiple hepatic abscesses and a not drained psoas abscess. All survivors could leave hospital recovered from renal failure with few other sequelae. The plasma exchange technique is easy to perform despite low blood pressures by using a vein to vein access. Plasma exchange, therefore, may be tried to reverse late stages of multiorgan failure.
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PMID:Plasma exchange in patients with acute renal failure in the course of multiorgan failure. 760 58

In the last five year, 198 critic patients developed acute renal failure, requiring hemodialysis in the hospital. We realized a descriptive study and analyzed the factors that were statistically associated with higher mortality: a surgical etiology, clinic criteria for the inicial of hemodialysis, respiratory failure, hemodynamic inestability, hepatic insufficciency, disseminated intravascular coagulacion and oliguric or anuria. The sepsis and the cardiorrespiratory complications were the cause of mortality most important. The 14% of the surviving requiring continue in the programs of hemodyalisis.
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PMID:[Descriptive study of hemodialysis in the critical patient. Report of 198 cases]. 773 64

Continuous hemofiltration (CHF) procedures (a total of 33 with overall duration 2495 hours and replacement of 2221 kg of fluid) were conducted in 23 patients (12 males and 11 females) aged 30.5 +/- 2.5 years suffering from severe acute renal failure (ARF). CHF efficacy was judged by the kinetics of urea and creatinine. With parenteral feeding the patients received protein and amino acids 1.2-1.5 g/day/kg b.m. The death of 13 patients resulted from sepsis, hemorrhage, shock, adrenal insufficiency. The filtration speed 15.6 +/- 0.6 (7-34) ml/min allowed replacement of 21.7 +/- 1.3 (8-49) kg or 0.49 +/- 0.03 of body fluid a day. The highest rate of hemofiltration was used on day 1, this reducing plasma urea from 35.7 +/- 2.5 (7.5-55.0) to 27.5 +/- 2.0 mmol/l (p < 0.05) and creatinine from 742 +/- 77 (182-1800 to 539 +/- 44 mumol/l (p < 0.05). Subsequently urea and creatinine were maintained in the plasma at the levels 26.8 +/- 1.0 mmol/l and 539 +/- 73 mumol/l, respectively. Urea eliminated with the filtrate amounted to 591 +/- 53, creatinine 13.5 +/- 4.0 mmol or 0.49 +/- 0.02 and 0.65 +/- 0.07 of the overall pools, respectively. In anuria urea generation reached 525 +/- 35 (108-1071) mmol/day, that of creatinine 9.6 +/- 1.4 (1.2-14.0) mmol/day, being on the average less than filtrate elimination of these substances. It is believed that CHF contributes to balanced treatment of severe ARF in spite of parenteral introduction of large quantities of protein and amino acids.
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PMID:[Urea and creatinine kinetics during the continuous hemofiltration of patients with acute kidney failure]. 794 Nov 23


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