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

In this prospective study done between 1983 and 1989, of 109 children with acute renal failure in Sivas, Turkey, infectious disease was found in 94. This was related mainly to preventable disease such as acute gastro-enteritis, sepsis and post-streptococcal acute glomerulonephritis. Within this infectious disease group, the highest incidence rate was found in sepsis.
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PMID:Acute renal failure related to infectious disease in infancy and childhood. 171 41

Continuous arterio-venous haemofiltration (CAVH) and continuous veno-venous haemofiltration (CVVH) were used as renal support in 52 critically ill infants and children with acute renal failure. The majority of the patients were on mechanical ventilation (90%) and needed vasopressor support (85%). Uraemia was satisfactorily controlled with both treatment modes. Post-treatment serum urea levels were not different between survivors (94 +/- 8.8 mg/dl) and non-survivors (99.5 +/- 8.8 mg/dl). There were significant differences between survivors and non-survivors in the mean arterial pressure (64.7 +/- 3.8 vs 48.0 +/- 2.2 mmHg, p less than 0.001), the number of organ system failures (2.9 +/- 0.16 vs 3.8 +/- 0.21, p less than 0.025), and the severity of illness assessed by the acute physiologic score for children (APSC 19.4 +/- 1.9 vs 26.3 +/- 1.9, p less than 0.01). The overall mortality was 48%. The mortality in the CVVH group (65%) was higher than in the CAVH group (40%). Death was significantly related to sepsis (p less than 0.005) and multiple system organ failure (p less than 0.005). A major complication during CAVH was one femoral artery thrombosis after 12 days of treatment. Technical problems were only observed during CVVH. CAVH and CVVH are safe and effective methods of continuous renal support for critically ill paediatric patients with multiple system organ failure. CAVH is simpler, needs no specially trained staff and seems to the ideal renal replacement system for critically ill infants.
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PMID:Five years experience with continuous extracorporeal renal support in paediatric intensive care. 174 19

The chemical composition of body fluids, which is regulated by the kidneys, may affect renal function. Conversely, the onset of acute renal failure (ARF) interrupts the normal regulation of the volume and content of the body fluids. In order to further study these relationships and determine the epidemiology and consequences of ARF in a tertiary-care setting, the computerized hospital data base was used to identify and obtain laboratory data on patients with ARF. 9,276 patients, encountered over a 90-day period, were surveyed and 96 were found to have developed ARF in the hospital (3.1% of admissions). The majority of the patients with ARF were found on the medicine service (68%), and sepsis with aminoglycoside use was the single most common of multiple etiologic factors. Patients with ARF experienced an increase in morbidity, as evidenced by an increase in the hospital length of stay and frequent need for ICU care. Mortality (29%) was due to the patients' underlying illnesses, and not uremia. Serum levels of the electrolytes prior to the onset of ARF were within the normal range with the exception of the creatinine (2.04 +/- 0.25 mg/dl) and bicarbonate (22.9 +/- 0.6 meq/l). After the development of ARF (mean creatinine 3.91 +/- 0.03) sodium, chloride, and bicarbonate were decreased, and phosphate, uric acid, and the anion gap were increased (p less than 0.05 for all values). The decrease in serum calcium became significant (p less than 0.05) in those patients whose creatinine increased by a factor of 2 or more.
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PMID:Electrolyte abnormalities before and after the onset of acute renal failure. 175 22

The factors predisposing to and complicating acute renal failure (ARF) in the medical intensive care unit (ICU), and their relative influence on outcome during ARF are unclear. We retrospectively evaluated the relative importance of age, prior chronic disease (including chronic renal failure), sepsis and organ system failure, for development and outcome of ARF in the medical ICU. Of 487 consecutively admitted patients, 78 (16%) had ARF, in 63% treated with renal replacement therapy. Mortality was 63%. Independently from each other, advancing age, prior chronic disease, and cardiovascular and pulmonary failure directly related to the development of ARF, while neurological failure related inversely. Sepsis only contributed to ARF prediction from these variables if cardiopulmonary failure was excluded. Advancing age, cardiovascular failure before and after onset of ARF, pulmonary failure before ARF and use of renal replacement therapy were the major independent factors directly related to ARF mortality, while prior chronic renal failure related inversely and sepsis did not contribute. Hence, the outcome of ARF in a medical ICU is largely dependent on factors predisposing to ARF, even though the severity and complications of ARF may partly contribute. Our results may help in deciding on the prevention and therapy of ARF in a medical ICU.
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PMID:Acute renal failure in the medical intensive care unit: predisposing, complicating factors and outcome. 176

A complex approach to the investigation of circulation system, using central hemodynamic and homeostasis parameters, made it possible to detect in due time compensatory and pathogenetic circulatory changes that differ quantitatively and qualitatively, in patients with acute renal failure of different etiology. The changes are most marked in patients with sepsis during oligoanuria. Timely differential and directed intensive therapy, using conservative and extracorporeal techniques, helps normalize homeostasis and eliminate the signs of circulatory failure at the early stages of therapy.
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PMID:[The status of the central hemodynamics in patients with acute renal insufficiency]. 176 51

Fifty infants and children with acute renal failure were treated with acute peritoneal dialysis between 1987 and 1990. The patients were dialyzed using either a catheter introduced percutaneously over a guide-wire (n = 40) or a Tenckhoff catheter (n = 10). The cause of the acute renal failure was primary renal disease in 17 children, cardiac disease in 19, and trauma/sepsis in 14. Peritoneal dialysis succeeded in controlling metabolic abnormalities, improving fluid balance, and relieving the complications of uremia. The procedure had few major complications. Overall mortality was 50%, reflecting the serious nature of the underlying diseases. We conclude that acute peritoneal dialysis is a safe and effective treatment in most pediatric patients with acute renal failure. Our series of patients treated with acute peritoneal dialysis serves as a basis of comparison for the evaluation of new modalities of therapy in childhood acute renal failure.
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PMID:Peritoneal dialysis for acute renal failure in children. 176 84

Fifty-two clinical charts of children who had been discharged from this hospital, after being treated for acute renal failure, were analyzed to determine the incidence, presentation and results of the treatment used. We found that 0.7% of the total number of children admitted developed this complication and that 4/5 of them were under two years old. The initial illnesses were gastroenteritis, bronchial pneumonia, cyanogenic cardiopathies and sepsis. Some of the patients had hypoxic episodes or went into hypovolemic shock or a combination of both. In half of the patients diagnosis was reached from anamnesis, from of oliguria, acidosis and nitrogen retention. In the rest from whom a urine sample was obtained, the diagnosis was confirmed when the FeNa was higher than 2 and because the U/P osmolarity and urea were under 1.3 and 5 respectively. The oliguric type of acute renal failure was seen in 65% of the cases; the non-oliguric type in 35%. In the first group the mortality rate reached 6.5% even though a third of them were placed under dialysis. Yet, in another 7 cases, dialysis could not be used because the child was in shock. Of the 18 cases of non-oliguric acute renal failure, 12 recovered; only 3 required dialysis. We conclude that the high mortality rate in cases of acute renal failure depends on the severity of the underlying illness, the age of the patient and the delay in the diagnosis of the disease. The use of dopamine and furosemide, as well as the application of hemoperfusion instead place of peritoneal dialysis in neonates with sepsis, could improve results.
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PMID:[Physiopathology, diagnosis and treatment of acute renal insufficiency]. 177 97

The records of 28 children with the pathological diagnosis of American Burkitt's lymphoma were reviewed. Twenty-three of these children (82%) presented with primary abdominal tumors and 5 with disease located in the head and neck. Twelve required an emergency operation for either intestinal obstruction (3), intussusception (5), or appendicitis (4); the others underwent an elective exploration for tissue diagnosis. Ten patients had disease localized to one particular site. Seven of these 10 children underwent complete resection of the tumor including a right colectomy (4), small bowel segmental resection (1), tonsillectomy (1), and appendectomy (1). Eight children had a subtotal resection of the tumor (less than 90% of tumor burden) and the rest underwent incisional biopsies. Following the diagnosis, all patients received chemotherapy; 8 (29%) also were treated concurrently with radiation therapy. Nineteen patients (70%) remain long-term survivors with a mean survival time of 3.6 years. Eight patients died of either recurrent disease (6) or sepsis secondary to their chemotherapy, with a mean survival time of 6 months. Sixteen patients (57%) developed complications during their hospitalization that required surgical consultation or intervention (acute renal failure [9], pleural effusion [2], intestinal obstruction [5], gastric outlet obstruction [1], and wound infection [1]). No subsequent treatment of these complications resulted in mortality or morbidity. The significant positive determinant for survival was the initial absence of either bone marrow or central nervous system involvement (P less than .05). In those children who had complete resection of their tumor, survival time was greater than 3.7 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The role of surgery in American Burkitt's lymphoma in children. 177 35

During a 12-year period 419 patients were admitted because of acute renal failure requiring dialysis. Fifty (12%) had septicemia verified by blood culture. In a retrospective study age, sex, focus of infection, blood culture results, kidney function, mode of dialysis treatment, numbers and durations of complicating organ failures, presence of gastrointestinal bleeding, and secondary complicating events of septicemia were recorded for the purpose of establishing a prognostic index based on clinical criteria. Respiratory failure was present in 34 patients, circulatory failure in 31 patients, failure of coagulation system in 25 patients, and hepatic failure in 10 patients. Overall mortality was 46%. Highest death-rates were found during the first days of dialysis. In patients with multiple organ failures, in elderly and in patients suffering from staphylococcus aureus septicemia, a non-significant trend towards higher mortality was found. The mode of dialysis treatment did not influence patient survival. Our intention of establishing a prognostic index based on bedside clinical criteria has not been fulfilled. Even though mortality-rate increases in patients with acute renal failure complicated by failure of one or more vital organs, survival-rate in patients with four or more organ failures was 30%.
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PMID:Prognosis in septicemia complicated by acute renal failure requiring dialysis. 178 Jul 7

Acute renal failure developed in a young female having puerperal sepsis due to beta-haemolytic streptococci. The patient succumbed to her illness and an autopsy revealed extensive crescentic glomerulonephritis. The association between chronic visceral sepsis and glomerulonephritis is discussed.
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PMID:Crescentic glomerulonephritis associated with puerperal sepsis. 181 8


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