Incidence, risk factors, and outcome of severe sepsis and septic shock in adults: a multicenter prospective study in intensive care units

Article Abstract:

Intensive care unit (ICU) patients with suspected sepsis and ICU patients with verified infection appear to have similar risks for death. Researchers studied 1,052 patients from 170 ICUs, and placed them into one of three groups: microbiologically verified sepsis; nonmicrobiologically documented severe sepsis; and noninfectious severe sepsis, which is also called systemic inflammatory response syndrome. Twenty-eight day mortality was 56% in patients with severe sepsis compared to 60% in culture-negative severe sepsis. Early death was associated with the patient's response to infection, and other risk factors included shock and low arterial blood pH. Secondary death was associated primarily with the patient's underlying disease and organ dysfunction. Other factors included hypothermia, multiple sources of infection, and preexisting liver or cardiovascular insufficiency. Patients with documented severe sepsis had many of the same characteristics as the other ICU patients without documented sepsis.

Mortality, Patient outcomes, Risk factors, Intensive care units

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Effect of subcutaneous tunneling on internal jugular catheter-related sepsis in critically ill patients: a prospective randomized multicenter study

Article Abstract:

Tunneling an internal jugular catheter under subcutaneous tissue appears to reduce the risk of infectious complications of these catheters. Researchers studied 231 patients in an intensive care unit, 117 of whom received a tunneled catheter and 114 received a non-tunneled catheter. Tunneled catheterization reduced the incidence of infectious complications of catheterization by 67% to 77%. Tunneling the catheter through subcutaneous tissue increases the distance between the catheter and skin, from which most infectious organisms originate.

Intravenous catheterization, Critically ill

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Use of Tunneled Femoral Catheters To Prevent Catheter-Related Infection

Article Abstract:

Tunneling a femoral catheter underneath the skin may lower the risk of bacterial infections. Catheters inserted in the femoral artery in the leg can cause infection more often than catheters inserted in other arteries. Researchers randomly assigned 336 people to have a catheter inserted directly into their femoral artery or to have it tunneled under the skin before inserting it into the artery. Tunneling the catheter reduced the risk of developing a bacterial blood infection by 75%.

Arterial catheterization

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