Medicine and Health Sciences Commons^™

Impact Of Sepsis And Non-Communicable Diseases On Prognostic Models To Predict The Outcome Of Hospitalized Chronic Liver Disease Patients, Fakhar Qazi, Shahab Abid, Preet Ayoub Shaikh, Safia Awan

Section of Gastroenterology

AIM: To evaluate the impact of sepsis and non-communicable diseases (NCDs) on the outcome of decompensated chronic liver disease(CLD) patients.

Methods: In this cross-sectional study, medical records of patients with CLD admitted to the Gastroenterology unit at the Aga Khan University Hospital were reviewed. Patients older than 18 years with decompensation of CLD (i.e., jaundice, ascites, encephalopathy, and/or upper gastrointestinal bleed) as the primary reason for admission were included, while those who were admitted for reasons other than decompensation of CLD were excluded. Each patient was followed for 6 wk after index admission to assess mortality, prolonged hospital …

Prospective Evaluation Of Serum Procalcitonin In Critically Ill Patients With Suspected Sepsis- Experience From A Tertiary Care Hospital In Pakistan, Sibtain Ahmed, Imran Siddiqui, Lena Jafri, Madiha Hashmi, Aysha Habib, Farooq Ghani

Department of Pathology and Laboratory Medicine

Background: Sepsis is the leading cause of mortality in critically ill patients. Procalcitonin (PCT) is a promising marker for identification of bacterial sepsis. The aim of this study was to determine the diagnostic accuracy of serum PCT concentration in patients with suspected sepsis admitted to mixed medical-surgical Intensive care unit (ICU).
Material and methods: A cross-sectional study conducted at section of Chemical Pathology, Department of Pathology and Laboratory Medicine and ICU. Patients with suspected sepsis were included, serum PCT cut off ≥0.5 ng/ml was taken for diagnosing sepsis. Diagnostic accuracy was measured in terms of sensitivity, specificity, positive predictive value …

Corticosteroid Therapy For Sepsis: A Clinical Practice Guideline, Francois Lamontagne, Bram Rochwerg, Lyubov Lytvyn, Gordon H. Guyatt, Morten Hylander Møller, Djillali Annane, Michelle E. Kho, Neill K J Adhikari, Flavia Machado, Madiha Hashmi

Department of Anaesthesia

No abstract provided.

Ultrasound-Guided Peripheral Nerve Blocks In High-Risk Patients, Requiring Lower Limb (Above And Below Knee) Amputation, Faisal Shamim, Malika Hameed, Nadeem Ahmed Siddiqui, Shemila Abbasi

Department of Anaesthesia

A case series of five high-risk patients with lower limb ischemia, sepsis, altered coagulation, and multi-organ dysfunction requiring emergent or urgent lower limb amputation is presented. Use of peripheral nerve blocks for below and above knee amputations is quite uncommon which provides better hemodynamic stability and pain management, especially in the very sick patients. The surgeries were successfully carried out under ultrasound-guided combined femoral and sciatic nerve blocks. All five patients obtained adequate level of block at the area of amputation. There were no complications related to anesthetic management. Patients remained hemodynamically stable and pain-free during surgery and postoperatively. Combined …

Haemodynamic Assessment And Support In Sepsis And Septic Shock In Resource-Limited Settings, David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W. Dünser, Arjen M. Dondorp, Marcus J. Schultz, Global Intensive Care Working Group†, Of The European Society Of Intensive Care Medicine (Esicm) And The Mahidol Oxford Tropical Medicine Research Unit (Moru) In Bangkok, Thailand

Anaesthesiology, East Africa

Background: Recommendations for haemodynamic assessment and support in sepsis and septic shock in resource-limited settings are largely lacking.

Methods: A task force of six international experts in critical care medicine, all of them members of the Global Intensive Care Working Group of the European Society of Intensive Care Medicine and with extensive bedside experience in resource-limited intensive care units, reviewed the literature and provided recommendations regarding haemodynamic assessment and support, keeping aspects of efficacy and effectiveness, availability and feasibility and affordability and safety in mind.

Results: We suggest using capillary refill time, skin mottling scores and skin temperature gradients; suggest …