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

One of the dangers of topical therapy in thermal injuries is absorption of the therapeutic agent with subsequent metabolic and toxic complications. Two patients, one 30 years old with a 75% burn, the second 72 years old with a 35% burn, were treated topically with povidone-iodine ("Betadine", pH 2.43). In both patients severe metabolic acidosis developed which could not be attributed to sepsis, hypovolaemia, renal failure, diabetes, lactic acidaemia, &c. The acidosis associated with the 75% burn required large amounts of sodium bicarbonate to maintain pH at 7.35 and a serum-bicarbonate concentration of 15 mmol/l (meq/l); serum-iodine was 48000 mug/dl (normal 4-8.5mug/dl). Acidosis in the second patient was not as severe, and serum-iodine concentration reached 17600 mug/dl. The rate of urinary excretion of iodine was 50.8 +/- 7.4 mg/dl and seemed to be fixed. Haemodialysis was very effective in reducing serum-iodine concentration. Povidone was also systemically absorbed. The persistent acidosis could be caused by absorption of the iodine or the acidic povidone-iodine. Until the aetiology of the acidosis and renal damage is more clear, iodophors should not be used topically for burns greater than 20% of the body surface or in the presence of renal failure.
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PMID:Complications of povidone-iodine absorption in topically treated burn patients. 5 90

The inhibitory effect of sodium acetate on microorganism growth in protein hydrolysate solutions was studied. Solutions of 5% protein hydrolysate and 5% dextrose in water (seven parts) and 50% dextose in water (three parts) containing 0, 30, 50 and 90 mEq/liter of sodium acetate were inoculated with Staphylococcus aureus, Escherichia coli, Candida albicans and Pseudomonas aeruginosa. The number of colony-forming units in the solutions after inoculation was compared with that after incubation for 24 hours at 37 C. Sodium acetate inhibited growth of S aureus and E coli. Growth of P aeruginosa was inhibited in protein hydrolysate solutions with and without sodium acetate; inhibition could not be attributed solely to sodium acetate and may have been releated to pH of the solutions (4.7 to 5.4). Growth of C albicans was not inhibited by sodium acetate. Sodium acetate reduced growth of some common contaminants of protein hydrolysates. Sodium acetate is known to reduce metabolic acidosis, a reported complication of parenteral nutrient therapy and a possible predisposing factor in C albicans sepsis. Addition of sodium acetate to protein hydrolysate solutions should be considered seriously.
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PMID:Sodium acetate as a preservative in protein hydrolysate solutions. 11 72

On the bases of the published data and their own experience the authors outline the context of the functional biochemical alterations that give an orientation in the choice of the major objectives of pathogenic therapy in the course of septicemias. Analysis of the frequency and intensity of these alterations make it possible to establish therapeutical priorities. In this sense it is demonstrated that hyperazotemia, hyperalbuminemia, low alkaline reserve, elevated serum lactate and a decrease in the plasma Na+/K+ ratio are characteristic of septicemia with a state of toxiinfectious shock.
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PMID:[Major objectives of pathogenic therapy of septicemia]. 12 98

Postoperative necrotizing fasciitis with septicemia caused by Staphylococcus epidermidis was documented by cultures of the blood and wound biopsy specimen. Therapy consisted of surgical debridement, topical application of mafenide acetate dressings, and parenteral administration of cefazolin sodium. The combination effectively reversed the progression of infection and necrosis.
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PMID:Treatment of necrotizing fasciitis caused by Staphylococcus epidermidis. 14 58

Acid-base alterations in Streptococcus pneumoniae infection were studied in 80 male albino rats. Hematocrit and concentrations of plasma electrolytes, glucose, and total protein were also measured. At 3-h intervals throughout a 27-h study, four control and four infected rats were anesthetized with ether, and blood samples were taken. Arterial blood pH, Po2, and hematocrit increased in the infected group, whereas arterial Pco2, HCO3-, and venous Po2 decreased. Plasma K+ concentration increased slightly and glucose levels decreased in the infected rats as the sepsis progressed. No significant changes were observed in venous blood pH, HCO3-, and Pco2. Plasma Na+, Cl-, and total protein remained unchanged. The increase in arterial blood pH and decrease in arterial Pco2 and HCO3- indicated respiratory alkalosis, which was present in rats infected with S. pneumoniae.
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PMID:Changes in blood pH in rats after infection with Streptococcus pneumoniae. 23 92

In nine critically ill newborns, five of them with intractable diarrhea and four surgical patients, we administered a 5% crystalline aminoacids solution (AA) and glucose in sufficient amount to provide 120 cal times kg. in 24 hours. Six of them recovered after receiving parenteral alimentation for 3 to 15 days, gained weight during or after treatment and were discharged from the hospital in good conditions. Three died, one of them presented septicemia and two pneumonia and pulmonary infarcts. The solution used generated few metabolic alterations, the acid-base status remained within normal range and there were not important changes in the sodium and potassium serum concentrations. On the contrary, children with hyponatremia and hypokalemia at the beginning of the treatment, normalized these constants within the first hours, as diarrhea ceased. The most frequent complications were infiltrations and reaction of the surrounding tissue of the catheterized vein and local skin infection. Only one patient died of septicemia, possibly caused by this proceeding. In summary, parenteral alimentation though not free from risk, seems to be a useful proceeding when oral feeding is impossible or inadvisable. The utmost danger is septicemia. Metabolic changes are minimal and they do not mean a risk for child's life; nevertheless, there is a need for long term studies to bring up definite conclusions. The solutions in actual use are probably not the most physiological for the newborn. It is necessary to adequate them according to the new advances made on child nourishment during his first days of life.
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PMID:[Parenteral nutrition in critically ill newborns]. 23 14

Numerous studies have demonstrated that reticuloendothelial system (RES) depression induced by colloid blockade increases susceptibility to circulatory shock following trauma and sepsis. Recent data have suggested that this may relate to the failure of the RES to clear potentially embolic material derived from activation of the hemostatic system. The present study thus compared the hypotensive response precipitated by trauma or sepsis with that resulting from induction of intravascular coagulation. Mean arterial blood pressure (MABP) was monitored for 120 minutes after sublethal NCD trauma and after intra-aortic injection of live E coli (approximately 10(10) organisms per rat), E coli endotoxin (0.1 mg/100 gm), or bovine thrombin (10 units/100 gm) in 400-500 gm rats 30 minutes after RE blockade (50 mg/100 gm gelatinized lipid colloid) or saline injection. All rats were anesthetized with sodium pentobarbital. No hypotension was observed in blockaded control rats. After trauma, MABP decreased by 20 minutes after injury and recovered to normal levels by 1 hour post-trauma. MABP decreased in blockaded rats after trauma and remained diminished through 2 hours. After live E coli endotoxin or thrombin, both the normal and the blockaded groups underwent an initial hypotension of similar magnitude. A second period of hypotension was much more pronounced in the RE-blockaded animals. Reduced MABP persisted in these animals through 2 hours. These data indicate that RE blockade enhances the hypotensive response to intravascular coagulation and that resulting from trauma or sepsis. This effect was especially apparent during the second phase of hypotension during sepsis and intravascular coagulation. It was suggested that the RES manifests some protective effect against the agents inducing this secondary hypotensive response.
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PMID:Effect of reticuloendothelial blockade on the development of hypotension after trauma, sepsis, and intravascular coagulation. 26 5

To detect microorganisms in the blood it is necessary not only that the microbiologist uses reliable methods, but also that the clinician takes a sufficient number of blood samples at the right point in time using a correct method for drawing the blood. The best results are obtained if the blood sample is transferred to the culture media at the bedside. The media should contain anticoagulants, osmosis stabilizers and preparations to neutralize the microbial action of the blood (caused by intrinsic and extrinsic factors). Up until now sodium polyanetholsulfonate ("Liquoid") has proved to be the most suitable additive. The procedure used for blood culturing must enable growth of aerobes, anaerobes and microbes with cell-wall damage. Today, modern methods such as radiometry, impedance measurement and microcalorimetry are used or are in the process of being developed which facilitate screening for positive cultures. Antigens, cell-wall constituents and metabolites of bacteria and fungi present in the blood stream can be detected by means of counter-immunoelectrophoresis, the Limulus test and gas chromatography, without culturing being necessary. Concentration techniques such as filtration and centrifugation are also being refined to enable a more reliable and earlier detection of septicemia.
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PMID:[Microbiological diagnosis of septicemia (author's transl)]. 32 48

Resistance to intravenous (IV) and intraperitoneal (IP) bacterial challenge during periods of reticuloendothelial (RE) depression following trauma as well as the influence of bacteremia on RE phagocytosis were studied. The experimental shock model utilized was the anesthetized (2 mg/100 g sodium pentobarbital) male rat subjected to nonlethal Noble-Collip drum trauma. During post-traumatic RE depression (60 min after injury) rats were challenged IV or IP with Escherichia coli (1.02 X 10(10)). The clearance half-time of the bacterial load injected intravenously in controls was 1.23 +/- 0.10 min. In contrast, the half-time was 3.62 +/- 0.69 min after sublethal trauma (p less than 0.005) and associated with prolonged blood bacterial retention. Pulmonary localization of E. coli administered either IV or IP was elevated in traumatized rats. Comparison of routes of bacterial challenge with respect to blood levels of viable bacteria suggested lower host bacterial resistance to the IP injection as opposed to the IV route of administration. Production of experimental bacteremia in normal rats resulted in a 39% depression (p less than 0.01) of RE test colloid clearance rate accompanied by a 49% increase (p less than 0.01) in pulmonary colloid localization. The data suggest that depressed systemic RE clearance capacity following trauma may decrease systemic resistance to septicemia, and that severe bacteremia may further undermine the functional state of the reticuloendothelial system.
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PMID:Reticuloendothelial phagocytic response to bacterial challenge after traumatic shock. 33 34

Patients with refractory ascites and HRS should be considered to present an urgent indication for peritoneovenous shunting. The shunt offers a method of continuous reinfusion of ascitic fluid which corrects avid sodium retention, oliguria and azotemia. Severe encephalopathy, jaundice or peritoneal sepsis--common complications of cirrhosis--contraindicate installation of the shunt before improvement occurs. Associated cardiac disease does not contraindicate the use of the shunt provided that ascitic fluid is removed at the time of operation and large amounts of diuretics are used. This operation has also proved useful in ascites attributed to causes other than cirrhosis. The main complications include disseminated intravascular coagulopathy, hepatic coma and sepsis in a few patients. Results of a randomized prospective study indicate that the shunt should probably be considered in patients with diet-resistant massive ascites even before they prove to be refractory to diuretic therapy.
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PMID:Ascites: its correction by peritoneovenous shunting. 37 15


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