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

Serial TSH and T4 determinations were performed in sixty neonates admitted to our hospital for neonatal intensive care within a period of three months. Seven patients (12%) showed transient hypothyroidism on the basis of low T4 and high TSH values. Only one of these patients, who had meconium aspiration and pneumonia, did not have the respiratory distress syndrome. In addition, 4 of these patients had sepsis. All of the patients were born before 37 gestational weeks and had birth weights under 2200 g. In addition, two patients of this gestational age and birth weight group had a progressive fall of T4 to extremely hypothyroid values without simultaneous elevation of TSH. Two of the 5 patients who died had histological studies of their thyroids. These revealed colloid-depleted vesicles, desquamated epithelium, and prominent vascularisation of the thyroid. The results of this study show that early recognition and therapy of transient hypothyroidism may be live saving.
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PMID:Transient hypothyroidism associated with prematurity, sepsis, and respiratory distress. 49 63

Pulmonary alterations after shock and sepsis, described clinically as shock lung or adult respiratory distress syndrome, are of great importance in intensive care. Pathogenetically an alteration of the surfactant system of the lung is often discussed. Since phospholipids are constituents of lung surfactants, phospholipid metabolism is investigated in experimental peritonitis in rats in our laboratory. 15 hours after inducing a peritonitis, the lung incorporates more oleic acid than that in animals of the reference group. 33 hours after inducing peritonitis, the capacity of the lung to incorporate choline and fatty acids is markedly reduced, histologically the lungs represent morphological equivalents of the so-called shock lung at this time. Therefore we conclude, that an alteration of phospholipid metabolism with a diminished and/or altered synthesis of lung surfactant plays, at least in part, an important role in the pathogenesis of respiratory distress in sepsis and peritonitis.
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PMID:Altered metabolism of phospholipids in the lung of rats with peritonitis. 58 Aug 12

To analyze the risk of cannula sepsis from indwelling umbilical arterial catheters and the indication for prophylactic antibiotics, 137 catheterized neonates with respiratory distress were prospectively placed into either antibiotic-treated (penicillin 50,000U/kg/day and kanamycin 15 mg./kg./day) or non-treated groups. Although bacteria were frequently isolated from blood and catheter tip cultures obtained upon removal of the catheter, especially among non-antibiotic treated infants, these isolates were predominantly non-pathogens and probably skin flora. Corresponding peripheral blood cultures were usually sterile. No cases of cannula-associated sepsis occurred among treated and non-treated newborns. The risk of bacteriologically proven sepsis resulting from an indwelling umbilical artery catheter appears insufficient to justify prophylactic antibiotics.
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PMID:Prophylactic antibiotics in neonates with umbilical artery catheter placement: a prospective study of 137 patients. 60 56

Seven cases of heart arrest or pronounced bradycardia during 308 correct catheterizations of the umbilical vein in the first hours of life are reported. The indications for the catheterization were: 1. unsuccessful catheterization of the umbilical arteries in newborns with respiratory distress or post-asphyxia syndrome; 2. exchange transfusions for severe neonatal hyperbilirubinemia or sepsis; 3. monitoring the central vein pressure in severely compromised shocky newborns. Cardiac massage was always effective, at least temporarily, in restoring the heart activity. However, only three infants survived. Two of them had normal follow-up reported at 6 and 12 months respectively. The immediate risks and the necessary precautions for carrying out umbilical vein catheterization in severely ill newborns in the first hours of life are stressed.
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PMID:Umbilical vessel catheterization; the immediate risks with the venous route. 62 82

An increased morbidity by Streptococcus agalactiae (group B streptococci) during the perinatal period was to be found in some countries since 1961. Six cases of group B streptococcal meningitis were confirmed by the Central Streptococcus Laboratory of the GDR from July to December 1975. Therefore it is necessary to look for group B streptococcal infection in certain cases of diseases of the newborn. In a short review of literature the clinical signs (acute onset with respiratory distress, sepsis or late onset with meningitis), prevalence, source of infection and therapy (ampicillin or a combination of penicillin G and gentamicin) were summarized. The diagnosis is confirmed by isolation of group B streptococci.
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PMID:[Infections in newborn infants caused to B-streptococci]. 79 Aug 43

A retrospective study involving all admissions to two neonatal intensive care centers over a 4-year period was carried out to assess the protective effect, or lack of it, of prolonged rupture of membranes (ROM) on the prevalence of idiopathic respiratory distress syndrome (IRDS) in premature infants. Significantly fewer cases of IRDS were found in patients in all gestational age groups when ROM was greater than 24 hours as compared with those with ROM of less than 12 hours' duration. However, prolonged ROM was not consistently associated with a difference in prevalence of respiratory failure accompanying IRDS, or in the prevalence of sepsis or neonatal mortality in this patient population. It is concluded that benefit to a premature infant in the form of reduced risk of developing IRDS is possible if the mother is allowed 24 hours after ROM before the delivery is initiated.
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PMID:Association of premature rupture of membranes with idiopathic respiratory distress syndrome. 83 98

Observations were made on 153 preterm infants (25 to 34 weeks' gestation) in an attempt to answer the following questions: dose prolonged rupture of the fetal membranes (ROM) correlate with a decreased frequency of respiratory distress syndrome (RDS) and patent ductus arteriosus, and, if so, what is the duration of ROM required? An analysis of the data indicates that as the duration of ROM is lengthened the incidence of RDS and patent ductus arteriosus decreases. In fact, after 48 hours of prolonged ROM (PROM), there is a virtual absence of RDS. In addition, after 72 hours of PROM, the frequency of patient ductus arteriosus was markedly reduced to only 12 per cent (three of 25 infants). PROM beyond 24 hours was also associated with a significant decrease in deaths (p less than 0.05). Amnionitis occurred in 33 per cent of pregnancies with PROM greater than 48 hours; however, only one infant died of sepsis. These findings support the hypothesis put forth by the others 1-5 that PROM is indeed associated with a decreased frequenct of RDS in preterm infants. Moreover, our findings suggest that PROM greater than 72 hours is associated with a relatively low frequency of patent ductus arteriosus. The question is then raised that perhaps pregnancies less than or equal to 34 weeks' gestation with PROM should be allowed to continue for 72 hours in the absence of amnionitis.
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PMID:Prolonged rupture of fetal membranes and decreased frequency of respiratory distress syndrome and patent ductus arteriosus in preterm infants. 90 Jan 67

The records of 212 patients of 36 weeks' gestational age or less were reviewed to study the relationship between premature rupture of the membranes (PRM) and the development of the respiratory distress syndrome (RDS). PRM greater than 16 hours resulted in a statistically significant decrease of RDS in neonates of 32 weeks' gestational age or less but not in the group from 32 to 36 weeks' gestational age. However, survival was significantly improved with PRM greater than 16 hours in the latter group but not in the former. A possible explanation for this observation is offered. Black patients had a higher over-all infant mortality rate than white patients, and, although the incidence of RDS is similar in both races, it may be a more lethal condition in black patients. There was no significant difference noted between female and male infants. Sepsis was responsible for only seven deaths in this series, and three of those cases could not be etiologically related to prolonged PRM.
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PMID:The relationship between premature rupture of the membranes and the respiratory distress syndrome. 94 82

50 low-birth-weight infants (1,000 g. or less) admitted to an Intensive Care Unit from January 1972 up to December 1974 are evaluated. Obstetrical data maturity and morbidity are compared in order to investigate factors that might predispose survival of these infants. Significant differences in gestational age, birth weight and maturity have been encountered. Mortality rate increases with a low Apgar score at one and five minutes, a low hematocrit an admission, early appearance of apnea, respiratory distress, when ressuscitation was required, need for assisted ventilation and septicemia. Among the factors that improve the rate of survival are: being small for gestational age, early rupture of membranes and temperature on admission above 35.5 degrees (axillary). Problems most frequently encountered were respiratory distress, apnea, infection and metabolic disturbances. Mortality rate was 76%, lowered to 50% among the small for gestational age group. The main causes of death were sepsis, severe hypoxia and intracraneal hemorrhage.
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PMID:[Morbidity and mortality in low-birth-weight infants (1,000 g, or less (author's transl)]. 99 93

Early diagnosis is mandatory in the adult respiratory distress syndromes, particularly in sepsis, and therapy should begin as soon as there is a reasonable suspicion that this problem is developing. Blood-gas changes cannot usually be appreciated clinically until the respiratory problem is quite severe. Accordingly, serial blood-gas analyses should be performed in any septic patient who has an increased chance of developing ARDS. Any deterioration in the patient's condition, blood gases, or ventilatory effort should be considered as an indication for early ventilatory assistance. Control of the primary process, high tidal volumes, PEEP, and careful dehydration are the mainstays of therapy. Serial blood gases and careful observation of the patient's effective compliance are essential to determine the optimal ventilator settings and the optimal PEEP. Early administration of massive steroids should be considered if the patient fails to respond to correction of the underlying etiologic problem (particularly sepsis), careful progressive dehydration, and optimal expansion of the alveoli (using high tidal volumes and/or PEEP).
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PMID:The diagnosis and treatment of acute respiratory failure in sepsis. 104 56


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