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

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

There appears to be a great similarity between all of the various types of Adult Respiratory Distress Syndromes (ARDS) in that they are all characterized by progressively increasing interstitial edema in the lungs and a reduced functional residual capacity. Early diagnosis is mandatory and therapy should be started as soon as there is a reasonable suspicion, based on the patient's injury or illness and the previous condition of his lungs, that acute respiratory failure is developing. Sepsis, shock, CNS or thoracic disease and trauma are important associated factors. Blood gas changes usually cannot be appreciated clinically until the respiratory problem is quite severe. Accordingly, serial blood gas analyses should be performed on any patient who has a reasonable chance of developing ARDS. We have found that changes in the estimated AaDO2 on room air are especially helpful. Any deterioration in the patient's clinical condition, blood gases or ventilatory effort should be considered as an indication for early ventilatory assistance. Control of the primary process, careful dehydration, high tidal volumes, and PEEP are the mainstays of therapy. Serial blood gases and careful observation of the patient's effective compliance are essential to determine the optimal ventilator setting and the optimal amount of PEEP. Recently intermittent mandatory ventilation (IMV) with very large amounts of PEEP have been reported to be of value. Early administration of massive steroids should be considered if the patient fails to respond promptly to correction of the underlying etiologic problem, particularly sepsis, careful progressive dehydration and optimal expansion of the alveoli, with high tidal volumes and PEEP.
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PMID:Acute respiratory failure. 127 53

Aeromonas hydrophila is a gram-negative bacterium that commonly inhabits soil and stagnant water. On extremely rare occasions, the organism can cause an aggressive, rapidly spreading, necrotizing infection in humans. The systemic signs of high fever, tachycardia, and elevation of the white blood cell count appear within 24 hours of wound contamination. If the wound is obscured by a cast, these signs erroneously may be attributed to a respiratory problem, e.g., atelectasis or fat metabolism. The organism is not usually sensitive to penicillin or cephalothin. The key to success for saving the extremity appears to be early aggressive debridement. Early diagnosis requires prompt wound inspection as soon as clinical signs of sepsis appear.
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PMID:Aeromonas hydrophila infection complicating an open tibial fracture. A case report. 714 58