I principali markers di sepsi e la loro importanza nella fase diagnostico-terapeutica
|
|
- Ethan Wilkins
- 6 years ago
- Views:
Transcription
1 1
2 I principali markers di sepsi e la loro importanza nella fase diagnostico-terapeutica Alessandro Russo Department of Public Health and Infectious Diseases Sapienza University of Rome a.russo@uniroma1.it
3 Effect of timing on survival Fraction of total patients Time from hypotension onset (hours) Crit Care Med 2006;34:
4
5 Emergency
6 Possible sources of 35 infection Lung Intra- Genito- SSTI Bloodstream abdominal urinary Crit Care Med. 2006;34:
7 Positivity of blood cultures in different clinical syndromes Endocarditis and bloodstream infections 85% - 95% Bacteremic pneumonia 5% - 30% Ascending Pyelonefritis 30% - 50% Ematogenous osteomyelitis 30% - 50% Bacterial Meningitis Intra-abdominal abscesses FUO Variable Variable Variable Crit Care Med. 2006;34:
8
9 Surviving sepsis campaign 3
10 Uses of biomarkers Screening To identify patients at increased risk of adverse outcome to inform a prophylactic intervention or further diagnostic test Diagnosis To establish a diagnosis to inform a treatment decision and to do so more reliably, more rapidly, or more inexpensively than available methods Risk stratification To identify subgroups of patients within a particular diagnostic group who may experience greater benefit or harm with therapeutic intervention Monitoring To measure response to intervention to permit the titration of dose or duration of treatment Surrogate endpoint To provide a more sensitive measure of the consequences of treatment that can substitute for a direct measure of a patient-centered outcome 10
11 11
12 12 Ann Emerg Med. 2005; 45:
13 Algoritmo paziente infetto
14 Sepsis: Diagnostic Methods and Protocols, Methods in Molecular Biology, vol. 1237
15
16 16 Sepsis: Diagnostic Methods and Protocols, Methods in Molecular Biology, vol. 1237
17 PCT levels accurately differentiate sepsis from noninfectious inflammation Simon L. et al. Clin Infect Dis. 2004; 39:
18 SIGNIFICATO CLINICO DELLA PROCALCITONINA POSSIBILE SEPSI ELEVATO RISCHIO DI PROGRESSIONE A SEPSI SEVERA E/O A SHOCK SETTICO BASSO RISCHIO DI PROGRESSIONE A SEPSI SEVERA E/O A SHOCK SETTICO
19 CINETICA DELLA PROCALCITONINA La cinetica della PCT mostra : 1.un aumento rispetto al valore basale dopo 3-6 ore dalla somministrazione di endotossina (o dell invasione batterica) 2.un incremento significativo dopo circa 6 ore 3.il valore di picco viene raggiunto tre le 12 e le 48 ore 4.Ha un'emivita di 24 ore. 5.Cinetica migliore per descrivere l evento infettivo rispetto alla PCR
20 I livelli di PCT sono progressivamente maggiori a seconda della severità della sepsi Zeni et al. Clin Intens Care 1994; 5: 2 I livelli di PCT correlano con il grado di insufficienza dorgano nei pazienti settici, valutato con il SOFA-score Luzzani et al. Crit Care Med 2001; Vol.31 No.6
21 EVIDENZE SULL UTILITA DELLA PCT NELLA GESTIONE DELL ANTIBIOTICOTERAPIA
22 Procalcitonin in septic shock Muller and Trampuz. Int J Antimicrob Agents 2007; 30 Suppl 1: S16-23
23 IL SETTING CLINICO INFLUISCE SUI VALORI NORMALI DELLA PCT
24 Expert Rev. Clin. Immunol. 10(9), (2014) 26
25 Lancet Infect Dis 2016; 16:819-27
26
27 Conditions causing elevation of C- reactive protein Bacterial infections Hypersensitivity complications of infections Inflammatory diseases Transplantation Cancer Necrosis Trauma Burns Fractures 29
28 Situations where the PCT elevations may be due to a non-bacterial cause Newborns Massive stress (severe trauma, surgery, cardiac shock, burns) Pancreatitis Treatment with agents which stimulate cytokines (OKT3, antilymphocyte globulins, alemtuzumab, IL-2, granulocyte transfusion ) Malaria and fungal infections Prolonged, severe cardiogenic shock or organ perfusion abnormalities Some forms of vasculitis and acute graft vs. host disease Paraneoplastic syndromes due to medullary thyroid and small cell lung cancer Significantly compromised renal function, especially ESRD/hemodialysis 30
29 Serum procalcitonin measurement contribution to the early diagnosis of candidemia in critically ill patients Charles E et al Intensive Care Med (2006) 32:
30 Early diagnosis of candidemia in ICU patients with sepsis: a prospective comparison of (1 3)-b-D-glucan assay, Candida score, and colonization index Posteraro B, Antonelli M, Tumbarello M,..& Sanguinetti M Crit Care Med, 2012
31 Beta 1 3 D glucan as a prognostic marker of treatment response in invasive candidiasis Jaijkul S et al Clin Infect Dis 55: 521, 2012
32 Un possibile approccio pre-emptive nel paziente critico BDG>250 pg/ul inizia echinocandina BDG <200 - >80 pg/ul Candida score >=3 inizia echinocandina
33 BioMed Research International Volume 2014, Article ID , 10 pages
34 Platelet Activation Is Associated With Myocardial Infarction in Patients With Pneumonia Cangemi, R., et al., J Am Coll Cardiol. 2014; 64(18): Potential Mechanisms for Platelet Activation During Severe Pneumonia
35 Expert Rev. Clin. Immunol. 10(9), (2014) 37
36 PRESEPSIN AS A POTENTIAL USEFUL MARKER TO PREDICT A BACTERIAL INFECTION RELAPSE IN CRITICAL CARE UNIT PATIENTS. PRELIMINARY STUDY Sargentini V, Ceccarelli G, Morelli A, Venditti M & Bachettoni A et Clin Chem Lab Med Clinical course of Presepsin and Procalcitonin in a septic patient 38
37 39
38 40
39 41
40 42 Trends Mol Med March ; 15(3): 129
41 43 AUTOPHAGY 2016, VOL. 12, NO. 7,
42 44
43 How to manage septic shock? Every medical therapy has potential adverse effects, and selection of patients most likely to benefit is crucial, making more personalized approaches necessary. Immune biomarkers measured on admission and during follow-up can guide/support the clinician s early recognition of sepsis, severity assessment and therapeutic decisions in individual patients. Biomarkers may allow transition from generalizing sepsis care bundles to a more tailored management in individual patients thereby reducing the risk for adverse treatment outcomes in patients who based on their biomarker levels do not likely benefit from therapy. Lactate improves initial risk stratification and prompts early fluid resuscitation. Lactate clearance may be used for assessing a patient s response to fluids. Procalcitonin facilitates assessment of bacterial infection risk. Procalcitonin algorithms for guiding therapeutic decisions about initiation and duration of antimicrobial therapy have shown strong effects in regard to lower antibiotic consumption and appear to be safe regarding the results from interventional trials. Proadrenomedullin is an inflammatory prognostic immune marker that improves early mortality prediction and might improve site-of care decisions in patients with respiratory infections. Autophagy and precisione medicine are the new frontiers?
Sepsi: nuove definizioni, approccio diagnostico e terapia
GIORNATA MONDIALE DELLA SEPSI DIAGNOSI E GESTIONE CLINICA DELLA SEPSI Giovedì, 13 settembre 2018 Sepsi: nuove definizioni, approccio diagnostico e terapia Nicola Petrosillo Società Italiana Terapia Antiinfettiva
More informationDisclosures. Objectives. Procalcitonin: Pearls and Pitfalls in Daily Practice
Procalcitonin: Pearls and Pitfalls in Daily Practice Sarah K Harrison, PharmD, BCCCP Clinical Pearl Disclosures The author of this presentation has no disclosures concerning possible financial or personal
More informationProcalcitonin YUKON KUSKOKWIM HEALTH CORPORATION PRESENTED BY: CURT BUCHHOLZ, MD AUGUST 2017
Procalcitonin YUKON KUSKOKWIM HEALTH CORPORATION PRESENTED BY: CURT BUCHHOLZ, MD AUGUST 2017 Procalcitonin (PCT) PCT isbeing studied as a biomarker for infection PCT consists of 116 amino
More informationThe Usefulness of Sepsis Biomarkers. Dr Vineya Rai Department of Anesthesiology University of Malaya
The Usefulness of Sepsis Biomarkers Dr Vineya Rai Department of Anesthesiology University of Malaya 1 What is Sepsis? Whole Body Inflammatory State + Infection 2 Incidence and Burden of Sepsis in US In
More informationL utilizzo della Procalcitonina in Medicina d Urgenza
L utilizzo della Procalcitonina in Medicina d Urgenza Stefania Battista Dirigente Medico S.C. Medicina d Urgenza Azienda Ospedaliero-Universitaria San Giovanni Battista di Torino Savona, 15 ottobre 2009
More information6/29/2017. Role of Biomarkers in the Management of Heart Failure Patients. What s New in Biomarkers for HF Patients?
What s New in Biomarkers for HF Patients? Role of Biomarkers in the Management of Heart Failure Patients Lori B. Daniels, MD, MAS, FACC Professor of Medicine Director, Cardiovascular Intensive Care Unit
More informationPCT. PCT in Bacterial Infections and Sepsis. Early Diagnosis. Assessment of Severity and Prognosis. Support for Therapeutic Decision Making
PCT PCT in Bacterial Infections and Sepsis Early Diagnosis Assessment of Severity and Prognosis Support for Therapeutic Decision Making Diagnosis and monitoring of sepsis Clinical need for earlier detection
More informationBIOMARKERS IN SEPSIS: DO THEY REALLY GUIDE US? Asist. Prof. M.D. Mehmet Akif KARAMERCAN Gazi University School of Medicine Depertment of Emergency
BIOMARKERS IN SEPSIS: DO THEY REALLY GUIDE US? Asist. Prof. M.D. Mehmet Akif KARAMERCAN Gazi University School of Medicine Depertment of Emergency Medicine 1 NO CONFLICT OF INTEREST 2 We do not fully understand
More informationCosa non è ancora chiaro nella sepsi dell anziano?
Cosa non è ancora chiaro nella sepsi dell anziano? Sepsis is amongst the most complex of diseases known to man P Marik 2016 Preexisting conditions Hypertension Recent surgery COPD Malignancy Diabetes Myocardial
More informationInitial Resuscitation of Sepsis & Septic Shock
Initial Resuscitation of Sepsis & Septic Shock Dr. Fatema Ahmed MD (Critical Care Medicine) FCPS (Medicine) Associate professor Dept. of Critical Care Medicine BIRDEM General Hospital Is Sepsis a known
More informationFluorescence immunoassay Point of care test Wide range PCT. whole blood. plasma. serum
Fluorescence immunoassay Point of care test Wide range PCT whole blood serum plasma ichroma PCT Description ichroma PCT along with ichroma Reader is a fluorescence immunoassay for quantitative determination
More informationADVANCES IN BIOMARKER TESTING FOR SEPSIS AND BACTERIAL INFECTIONS
ADVANCES IN BIOMARKER TESTING FOR SEPSIS AND BACTERIAL INFECTIONS ERIC H GLUCK MD JD FCCP FCCM DIRECTOR OF CRITICAL SERVICES SWEDISH COVENANT HOSPTIAL DISCLOSURES: Speaking engagements and consulting:
More informationUse of procalcitonin assay to streamline antibiotic usage. Dr Kristine Luk
Use of procalcitonin assay to streamline antibiotic usage Dr Kristine Luk Outline Procalcitonin physiology & kinetics Limitations Different settings - primary care & AED - critically ill patients - neutropenic
More informationUsefulness of Procalcitonin in the management of Infections in ICU. P Damas CHU Sart Tilman Liège
Usefulness of Procalcitonin in the management of Infections in ICU P Damas CHU Sart Tilman Liège Procalcitonin Peptide 116 AA Produced by parenchymal cells during «sepsis»: IL1, TNF, IL6 : stimulators
More informationSepsis is an important issue. Clinician s decision-making capability. Guideline recommendations
Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012 Clinicians decision-making capability Guideline recommendations Sepsis is an important issue 8.7%
More informationDisclosure: Member of the advisory board of EUPHAS 2
Disclosure: Member of the advisory board of EUPHAS 2 SEPSI SEVERA confronto con altre patologie maggiori (USA) MORTALITA Mortality of Severe Sepsis Morti / anno AIDS* CANCRO mammella IMA SEPSI SEVERA
More informationBiomarkers in sepsis: Utility in critical care
Biomarkers in sepsis: Utility in critical care Fathima Paruk, PhD Charlotte Maxeke Johannesburg Academic Hospital and University of Witwatersrand Kumar A et al, Chest 2009; 136:1237-48. von Gunten et al
More informationFluid Resuscitation and Monitoring in Sepsis. Deepa Gotur, MD, FCCP Anne Rain T. Brown, PharmD, BCPS
Fluid Resuscitation and Monitoring in Sepsis Deepa Gotur, MD, FCCP Anne Rain T. Brown, PharmD, BCPS Learning Objectives Compare and contrast fluid resuscitation strategies in septic shock Discuss available
More informationUse of surrogate inflammatory markers in the diagnosis & monitoring of patients with severe sepsis
Thursday 11 th June 2015 Use of surrogate inflammatory markers in the diagnosis & monitoring of patients with severe sepsis Dr Duncan Wyncoll Guy s & St Thomas NHS Trust, London Conflicts of Interest In
More informationTop 5 papers in clinical mycology
Top 5 papers in clinical mycology Dirk Vogelaers Department of General Internal Medicine University Hospital Ghent Joint symposium BVIKM/BSIMC and SBMHA/BVMDM Influenza-associated aspergillosis in critically
More informationChapter 5: Sepsis Stephen Lo
Chapter 5: Sepsis Stephen Lo Introduction Sepsis and its consequence are the bread and butter of intensive care medicine and management of it is time critical. This chapter will discuss the definitions,
More informationLa terapia empirica nelle infezioni micotiche
La terapia empirica nelle infezioni micotiche Spinello Antinori Dipartimento di Scienze Biomediche e Cliniche Luigi Sacco Castellanza, 5 ottobre 2013 Empiric antifungal therapy: definition The receipt
More informationBiomarkers in sepsis. Dr S Omar University of Witwatersrand CHBAH Bara ICU
Biomarkers in sepsis Dr S Omar University of Witwatersrand CHBAH Bara ICU Procalcitonin PCT biomarker 1993- described as a sepsis associated protein Identical to the precursor protein of calcitonin which
More informationSeptic Shock. Rontgene M. Solante, MD, FPCP,FPSMID
Septic Shock Rontgene M. Solante, MD, FPCP,FPSMID Learning Objectives Identify situations wherein high or low BP are hemodynamically significant Recognize complications arising from BP emergencies Manage
More informationCEDR 2018 QCDR Measures for CMS 2018 MIPS Performance Year Reporting
ACEP19 Emergency Department Utilization of CT for Minor Blunt Head Trauma for Aged 18 Years and Older Percentage of visits for aged 18 years and older who presented with a minor blunt head trauma who had
More informationSepsis: What Is It Really?
Sepsis: What Is It Really? Steven D. Burdette, MD, FIDSA, FACP Professor of Medicine Wright State University Boonshoft School of Medicine Director of Antimicrobial Stewardship for Premier Health and Miami
More informationStaging Sepsis for the Emergency Department: Physician
Staging Sepsis for the Emergency Department: Physician Sepsis Continuum 1 Sepsis Continuum SIRS = 2 or more clinical criteria, resulting in Systemic Inflammatory Response Syndrome Sepsis = SIRS + proven/suspected
More informationSurviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock 2012
本檔僅供內部教學使用檔案內所使用之照片之版權仍屬於原期刊公開使用時, 須獲得原期刊之同意授權 Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock 2012 Definition Sepsis the presence of infection with
More informationProcalcitonin kinetics guided antibiotic management of the critically ill patient
Procalcitonin kinetics guided antibiotic management of the critically ill patient András LOVAS MD, PhD, EDIC, EDAIC University of Szeged, Hungary Department of Anaesthesiology and Intensive Therapy 19/11/2016,
More information5/1/2015 SEPSIS SURVIVING SEPSIS CAMPAIGN HOW TO APPROACH THE POSSIBLE SEPTIC CHILD 2015 INFECTION CAN BE CONFIRMED BY:
SURVIVING SEPSIS CAMPAIGN HOW TO APPROACH THE POSSIBLE SEPTIC CHILD 2015 Omer Nasiroglu MD Baptist Children s Hospital Pediatric Emergency Department SEPSIS IS A SYSTEMIC INFLAMMATORY RESPONSE SYNDROME
More informationUpdates in Emergency Department Management of Sepsis
Resident Journal Review Updates in Emergency Department Management of Sepsis Authors: Eli Brown, MD; Allison Regan, MD; Kaycie Corburn, MD; Jacqueline Shibata, MD Edited by: Jay Khadpe, MD FAAEM; Michael
More informationDIAGNOSIS AND INVESTIGATIONS FOR SEPSIS. B. Mrara
DIAGNOSIS AND INVESTIGATIONS FOR SEPSIS B. Mrara CH C.H. Baragwanath ICU OUTLINE Introduction Diagnostic issues in sepsis Diagnosis and investigations for sepsis: clinical and laboratory lb investigations
More informationWHAT IS THE ROLE OF EMPIRIC TREATMENT FOR SUSPECTED INVASIVE CANDIDIASIS IN NONNEUTROPENIC PATIENTS IN THE ICU?
WHAT IS THE ROLE OF EMPIRIC TREATMENT FOR SUSPECTED INVASIVE CANDIDIASIS IN NONNEUTROPENIC PATIENTS IN THE ICU? Empiric antifungal therapy should be considered in critically ill patients with risk factors
More informationImportance of kinetics of procalcitonin in septic patients. János Fazakas MD, PhD Semmelweis University, Department of Transplantation and Surgery
Importance of kinetics of procalcitonin in septic patients János Fazakas MD, PhD Semmelweis University, Department of Transplantation and Surgery Host pathogen interactions the innate and the adaptive
More informationEndothelium as a part of septic Multiple Organ Dysfunction Syndrome (MODS)-is endocan an answer?
Endothelium as a part of septic Multiple Organ Dysfunction Syndrome (MODS)-is endocan an answer? Małgorzata Lipinska-Gediga Department of Anaesthesiology and Intensive Therapy Medical University Wroclaw,
More informationNo conflicts of interest to disclose
No conflicts of interest to disclose Introduction Epidemiology Surviving sepsis guidelines 2012 Updates Resuscitation protocols Map Goals Transfusion Sepsis-3 Bundle Management Questions Sepsis is a systemic,
More informationSEPSIS & SEPTIC SHOCK
SEPSIS & SEPTIC SHOCK DISCLOSURE Relevant relationships with commercial entities none Potential for conflicts of interest within this presentation none Steps taken to review and mitigate potential bias
More informationAlbumina nel paziente critico. Savona 18 aprile 2007
Albumina nel paziente critico Savona 18 aprile 2007 What Is Unique About Critical Care RCTs patients eligibility is primarily defined by location of care in the ICU rather than by the presence of a specific
More informationBIOMARKERS IN SEPSIS
BIOMARKERS IN SEPSIS Dr. Syed Ghulam Mogni Mowla Assistant Professor, Medicine, DMC BSMCON 17 WHY WE NEED TO KNOW Sepsis and its complications are a common cause of infectious disease illness and mortality
More information3/14/2017. Pediatric Sepsis: From Goal Directed Therapy to Protocolized Care. Objectives. Developmental Response to Sepsis
Pediatric Sepsis: From Goal Directed Therapy to Protocolized Care March 20, 2017 Reid WD Farris, MS MD Objectives Review the evolution & current state of the pediatric septic shock treatment guidelines
More informationSepsis the clinical syndrome
Sepsis the clinical syndrome João Gonçalves Pereira ICU director Vila Franca Xira Hospital Systemic Inflamatory Response 2 Temperature 38ºC or 36ºC bacteraemia other trauma HR 90/min INFECTION RR 20/min
More informationNothing to disclose 9/25/2017
Jessie O Neal, PharmD, BCCCP Critical Care Clinical Pharmacist University of New Mexico Hospital New Mexico Society of Health-System Pharmacists 2017 Balloon Fiesta Symposium Nothing to disclose 1 Explain
More information9/25/2017. Nothing to disclose
Nothing to disclose Jessie O Neal, PharmD, BCCCP Critical Care Clinical Pharmacist University of New Mexico Hospital New Mexico Society of Health-System Pharmacists 2017 Balloon Fiesta Symposium Explain
More informationSurviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016
Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 Mitchell M. Levy MD, MCCM Professor of Medicine Chief, Division of Pulmonary, Sleep, and Critical Care
More informationISF criteria (International sepsis forum consensus conference of infection in the ICU) Secondary peritonitis
Appendix with supplementary material. This appendix was part of the submitted manuscript and has been peer reviewed. It is posted as supplied by the authors. Supplementary Tables Table S1. Definitions
More informationSepsis Management: Past, Present, and Future
Sepsis Management: Past, Present, and Future Benjamin Ferrell, MD Tennessee ACP Meeting October 28, 2017 Learning Objectives Identify the most updated definition and clinical criteria for sepsis Describe
More informationSevere β-lactam allergy. Alternative (use for mild-moderate β-lactam allergy) therapy
Recommended Empirical Antibiotic Regimens for MICU Patients Notes: The antibiotic regimens shown are general guidelines and should not replace clinical judgment. Always assess for antibiotic allergies.
More informationSepsis Update: Early Identification and Management
Sepsis Update: Early Identification and Management Q&A From the Live Webinar Presenter: Tom Ahrens, RN, PhD, FAAN Live webinar: Thursday, May 09, 2013 The AACN Critical Care Webinar Series is not only
More informationAntifungal Stewardship. Önder Ergönül, MD, MPH Koç University, School of Medicine, Istanbul 6 October 2017, ESGAP course, Istanbul
Antifungal Stewardship Önder Ergönül, MD, MPH Koç University, School of Medicine, Istanbul 6 October 2017, ESGAP course, Istanbul 1 2 Objectives What do we know? Invasive Candida and Aspergillosis Impact
More informationTOP PAPERS in MEDICAL MYCOLOGY Laboratory Diagnosis Manuel Cuenca-Estrella Abril 2018
TOP PAPERS in MEDICAL MYCOLOGY Laboratory Diagnosis Manuel Cuenca-Estrella Abril 2018 MCE01 Conflict of interest disclosure In the past 5 years, M.C.E. has received grant support from Astellas Pharma,
More informationEFFECT OF EARLY VASOPRESSIN VS NOREPINEPHRINE ON KIDNEY FAILURE IN PATIENTS WITH SEPTIC SHOCK. Alexandria Rydz
EFFECT OF EARLY VASOPRESSIN VS NOREPINEPHRINE ON KIDNEY FAILURE IN PATIENTS WITH SEPTIC SHOCK Alexandria Rydz BACKGROUND- SEPSIS Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated
More informationSupplementary Materials to the Manuscript: Polymorphisms in TNF-α Increase Susceptibility to
Supplementary Materials to the Manuscript: Polymorphisms in TNF-α Increase Susceptibility to Intra-abdominal Candida Infection in High Risk Surgical ICU Patients A. Wójtowicz, Ph.D. 1, F. Tissot, M.D.
More informationBC Sepsis Network Emergency Department Sepsis Guidelines
The provincial Sepsis Clinical Expert Group developed the BC, taking into account the most up-to-date literature (references below) and expert opinion. For more information about the guidelines, and to
More informationACCP/SCCM Critical Care Preparatory Review and Recertification Course Learning Objectives
ACCP/SCCM Critical Care Preparatory Review and Recertification Course Learning Objectives Module 1 Critical Care Pharmacy Evolution and Validation, Practice Standards, Training, and Professional Development,
More informationFluids in Sepsis: How much and what type? John Fowler, MD, FACEP Kent Hospital, İzmir Eisenhower Medical Center, USA American Hospital Dubai, UAE
Fluids in Sepsis: How much and what type? John Fowler, MD, FACEP Kent Hospital, İzmir Eisenhower Medical Center, USA American Hospital Dubai, UAE In critically ill patients: too little fluid Low preload,
More informationInfezioni fungine invasive di interesse internistico Dott. Marco Falcone
Infezioni fungine invasive di interesse internistico Dott. Marco Falcone Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Pisa (Italy) % Internal Medicine
More informationTerapia della candidiasi addomaniale
Verona 16 marzo 2018 Terapia della candidiasi addomaniale Pierluigi Viale Infectious Disease Unit Teaching Hospital S. Orsola Malpighi Bologna INTRA ABDOMINAL CANDIDIASIS open questions a single definition
More informationCandiduria in ICU : when and how to treat? Dr. Debashis Dhar Dept of Critical Care and Emergency Medicine Sir Ganga Ram Hospital
Candiduria in ICU : when and how to treat? Dr. Debashis Dhar Dept of Critical Care and Emergency Medicine Sir Ganga Ram Hospital Introduction Nosocomial bacteriuria or candiduria develops in up to 25%
More informationPneumonia in the Hospitalized
Pneumonia in the Hospitalized Patient: Use of Steroids Nicolette Myers, MD Pulmonary/Sleep/Critical Care November 9, 2018 Park Nicollet Clinic Facts About Pneumonia CAP is the 8 th most common cause of
More informationUnderstand the scope of sepsis morbidity and mortality Identify risk factors that predispose a patient to development of sepsis Define and know the
Understand the scope of sepsis morbidity and mortality Identify risk factors that predispose a patient to development of sepsis Define and know the differences between sepsis, severe sepsis and septic
More informationAdvancements in Sepsis
Objectives Advancements in Sepsis Brian Gilbert, PharmD PGY-1 Pharmacy Resident Jackson Memorial Hospital 3/13/2016 www.fshp.org Pharmacist objectives Review recent updates in resuscitation strategies
More informationIntravenous Vitamin C. Severe Sepsis Acute Lung Injury
Intravenous Vitamin C Severe Sepsis Acute Lung Injury Alpha A. (Berry) Fowler, III, MD Professor of Medicine VCU Pulmonary Disease and Critical Care Medicine I Have No Disclosures Bacterial Sepsis Approximately
More information/////// Procalcitonin. Solutions for Emergency Diagnostics. A Novel Biomarker for Bacterial Infections and Sepsis. VIDAS Emergency Assays
/////// Solutions for Emergency Diagnostics 2015 BIOMÉRIEUX, INC. BIOMÉRIEUX, THE BLUE LOGO AND VIDAS ARE USED PENDING AND/OR REGISTERED TRADEMARKS BELONGING TO BIOMÉRIEUX SA OR ONE OF ITS SUBSIDIARIES
More informationOverview of the ID PRN
Overview of the ID PRN The Infectious Diseases Practice and Research Network (ID PRN) is composed of students, residents, fellows, pharmacists, and other clinical research specialists throughout the world
More informationDecember 3, 2015 Severe Sepsis and Septic Shock Antibiotic Guide
Severe Sepsis and Septic Shock Antibiotic Guide Surviving Sepsis: The choice of empirical antimicrobial therapy depends on complex issues related to the patient s history, including drug intolerances,
More informationWHICH ANTIFUNGAL AGENT IS THE CHOICE FOR SUSPECTED FUNGAL INFECTIONS?
WHICH ANTIFUNGAL AGENT IS THE CHOICE FOR SUSPECTED FUNGAL INFECTIONS? Assoc. Prof. Dr. Serkan SENER Acibadem University Medical School Department of Emergency Medicine, Istanbul Acibadem Ankara Hospital,
More informationLa Sindrome cardiorenale nel paziente critico
La Sindrome cardiorenale nel paziente critico Lo scompenso cardiaco nel paziente postcardiochirurgico F.L. Lorini DEFINITION AHF is a critical inability of the myocardium to maintain a cardiac output sufficient
More informationUsing procalcitonin (PCT) to improve the odds in sepsis management
Using procalcitonin (PCT) to improve the odds in sepsis management Disclaimer This guide provides information for healthcare professionals on the optimal use of procalcitonin (PCT) testing and the subsequent
More informationJohn Park, MD Assistant Professor of Medicine
John Park, MD Assistant Professor of Medicine Faculty photo will be placed here park.john@mayo.edu 2015 MFMER 3543652-1 Sepsis Out with the Old, In with the New Mayo School of Continuous Professional Development
More informationWhat the ED clinician needs to know about SEPSIS - 3. Anna Morgan Consultant EM Barts Health
What the ED clinician needs to know about SEPSIS - 3 Anna Morgan Consultant EM Barts Health Aims: (1) To review the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) (2)
More informationEarly Goal-Directed Therapy
Early Goal-Directed Therapy Where do we stand? Jean-Daniel Chiche, MD PhD MICU & Dept of Host-Pathogen Interaction Hôpital Cochin & Institut Cochin, Paris-F Resuscitation targets in septic shock 1 The
More informationGuidelines are the Future of Sepsis Management Pro
Guidelines are the Future of Sepsis Management Pro R. Phillip Dellinger MD, MCCM Professor and Chair of Medicine Director Adult Health Institute Senior Critical Care Attending Camden NJ USA Objectives
More informationL uso appropriato dell albumina nel trattamento del paziente settico
Uso appropriato dell Albumina nella Cirrosi Epatica: le raccomandazioni AISF-SIMTI Istituto Superiore di Sanità, Roma Martedì 29 Marzo, 2016 L uso appropriato dell albumina nel trattamento del paziente
More informationMajor Points. The ED-ICU Interface. Chain of Survival. It usually starts here
Major Points The ED-ICU Interface Robert M. Rodriguez, MD FAAEM Most ICU patients start in ED Chain of critical care starting in field and ED Collaborate, develop protocols (define roles), communicate
More informationIs ARDS Important to Recognize?
Is ARDS Important to Recognize? Lorraine B. Ware MD Vanderbilt University Financial Disclosures: research funding from Boehringer Ingelheim, Global Blood Therapeutics Why diagnose ARDS? -initiate specific
More informationAn Update in the Management of Candidiasis
An Update in the Management of Candidiasis Daniel B. Chastain, Pharm.D., AAHIVP Infectious Diseases Pharmacy Specialist Phoebe Putney Memorial Hospital Adjunct Clinical Assistant Professor UGA College
More informationClinical and Molecular Characteristics of Community- Acquired Methicillin-Resistant Staphylococcus Aureus Infections In Chinese Neonates
Clinical and Molecular Characteristics of Community- Acquired Methicillin-Resistant Staphylococcus Aureus Infections In Chinese Neonates Xuzhuang Shen Beijing Children's Hospital, Capital Medical University,
More informationSeptic shock in children. Is it different than adults? Peter Kanizsai, MD, PhD associate professor in emergency medicine
Septic shock in children. Is it different than adults? Peter Kanizsai, MD, PhD associate professor in emergency medicine http://www.ipaustralia.com.au/applicant/clinical-excellence-commission/trademarks/1473265/
More informationOHSU. Update in Sepsis
Update in Sepsis Jonathan Pak, MD June 1, 2017 Structure of Talk 1. Sepsis-3: The latest definition 2. Clinical Management - Is EGDT dead? - Surviving Sepsis Campaign Guidelines 3. A novel therapy: Vitamin
More informationNew insights in the diagnosis of Candida infections
New insights in the diagnosis of Candida infections Maurizio Sanguinetti Institute of Microbiology Fondazione Policlinico Universitario «A. Gemelli» - Rome - Italy Improving microbiology diagnostic methods
More informationWhat is sepsis? RECOGNITION. Sepsis I Know It When I See It 9/21/2017
Sepsis I Know It When I See It September 15, 2017 Matthew Exline, MD MPH Medical Director, Medical ICU What is sepsis? I shall not today attempt further to define the kinds of material [b]ut I know it
More informationFungal infections in ICU. Tang Swee Fong Department of Paediatrics Universiti Kebangsaan Malaysia
Fungal infections in ICU Tang Swee Fong Department of Paediatrics Universiti Kebangsaan Malaysia Epidemiology of invasive fungal infections - US +300% Martin GS, et al. N Engl J Med 2003;348:1546-1554
More informationMAKING SENSE OF IT ALL AUGUST 17
MAKING SENSE OF IT ALL AUGUST 17 @SepsisUK Dr Ron Daniels B.E.M. CEO, UK Sepsis Trust CEO, Global Sepsis Alliance Special Adviser to WHO SCALE AND BURDEN @sepsisuk Dr Ron Daniels B.E.M. CEO, UK Sepsis
More informationESCMID Online Lecture Library. by author
What room for biomarkers in the management of anti-infective therapy Philippe Montravers Hôpital Bichat-Claude Bernard, Pole SUPRA APHP UFR Paris Diderot, Paris 7, Paris Cité Sorbonne Disclosures Speaker
More informationINTENSIVE CARE MEDICINE CPD EVENING. Dr Alastair Morgan Wednesday 13 th September 2017
INTENSIVE CARE MEDICINE CPD EVENING Dr Alastair Morgan Wednesday 13 th September 2017 WHAT IS NEW IN ICU? (RELEVANT TO ANAESTHETISTS) Not much! SURVIVING SEPSIS How many deaths in England were thought
More informationAllinaHealthSystem 1
: Definition End-organ hypoperfusion secondary to cardiac failure Venoarterial ECMO: Patient Selection Michael A. Samara, MD FACC Advanced Heart Failure, Cardiac Transplant & Mechanical Circulatory Support
More informationText-based Document. Implications of the Sepsis-3 Definition on Nursing Research and Practice. Authors Peach, Brian C. Downloaded 5-Jul :03:48
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationImmune monitoring in intensive care patients
28th General annual Meeting of the Belgian Hematological Society Immune monitoring in intensive care patients Guillaume Monneret Head Cellular Immunology Unit Hôp. E. Herriot-Hospices Civilsde Lyon -F
More information2017 ACCP/SCCM Critical Care Preparatory Review and Recertification Course Learning Objectives
2017 ACCP/SCCM Critical Care Preparatory Review and Recertification Course Learning Objectives Shock Syndromes and Sepsis, Pulmonary Disorders, Hepatic Failure/GI/Endocrine Emergencies, Supportive and
More informationAbstracts. Supplement 2 September rd ESICM Annual Congress. Barcelona, Spain 9 13 October 2010
Supplement 2 September 2010 Abstracts 23 rd ESICM Annual Congress Barcelona, Spain 9 13 October 2010 This supplement issue of the official ESICM/ESPNIC journal Intensive Care Medicine contains abstracts
More informationDiagnosis and Management of Sepsis and Septic Shock. Martin D. Black MD Concord Pulmonary Medicine Concord, New Hampshire
Diagnosis and Management of Sepsis and Septic Shock Martin D. Black MD Concord Pulmonary Medicine Concord, New Hampshire Financial: none Disclosures Objectives: Identify physiologic principles of septic
More informationOsteomyelitis Samir S. Shah, MD, MSCE
Osteomyelitis Samir S. Shah, MD, MSCE Professor, Department of Pediatrics University of Cincinnati College of Medicine Director, Division of Hospital Medicine Attending Physician in Infectious Diseases
More informationSystemic inflammation after myocardial infarction
Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2013 Systemic inflammation after myocardial infarction Rudiger, Alain DOI:
More informationSepsis. Reliability- can we achieve Dr Ron Daniels
Sepsis. Reliability- can we achieve it? @SepsisUK Dr Ron Daniels Chief Executive, Global Sepsis Alliance Fellow: NHS Improvement Faculty Chief Executive: United Kingdom Sepsis Trust & Chair, UK SSC RRAILS
More informationSEPSIS SYNDROME
INTRODUCTION Sepsis has been defined as a life threatening condition that arises when the body s response to an infection injures its own tissues and organs. Sepsis may lead to shock, multiple organ failure
More informationPrehospital recognition of sepsis Christopher W. Seymour, MD MSc
Prehospital recognition of sepsis Christopher W. Seymour, MD MSc The CRISMA Center Assistant Professor of Critical Care Medicine & Emergency Medicine University of Pittsburgh School of Medicine Disclosures
More informationSepsis new definitions of sepsis and septic shock and Novelities in sepsis treatment
Sepsis new definitions of sepsis and septic shock and Novelities in sepsis treatment What is sepsis? Life-threatening organ dysfunction caused by a dysregulated host response to infection A 1991 consensus
More informationThe Septic Patient. Dr Arunraj Navaratnarajah. Renal SpR Imperial College NHS Healthcare Trust
The Septic Patient Dr Arunraj Navaratnarajah Renal SpR Imperial College NHS Healthcare Trust Objectives of this session Define SIRS / sepsis / severe sepsis / septic shock Early recognition of Sepsis The
More informationObjectives. Epidemiology of Sepsis. Review Guidelines for Resuscitation. Tx: EGDT, timing/choice of abx, activated
Update on Surviving Sepsis 2008 Objectives Epidemiology of Sepsis Definition of Sepsis and Septic Shock Review Guidelines for Resuscitation Dx: Lactate, t cultures, SVO2 Tx: EGDT, timing/choice of abx,
More informationPrognostic role of adrenomedullin in sepsis
Int. J. Adv. Res. Biol. Sci. (2016). 3(5): 136-141 International Journal of Advanced Research in Biological Sciences ISSN: 2348-8069 www.ijarbs.com Volume 3, Issue 5-2016 Research Article Prognostic role
More information