Sepsis Management in Resource-limited Settings

Sepsis Management in Resource-limited Settings
Author: Arjen M. Dondorp
Publisher: Springer
Total Pages: 216
Release: 2019-02-08
Genre: Medical
ISBN: 3030031438
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This book is open access under a CC BY 4.0 license. It constitutes a unique source of knowledge and guidance for all healthcare workers who care for patients with sepsis and septic shock in resource-limited settings. More than eighty percent of the worldwide deaths related to sepsis occur in resource-limited settings in low and middle-income countries. Current international sepsis guidelines cannot be implemented without adaptations towards these settings, mainly because of the difference in local resources and a different spectrum of infectious diseases causing sepsis. This prompted members of the Global Intensive Care working group of the European Society of Intensive Care Medicine (ESICM) and the Mahidol-Oxford Tropical Medicine Research Unit (MORU, Bangkok, Thailand) - among which the Editors – to develop with an international group of experts a comprehensive set of recommendations for the management of sepsis in resource-limited settings. Recommendations are based on both current scientific evidence and clinical experience of clinicians working in resource-limited settings. The book includes an overview chapter outlining the current challenges and future directions of sepsis management as well as general recommendations on the structure and organization of intensive care services in resource-limited settings. Specific recommendations on the recognition and management of patients with sepsis and septic shock in these settings are grouped into seven chapters. The book provides evidence-based practical guidance for doctors in low and middle income countries treating patients with sepsis, and highlights areas for further research and discussion.

Hemodynamic Monitoring

Hemodynamic Monitoring
Author: Michael R. Pinsky
Publisher: Springer
Total Pages: 476
Release: 2019-02-21
Genre: Medical
ISBN: 3319692690
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This book, part of the European Society of Intensive Care Medicine textbook series, teaches readers how to use hemodynamic monitoring, an essential skill for today’s intensivists. It offers a valuable guide for beginners, as well as for experienced intensivists who want to hone their skills, helping both groups detect an inadequacy of perfusion and make the right choices to achieve the main goal of hemodynamic monitoring in the critically ill, i.e., to correctly assess the cardiovascular system and its response to tissue oxygen demands. The book is divided into distinguished sections: from physiology to pathophysiology; clinical assessment and measurements; and clinical practice achievements including techniques, the basic goals in clinical practice as well as the more appropriate hemodynamic therapy to be applied in different conditions. All chapters use a learning-oriented style, with practical examples, key points and take home messages, helping readers quickly absorb the content and, at the same time, apply what they have learned in the clinical setting. The European Society of Intensive Care Medicine has developed the Lessons from the ICU series with the vision of providing focused and state-of-the-art overviews of central topics in Intensive Care and optimal resources for clinicians working in Intensive Care.

Novel Strategies for Septic Shock Management ( Based on Current Guidelunes and Research)

Novel Strategies for Septic Shock Management ( Based on Current Guidelunes and Research)
Author: Gandhi Bhaskar Patrudu Lanka
Publisher: International Journal of Medical Conference Presentations (IJMCP), January 2020. Citation: Lanka Gandhi Bhaskar Patrudu, Belekar DM. Novel strategies for septic shock management: based on current guidelines and research. Presented at: 42nd Annual Conference of Maharashtra State Chapter of ASI (MASICON 2020); 2020 Jan 24; Amravati, India. Terna Medical College & Hospital, Nerul, Navi Mumbai. Published by International Journal of Medical Conference Presentations (IJMCP); January 2020.
Total Pages: 23
Release: 2020-01-24
Genre: Medical
ISBN:
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Paper Presented at 42nd annual Conference of Maharashtra State Chapter of ASI ( MASICON 2020) in Amravati on 24 January 2020. ) Abstract: Background: Septic shock remains a leading cause of mortality despite advances in critical care. Recent updates and guidelines have shifted clinical approaches to improve recognition and management. This review highlights the role of various clinical tools, interventions, and therapeutic strategies in managing septic shock. Objective: To examine the current clinical strategies and guidelines in recognizing and treating septic shock, with emphasis on occult septic shock, fluid resuscitation, vasopressor usage, and the role of steroids, lactate monitoring, and procalcitonin in prognosis. Methods: A comprehensive review of the literature, including the latest guidelines from the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), the Surviving Sepsis Campaign, and retrospective studies comparing clinical tools such as SIRS, qSOFA, and NEWS for early identification of septic shock. Results: 1. Recognition of Septic Shock: - SIRS, qSOFA, and NEWS were evaluated, with NEWS emerging as a more accurate tool for early recognition. - Lactate and procalcitonin are valuable markers but have limitations in predicting patient outcomes.2. Resuscitation Strategies: - Ringer's Lactate is preferred over saline for initial resuscitation due to the latter’s association with hyperchloremic acidosis. - The recommended fluid resuscitation strategy includes rapid administration of 30mL/kg crystalloid for hypotension or lactate > 4 mmol/L.3. Vasopressor and Steroid Use: - Early norepinephrine administration is recommended to maintain a MAP > 65 mmHg. - Vasopressin is the second-line vasopressor, though its benefits in reducing mortality are uncertain. - Steroids, particularly in conjunction with vitamin C and thiamine, may improve outcomes in vasopressor-refractory septic shock.4. Antibiotic Timing and Administration: - Early antibiotic administration, ideally within one hour of sepsis diagnosis, significantly improves survival rates. Conclusion: Effective management of septic shock involves early recognition using appropriate clinical tools like NEWS, aggressive fluid resuscitation with balanced crystalloids, timely initiation of vasopressors, and careful consideration of steroids and antibiotics. Further large-scale randomized controlled trials are needed to refine these approaches, particularly in vasopressor and steroid administration.

Clinical Fluid Therapy in the Perioperative Setting

Clinical Fluid Therapy in the Perioperative Setting
Author: Robert G. Hahn
Publisher: Cambridge University Press
Total Pages: 309
Release: 2016-05-26
Genre: Medical
ISBN: 1107119553
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The world's most renowned researchers in fluid management explain what you should know when providing infusion fluids to surgical patients.

Chalk Talks in Internal Medicine

Chalk Talks in Internal Medicine
Author: Somnath Mookherjee
Publisher: Springer Nature
Total Pages: 347
Release: 2020-09-30
Genre: Education
ISBN: 3030348148
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This book provides teaching scripts for medical educators in internal medicine and coaches them in creating their own teaching scripts. Every year, thousands of attending internists are asked to train the next generation of physicians to master a growing body of knowledge. Formal teaching time has become increasingly limited due to rising clinical workload, medical documentation requirements, duty hour restrictions, and other time pressures. In addition, today’s physicians-in-training expect teaching sessions that deliver focused, evidence-based content that is integrated into clinical workflow. In keeping with both time pressures and trainee expectations, academic internists must be prepared to effectively and efficiently teach important diagnostic and management concepts. A teaching script is a methodical and structured plan that aids in effective teaching. The teaching scripts in this book anticipate learners’ misconceptions, highlight a limited number of teaching points, provide evidence to support the teaching points, use strategies to engage the learners, and provide a cognitive scaffold for teaching the topic that the teacher can refine over time. All divisions of internal medicine (e.g. cardiology, rheumatology, and gastroenterology) are covered and a section on undifferentiated symptom-based presentations (e.g. fatigue, fever, and unintentional weight loss) is included. This book provides well-constructed teaching scripts for commonly encountered clinical scenarios, is authored by experienced academic internists and allows the reader to either implement them directly or modify them for their own use. Each teaching script is designed to be taught in 10-15 minutes, but can be easily adjusted by the reader for longer or shorter talks. Teaching Scripts in Internal Medicine is an ideal tool for internal medicine attending physicians and trainees, as well as physician’s assistants, nurse practitioners, and all others who teach and learn internal medicine.

Surgical Intensive Care Medicine

Surgical Intensive Care Medicine
Author: John M. O'Donnell
Publisher: Springer Science & Business Media
Total Pages: 711
Release: 2009-11-18
Genre: Medical
ISBN: 0387778934
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We are honored to present the second edition of Surgical Intensive Care Medicine. Our first edition was considered to be an important contribution to the critical care literature and received excellent reviews from Critical Care Medicine, Chest, and Anesthesiology. In the second edition, the basic organization of the book remains unchanged, being composed of 60 carefully selected chapters divided into 11 sections. The book begins with general topics in primary intensive care, such as airway management and vascular cannulation, followed by categories based on medical and surgical subspecialties. While the chapters discuss definitions, pathophysiology, clinical course, complications, and prognosis, the primary emphasis is devoted to patient management. The contents of the current edition have been comprehensively upgraded and the chapters retained from the first edition have been thoroughly updated, revised, or rewritten. In this second edition, some new topics have been added including Postoperative Care of the Obese Patient, Postoperative Care of the Pancreas Transplant Patient, Optimization of High-Risk Surgical Patients, Post- erative Alcohol Withdrawal Syndrome, Ethics and End of Life Issues, Improving the ICU, and Continuous Medical Education in Intensive Care Medicine. We are extremely fortunate to have high-quality contributors, many of whom are nationally and internationally recognized researchers, speakers, and practitioners in Cri- cal Care Medicine. An important feature of this latest edition is the geographical diversity of its authors. Most are based in the United States, but colleagues from Canada, England, Ireland, Germany, Belgium, Holland, France, Italy, Portugal, and Australia have also made notable contributions.

Clinical Management of Shock

Clinical Management of Shock
Author: Stanislaw P. Stawicki
Publisher: BoD – Books on Demand
Total Pages: 210
Release: 2020-06-24
Genre: Medical
ISBN: 1838811702
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Shock is a physiological state of war! From a healthcare provider perspective, the word “shock” is associated with a mixed array of feelings, including dread, well-founded fear, and deep respect. The physiological state of shock is well recognized for the associated destructive consequences, and its successful management requires prompt identification, immediate action, and sustained effort by all members of the healthcare team. This mindset of advanced preparation and constant readiness constitutes the foundation of the modern approach toward shock – early detection and prompt treatment for optimal outcomes. Despite the heterogeneity of “shock” as a clinico-pathological entity, there are some common threads that permeate all forms and manifestations of shock, with apparent increase in observed commonalities in the more advanced (and often irreversible) stages of the systemic syndrome. When faced with shock, the body and its systems do their best to compensate for the maldistribution of oxygen and nutrients. This is known as the so-called compensated shock. Beyond that, the body loses its ability to adjust any further, thus descending into “uncompensated shock,” with a refractory state characterized by vasoplegia and irreversible cardiovascular failure. As the reader journeys through the chapters of the book, he or she will read about various biomarkers and endpoints of resuscitation, explore different types of shock (e.g., septic, hemorrhagic, anaphylactic) and learn about some of the less often discussed topics such as neurogenic and spinal shock, as well as the amniotic fluid embolism. Our goals were to keep things clinically relevant and practically oriented, thus enabling the reader to apply the newly acquired knowledge in their everyday clinical routines. As the reader progresses through the book, we hope to help stimulate further discourse and innovative thinking about the topic. In this context, it is critical that basic, translational, and clinical research on shock continues to advance. Only through ongoing scientific progress can we help improve outcomes for patients with both rare and common forms of shock.

ABC of Sepsis

ABC of Sepsis
Author: Ron Daniels
Publisher: John Wiley & Sons
Total Pages: 104
Release: 2009-11-11
Genre: Medical
ISBN: 9781444316650
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The importance of early prevention and treatment of sepsis hasnever been greater. In the UK alone sepsis contributes to moredeaths than lung cancer, from bowel cancer and breast cancercombined, and approximately one third of patients who suffer fromsevere sepsis die. The ABC of Sepsis provides a much neededintroduction and an invaluable aid in the increasing efforts toreduce hospital infection and improve patient safety. As growing numbers of junior medical staff experience emergencymedicine, critical care and acute medicine as part of theFoundation Programme, there is an increasing need to develop theskills required to treat severe sepsis. The editors are involvedwith the Survive Sepsis campaign - developed to improve therecognition, diagnosis and treatment of sepsis - and are perfectlyplaced to guide junior medics, GPs, specialist nurses, criticalcare nurses and primary care staff through this core aspect ofacute medicine.

Maternal Critical Care

Maternal Critical Care
Author: Marc van de Velde
Publisher: Cambridge University Press
Total Pages: 503
Release: 2013-07-04
Genre: Health & Fitness
ISBN: 1107018498
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Addresses the challenges of managing critically ill obstetric patients, with chapters authored by intensivists/anesthesiologists and obstetricians/maternal-fetal medicine specialists.