1 Kumar et al, Chest 2009; 136:1237–1248. 2 Impact of Appropriateness of Initial Antimicrobial Therapy on Survival from Septic Shock Kumar et al, Chest.

Slides:



Advertisements
Similar presentations
A Comparison of Early Versus Late Initiation of Renal Replacement Therapy in Critically III Patients with Acute Kidney Injury: A Systematic Review and.
Advertisements

The Duration of Hypotension Prior to Initiation of Effective Antimicrobial Therapy is the Critical Determinant of Survival in Human Septic Shock Anand.
Copyright Wigfull 2013 The Sepsis Timebomb James Wigfull Critical Care and Anaesthesia Sheffield Teaching Hospitals.
Serum Lactate Post-Antibiotic antibiotic † † * * Kumar et al. J Infect Dis 2006; 193:
1 Severity of illness (APACHE II score ≥ 25) stratified by RIFLE category in septic shock NoneRiskInjuryFailure.
1 Heparin-associated 30 Day Mortality Zarychanski et al, CCM 2008;36:
1 MT vs CT: 28 day survival Number at risk CT MT day % Surviving Monotherapy.
1 Kumar et al. CCM. 2006:34: Cumulative Initiation of Effective Antimicrobial Therapy and Survival in Septic Shock time from hypotension onset.
(a) (b) (c) (d). What is (1,2,3)  (3,4,2)? (a) (1, 2, 3, 4) (b) (1,2)  (3,4) (c) (1,3,4,2) (d) (3,1)  (4,2)
SEPSIS Early recognition and management. Aims of the talk Understand the definition of sepsis and severe sepsis Understand the clinical significance of.
Estimates of the Impact of Sepsis Syndromes Annually in U.S. Sepsis 200,000 Severe sepsis 200,000 Septic shock 200,000 Mortality Deaths -46%92, %40,000.
Solomon Tesfaye et al N Engl J Med 2005;352: Comparison of Baseline Data in 1819 Patients According to Whether There Was an Assessment for Neuropathy.
Literature Appraisal Effectiveness of Therapy. Measures of treatment effect Statistical significance Odds ratio Relative risk Absolute risk reduction.
Date of download: 5/28/2016 Copyright © The American College of Cardiology. All rights reserved. From: Recent Advances in Cardiopulmonary Resuscitation:
Dr Alex Hieatt, EM Consultant MEHT Dr Ron Daniels, Chair of the UK Sepsis Trust and Global Sepsis Alliance (Slides with permission.)
SIRS S EPSIS S EVERE S EPSIS S EPTIC S HOCK D EATH Early recognition Early antibiotics Source control.
1) Initiation of ICS therapy or 2) Increase ICS therapy (50% dose increase) Baseline period: 1 year Outcome period: 2 years Extra-fine HFA-BDP via MDI.
Preventing Sepsis in Wales
10/3/2014. Εμφραγμα - Στηθαγχη - Πονος στο στηθος : Εμφραγμα μυοκαρδιου λεμε την βαρυτατη εκεινη κατασταση που οφειλεται στην αποφραξη που μπορει να γινει.
Sepsis is a common and potentially life-threatening condition: the body’s immune system goes into overdrive in response to an infection, that can lead.
Antibiotics – Friend and enemy (or revenge of the microbes).
The Duration of Hypotension Prior to Initiation of Effective Antimicrobial Therapy is the Critical Determinant of Survival in Human Septic Shock Anand.
Kaylee Wentworth, PharmD PGY-1 Pharmacy Resident April 2017
‘TAP THE TAZ’ Liz Casey A/Resuscitation & EWS Training Officer
Volume 115, Issue 3, Pages 19S-23S (March 1999)
Odds ratios for change in PD from earliest mammogram within levels of earliest PD. No evidence for an interaction of earliest PD and change in PD on breast.
© The Author(s) Published by Science and Education Publishing.
Checklist for Site Reconnaissance (Sabatini et al_2002)
בטיחות בתעשייה בהיבט חברות הביטוח
Weekly count of chocolate exposure consultations (blue line, left axis) with odds ratio for presenting with chocolate intoxication during given celebration.
Avilla et al, 2009.
(pnoninferiority < )
Improving Outcomes for Severe Sepsis and Septic Shock: Tools for Early Identification of At-Risk Patients and Treatment Protocol Implementation  Emanuel.
PREMIER: Rate of hypertension at 18 months
Nilratan Sircar Medical College & Hospital, Kolkata
75 Has 7 in the tens place Odd Number Less than 100
Creatinine clearance in cases and controls
Antimicrobial Therapy for Life-threatening Infections: Speed is Life
Gaurav A. Upadhyay, MD, Jonathan S. Steinberg, MD  Heart Rhythm 
Weekly count of chocolate exposure consultations (blue line, left axis) with odds ratio for presenting with chocolate intoxication during given celebration.
Adjusted odds ratio for hypoglycemia with gatifloxacin and levofloxacin compared with macrolide antibiotics Antibiotic Odds ratio of hypoglycemia 95% CI.
Appropriate vs. inappropriate antimicrobial therapy
Recognising sepsis and taking action
Evaluation of the effect of appropriate antimicrobial therapy on mortality associated with Acinetobacter nosocomialis bacteraemia  S.-C. Kuo, Y.-T. Lee,
Database-specific risk of ventricular arrhythmia associated with current use of azithromycin compared with current use of amoxicillin (2-stage random-effects.
Optimizing Outcomes in Sepsis Dr. Anand Kumar
Factors independently associated with odds of fractures
John A. Bittl et al. JACC 2016;68:
Ch 10: Basic Logic of Factorial Designs & Interaction Effects
Kaplan–Meier analysis of survival over 2 years of treatment with riociguat in the CHEST-2 study [54]. Kaplan–Meier analysis of survival over 2 years of.
Prabhat Kumar et al. JACEP 2016;j.jacep
Direct role of HIS-24 and HPL in stress response.
G.M. Rossolini, E. Mantengoli  Clinical Microbiology and Infection 
12 Has 1 in the tens place Even Number Less than 20
Kaplan-Meier curves showing the time in months to the first inappropriate shock from the start of remote monitoring in primary and secondary prevention.
Forest plot of adjusted odds ratios (with 95% confidence intervals) from multivariable multinomial logistic regression analysis (table 4), by number of.
Systemic infection in Drosophila larvae by septic injury with a fine tungsten needle. Systemic infection in Drosophila larvae by septic injury with a fine.
Kaplan-Meier curves depicting the probability of survival from study enrollment in patients receiving conventional chest physical therapy (CCPT) (solid.
Rebuttal From Drs Mohr and Doerschug
Flowchart of the process of study selection LAR indicates laboratory-defined aspirin resistance Jaapjan D. Snoep, et al. Arch Intern Med 2007;167:
Characteristics of 3415 patients admitted to hospital with
Kaplan-Meir survival plots for CHD mortality (A), CVD mortality (B), and all-cause mortality (C) in men grouped by TG/HDL-C ratio of 3.5. Kaplan-Meir survival.
Various possible courses of the immune response to severe sepsis and septic shock over 28 days. Various possible courses of the immune response to severe.
The odds ratio comparing phonation to the breath-hold technique is given above the glottis, at the glottis, and below the glottis. The odds ratio comparing.
Pathway to initial antihypertensive therapy in patients with diabetes
Examples of novel short-term drainage devices
Comparison of cancer-specific survival in patients with nonsmall cell lung cancer detected incidentally by computed tomography (CT) (n=41) or chest radiography.
Odds ratio (95% confidence intervals) of reporting respiratory symptoms in patients with treated hypothyroidism or inflammatory bowel disease (IBD) compared.
(A). (A). Kaplan-Meier plot of event-free survival in 27 LMNA mutation carriers and 78 DCM control patients. Death, heart transplantation, resuscitation.
E2F4 program is predictive of the efficacy of intravesical BCG immunotherapy in NMIBC. A, the survival curves of intravesical therapy-treated and untreated.
Presentation transcript:

1 Kumar et al, Chest 2009; 136:1237–1248

2 Impact of Appropriateness of Initial Antimicrobial Therapy on Survival from Septic Shock Kumar et al, Chest 2009; 136:1237–1248

3 survival (%) yeast anaerobes g-b g+c inappropriate appropriate n p value odds ratio < <.0001

4 Impact of Appropriateness of Initial Antimicrobial Therapy on Survival from Septic Shock Kumar et al, Chest 2009; 136:1237–1248

5 Impact of Appropriateness of Initial Antimicrobial Therapy on Survival from Septic Shock Kumar et al, Chest 2009; 136:1237–1248 Odds Ratio <.0001 np value

6 Kumar et al, Chest 2009; 136:1237–1248

7 survival (%) pbi cri uti sst IAI pneu inappropriate appropriate n <.0001 p value odds ratio

8 Kumar et al, Chest 2009; 136:1237–1248

9

10 Kumar et al, Chest 2009; 136:1237–1248

11 Kumar et al, Chest 2009; 136:1237–1248