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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report a statistical analysis of 163 operations of aorto-iliac vascular surgery. A detailed study of their 14 deaths showed the various causes of mortality (immediate post-operative thrombosis, acute renal failure, digestive complications, septic cardiac, pulmonary, hemorrhagic and cerebro-vascular accidents). This analysis, compared with the findings in all the operated patients showed the main factors of risk in this type of surgery (age over 70 years immediate and late reoperations, heart lesions, renal, pulmonary and late lesions, the risk of sepsis). The indicate the means of prevention of such accidents and the therapeutic attitude when they occur. They conclude that the contra-indications are relative, but should be observed in order to lower the risk of this surgery below 5 p. cent mortality rate.
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PMID:[Risk factors in aorto-iliac surgery (author's transl)]. 21 67

Acute intrinsic renal failure occurred in an adult patient with Escherichia coli septicemia. The clinical course did not include any of the circumstances usually present when acute renal failure complicates Gram-negative sepsis. A renal biopsy showed acute proliferative glomerulonephritis. There was no evidence to support other known causes of acute parenchymal renal failure, such as poststreptococcal glomerulonephritis, subacute bacterial endocarditis, or vasculitis. The patient recovered completely with antibiotic therapy, and renal function returned to normal within two weeks. An immunologic mechanism involving E coli was considered responsible for the acute renal failure.
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PMID:Gram-negative sepsis with acute renal failure. Occurrence from acute glomerulonephritis. 33 Aug 92

Clinical characteristics of 46 cases of acute pancreatitis treated with total parenteral nutrition were examined. Hyperalimentation may be used in these severely ill patients with minimal technical or metabolic morbidity. This method of nutritional support can maintain patients with nonfunctional gastrointestinal tracts for several months. Catheter-related sepsis was more common than expected early in the course of acute pancreatitis but caused minimal morbidity. The incidence of catheter-related sepsis late in disease was minor. Hyperalimentation had little if any effect on the pathophysiology of acute pancreatitis as judged by the overall mortality and the incidence and severity of the complications of acute respiratory failure and acute renal failure. It is not clear that parenteral hyperalimentation alters the course of acute pancreatitis but it is a useful adjunct for nutritional support in this illness.
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PMID:Parenteral nutrition in the treatment of acute pancreatitis: effect on complications and mortality. 41 29

Eleven cases of renal failure associated with resection of ruptured abdominal aortic aneurysm and requiring hemodialysis are reported. Previously described series have emphasized the extremely high mortality rate in such patients. In our clinical experience, however, 8 of 11 consecutively treated patients with this clinical problem survived and recovered adequate renal function. We believe that these favorable results can be largely explained by the low incidence of pulmonary infection in our patients as opposed to the frequent occurrence of pulmonary sepsis in other reported series. The reduction in the incidence of pulmonary infection can probably be attributed to the early discontinuance of artificial ventilation after prompt removal of pulmonary edema fluid by intensive hemodialysis ultrafiltration. These survival figures demonstrate that, with appropriate intensive management, full recovery is possible in the majority of patients with acute renal failure complicating ruptured aortic abdominal aneurysm. Our experience serves as a stimulus to render full intensive care support to such patients.
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PMID:Acute renal failure after ruptured abdominal aortic aneurysm: an improved clinical prognosis. 45

A retrospective study of 35 newborn with acute renal failure is presented. The main causes of renal failure were neonatal hypoxia by asfixia or hemorrhagic shock (eight), congenital malformations (two) and hypertonic dehydration (25). Mortality rate was 22% including two neonates with severe congenital malformations. Sepsis was considered as the main complicating factor and often as inducer of renal failure. It was present on 55% of cases and on 75% of the deceased newborn. Cerebral injury was frequent but a follow-up study is necessary to establish the rate of neurologic sequelae. Early diagnosis and treatment of renal failure will decrease complications with improvement in prognosis. Etiological analysis of neonatal renal failure shows the need of a better health education of people and also medical control of pregnancy and perinatal period.
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PMID:[Morbidity and mortality of acute renal failure in neonatal period (author's transl)]. 46 2

A male patient was admitted to hospital 12 h after self-poisoning with mercuric chloride. He suffered multiple complications including acute renal failure, ulcerative colitis, anaemia, disseminated intravascular coagulation, chronic sepsis and severe weight loss. Initially he responded well to resuscitative measures and intensive supportive therapy, which included ventilation of the lungs, haemodialysis, dimercaprol, antibiotics, parenteral feeding and gastrointestinal surgery. Unfortunately the sepsis was never satisfactorily eradicated despite satisfactory serum concentrations of the appropriate antibiotics. On day 43 after poisoning he had a grand mal fit; after this there were focal neurological signs and on lumbar puncture he was found to have a raised protein concentration and raised pressure in his cerebrospinal fluid. The condition of the patient rapidly deteriorated and on day 47 he died. Post-mortem examination revealed a large cerebellar abscess. The literature on mercury poisoning is reviewed.
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PMID:A case of poisoning with mercuric chloride. 49 32

This is a retrospective study of 133 episodes of bacteremic infection in 112 hemodialysis patients. The frequency of bacteremic infection was 9.5% in patients with chronic renal failure and 10.9% in patients with acute renal failure. In patients with acute renal failure, pneumonia and intra-abdominal abscess were the most frequent sources of septicemia. Sepsis was usually due to Gram-negative organisms and mortality was high. In patients with chronic renal failure, infection of the shunt or fistula was the most common cause, was frequently due to Staphylococcus organism, and had a more favorable survival rate. Gram-negative septicemia from a nonaccess source in patients with chronic renal failure was associated with a higher mortality. Bacterial endocarditis and septic pulmonary emboli occurred in 3.6% of septic episodes and 0.35% of patients at risk and had very low mortality. A low threshold for obtaining blood cultures and early antibiotic treatment are believed to be important in the treatment of bacteremic infections in patients undergoing long-term hemodialysis.
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PMID:Bacteremic infection in hemodialysis. 50 22

Over a period of 2 years, 82 patients out of 2,390 (3.43%) admitted to an intensive care unit developed acute renal failure (ARF). The diagnosis of ARF was based on the usual criteria of oliguria, a rising blood urea nitrogen and creatinine, urine sodium concentration greater than 20 mmol/l and a U/P osmolality ratio less than 1.1. In 9.2% of patients the latter two criteria were misleading. Sepsis was the commonest cause of vasomotor nephropathy but in 20.7% potentially nephrotoxic agents had been administered before development of ARF. Overall mortality was 73.2%, with patients older than 50 years of age having the highest mortality. ARF is associated with prolonged bed occupancy--an average of 59.8 days for the dialysed patients with ARF versus an average length of stay of 8.4 days for the hospital overall.
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PMID:Aetiology, diagnosis, treatment and prognosis of acute renal failure in an intensive care unit. 54 32

The association of nephrotic syndrome and renal vein thrombosis has been increasingly reported in the literature due to the use of modern complementary explorative techniques. The incidence of renal vein thrombosis in the nephrotic syndrome varies according to the different authors. The pathogenesis of this association has been widely discussed and even though renal vein thrombosis has formerly been considered as one more cause of nephrotic syndrome, there are at present numerous arguments supporting the opposite thesis. A case of nephrotic syndrome and unilateral thrombosis of the renal vein in a patient with primitive extramembranous glomerulonephritis is reported. Blood coagulation studies revealed an initial hyperfibrinogenemia and a persistent decrease of factors V, VII, and X, with low rates of prothrombin. A thrombectomy was carried out, but the patient presented a Gram-negative sepsis without hypotension in the immediate postoperative period. As a consequence an acute renal failure developed and hemodyalisis was necessary for 2 months. The pathogenesis of both conditions are discussed.
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PMID:[Nephrotic syndrome and unilateral thrombosis of the renal vein. Acute renal failure and disturbances of the hemostasis (author's transl)]. 54 30

Acute renal failure may be a contributory cause of death in patients with acute leukemia. The purpose of this study was to define the causes and course of acute renal failure in group of patients with acute leukemia in order to identify preventive measures and reversible aspects of the renal insufficiency. Among 88 patients with acute leukemia whose courses were followed to the time of death, ten developed acute renal failure. Etiologic factors of the renal failure were uric acid nephropathy, sepsis with complicating hypotension and hypovolemia, and the administration of nephrotoxic antibiotics. In one patient ureteral obstruction from clots was responsible for renal failure, while in another patient disseminated aspergillosis led to renal failure. Other causes of acute renal failure in persons with acute leukemia, but not observed in this patient group, are hypercalcemia and leukemic infiltration of the kidneys.
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PMID:Acute renal failure in patients with acute leukemia. 63 12


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