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  1. Article ; Online: Sounds for a Waking Coma Patient.

    Green, Sherry

    Annals of internal medicine

    2020  Volume 173, Issue 1, Page(s) 69

    MeSH term(s) Coma ; Cryptogenic Organizing Pneumonia/therapy ; Humans ; Inpatients ; Intensive Care Units ; Narration ; Respiration, Artificial ; Sound ; Wakefulness
    Language English
    Publishing date 2020-07-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/M20-0704
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Sociodemographic Factors are Associated with Care Delivery and Outcomes in Pediatric Severe Sepsis.

    Webb, Lece V / Evans, Jakob / Smith, Veronica / Pettibone, Elisabeth / Tofil, Jarod / Hicks, Jessica Floyd / Green, Sherry / Nassel, Ariann / Loberger, Jeremy M

    Critical care explorations

    2024  Volume 6, Issue 3, Page(s) e1056

    Abstract: Importance: Sepsis is a leading cause of morbidity and mortality in the United States and disparate outcomes exist between racial/ethnic groups despite improvements in sepsis management. These observed differences are often related to social ... ...

    Abstract Importance: Sepsis is a leading cause of morbidity and mortality in the United States and disparate outcomes exist between racial/ethnic groups despite improvements in sepsis management. These observed differences are often related to social determinants of health (SDoH). Little is known about the role of SDoH on outcomes in pediatric sepsis.
    Objective: This study examined the differences in care delivery and outcomes in children with severe sepsis based on race/ethnicity and neighborhood context (as measured by the social vulnerability index).
    Design setting and participants: This retrospective, cross-sectional study was completed in a quaternary care children's hospital. Patients 18 years old or younger who were admitted between May 1, 2018, and February 28, 2022, met the improving pediatric sepsis outcomes (IPSO) collaborative definition for severe sepsis. Composite measures of social vulnerability, care delivery, and clinical outcomes were stratified by race/ethnicity.
    Main outcomes and measures: The primary outcome of interest was admission to the PICU. Secondary outcomes were sepsis recognition and early goal-directed therapy (EGDT).
    Results: A total of 967 children met the criteria for IPSO-defined severe sepsis, of whom 53.4% were White/non-Hispanic. Nearly half of the cohort (48.7%) required PICU admission. There was no difference in illness severity at PICU admission by race (1.01 vs. 1.1,
    Conclusions and relevance: Non-White race/ethnicity was independently associated with PICU admission. Differences in care delivery were also identified. Prospective studies are needed to further investigate these findings.
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Journal Article
    ISSN 2639-8028
    ISSN (online) 2639-8028
    DOI 10.1097/CCE.0000000000001056
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Beyond Vital Signs: Pediatric Sepsis Screening that Includes Organ Failure Assessment Detects Patients with Worse Outcomes

    Paulsen, Jesseca A. / Wang, Karen M. / Masler, Isabella M. / Hicks, Jessica F. / Green, Sherry N. / Loberger, Jeremy M.

    Journal of Pediatric Intensive Care

    2022  

    Abstract: Pediatric sepsis screening is recommended. The 2005 Goldstein criteria, the basis of our institutional sepsis screening tool (ISST), correlate poorly with clinically diagnosed sepsis. The study objective was to retrospectively evaluate the ISST ... ...

    Abstract Pediatric sepsis screening is recommended. The 2005 Goldstein criteria, the basis of our institutional sepsis screening tool (ISST), correlate poorly with clinically diagnosed sepsis. The study objective was to retrospectively evaluate the ISST sensitivity compared with the Pediatric Sequential Organ Failure Assessment (pSOFA). This was a single-center retrospective cohort study. The primary outcome was pSOFA score and ISST sensitivity for severe sepsis. Secondary outcomes included clinical outcome measures. In this severe sepsis cohort ( N  = 491), pSOFA and ISST sensitivity were 57.6 and 61.1%, respectively. In regression analysis for a positive pSOFA, positive blood culture (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.1–4.3, p  = 0.025), older age (OR 1.006, 95% CI 1.003–1.009, p  < 0.001), and pulmonary infectious source (OR 3.3, 95% CI 1.6–6.5, p  = 0.001) demonstrated independent association. In regression analysis for a positive ISST, older age (OR 1.003, 95% CI 1–1.006, p  = 0.031) and intra-abdominal infectious source (OR 0.3, 95% CI 0.1–0.8, p  = 0.014) demonstrated independent association. A negative ISST was associated with higher intensive care unit (ICU) admission prevalence ( p  = 0.01) and fewer ICU-free days ( p  = 0.018). A positive pSOFA score was associated with higher ICU admission prevalence, vasopressor requirement, and vasopressor days as well as fewer ICU, hospital, and mechanical ventilation-free days (all p  < 0.001). Exploratory analysis combining the ISST and pSOFA into a hybrid screen demonstrated superior sensitivity (84.3%) and outcome discrimination. The pSOFA demonstrated noninferior sensitivity to a Goldstein-based institutional sepsis screening model. Further, pSOFA was a better discriminator of poor clinical outcomes. An exploratory hybrid screening model shows superior performance but will require prospective study.
    Keywords severe sepsis ; pediatrics ; screening ; infection
    Language English
    Publishing date 2022-07-28
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2146-4626 ; 2146-4618
    ISSN (online) 2146-4626
    ISSN 2146-4618
    DOI 10.1055/s-0042-1753536
    Database Thieme publisher's database

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