04.04.2017 | Focus Editorial
Focus on infection and sepsis 2017
Erschienen in: Intensive Care Medicine | Ausgabe 6/2017
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Management of severe infections and sepsis in intensive care units (ICU) represents one of the most common and complex problems in daily clinical practice. Year by year, new studies are helping to improve physicians’ management and this manuscript aims to summarize the most relevant works published during 2015–2016 on these difficult areas of knowledge (Table 1).
2017 Surviving Sepsis Campaign controversies
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Critically ill patients frequently not receiving the recommended quantity of fluids during the first 24 h of sepsis or septic shock, mortality increased in patients with severe sepsis receiving <5 L of fluids
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Lower hemoglobin levels not associated with higher mortality or worse quality of life at 1 year after randomization
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“Area of need” population studies in sepsis
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Refractory septic shock in pediatric population
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Sepsis in resource-limited settings
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qSOFA-65?
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qSOFA accurate in patients with community-acquired pneumonia
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Older patients with influenza prone to higher rates of bacterial co-infection, and higher mortality rates
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ICU-acquired infections
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Duration of mechanical ventilation, but not antibiotics, associated with changes in lung microbiome
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Highly heterogeneous patterns of intestinal microbiota in both septic and non-septic ICU patients
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Treatment with probiotics effective and safe to prevent VAP
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De-escalation in ICU patients feasible and associated with better outcomes
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