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  1. Article ; Online: Fisiopatología del shock séptico.

    Chiscano-Camón, Luis / Plata-Menchaca, Erika / Ruiz-Rodríguez, Juan Carlos / Ferrer, Ricard

    Medicina intensiva

    2024  Volume 46 Suppl 1, Page(s) 1–13

    Abstract: Sepsis and septic shock result from an inadequate host response to an infection, which causes organ dysfunction. The progression of this condition is manifested by the occurrence of successive clinical stages, resulting from the systemic inflammatory ... ...

    Title translation Pathophysiology of septic shock.
    Abstract Sepsis and septic shock result from an inadequate host response to an infection, which causes organ dysfunction. The progression of this condition is manifested by the occurrence of successive clinical stages, resulting from the systemic inflammatory response secondary to the activation of different inflammatory mediators, leading to organ dysfunction. There is a high burden of evidence on the role of endotoxin in the pathogenesis of sepsis and its crucial role in triggering the inflammatory response in sepsis caused by gram-negative bacteria. The coagulation cascade activation in sepsis patients is part of the host's adaptive immune response to infection. The endothelium is the main target in sepsis, which is metabolically active and can.
    Language Spanish
    Publishing date 2024-01-04
    Publishing country Spain
    Document type English Abstract ; Journal Article
    ISSN 2173-5727
    ISSN (online) 2173-5727
    DOI 10.1016/j.medine.2022.03.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The authors reply.

    Plata-Menchaca, Erika P / Ferrer, Ricard

    Critical care medicine

    2021  Volume 49, Issue 6, Page(s) e660–e661

    Language English
    Publishing date 2021-05-17
    Publishing country United States
    Document type Research Support, Non-U.S. Gov't ; Letter ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000004997
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1261: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  3. Article ; Online: Procalcitonin Is Useful for Antibiotic Deescalation in Sepsis.

    Plata-Menchaca, Erika P / Ferrer, Ricard

    Critical care medicine

    2021  Volume 49, Issue 4, Page(s) 693–696

    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Biomarkers/blood ; Health Status Indicators ; Humans ; Intensive Care Units ; Procalcitonin/blood ; Sepsis/blood ; Sepsis/drug therapy ; Time Factors
    Chemical Substances Anti-Bacterial Agents ; Biomarkers ; Procalcitonin
    Language English
    Publishing date 2021-08-30
    Publishing country United States
    Document type Editorial
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000004776
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1261: Show issues Location:
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  4. Article ; Online: Evidence for the Application of Sepsis Bundles in 2021.

    Plata-Menchaca, Erika P / Ruiz-Rodríguez, Juan Carlos / Ferrer, Ricard

    Seminars in respiratory and critical care medicine

    2021  Volume 42, Issue 5, Page(s) 706–716

    Abstract: Sepsis represents a severe condition that predisposes patients to a high risk of death if its progression is not ended. As with other time-dependent conditions, the performance of determinant interventions has led to significant survival benefits and ... ...

    Abstract Sepsis represents a severe condition that predisposes patients to a high risk of death if its progression is not ended. As with other time-dependent conditions, the performance of determinant interventions has led to significant survival benefits and quality-of-care improvements in acute emergency care. Thus, the initial interventions in sepsis are a cornerstone for prognosis in most patients. Even though the evidence supporting the hour-1 bundle is perfectible, real-life application of thoughtful and organized sepsis care has improved survival and quality of care in settings promoting compliance to evidence-based treatments. Current evidence for implementing the Surviving Sepsis Campaign bundles for early sepsis management is moving forward to better approaches as more substantial evidence evolves.
    MeSH term(s) Critical Care ; Hospital Mortality ; Humans ; Prognosis ; Sepsis/diagnosis ; Sepsis/therapy ; Shock, Septic
    Language English
    Publishing date 2021-09-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1183617-9
    ISSN 1098-9048 ; 1069-3424
    ISSN (online) 1098-9048
    ISSN 1069-3424
    DOI 10.1055/s-0041-1733899
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1555: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  5. Article ; Online: Risk factors and outcomes of ventilator-associated pneumonia in COVID-19 patients: a propensity score matched analysis.

    Martínez-Martínez, María / Plata-Menchaca, Erika P / Nuvials, Francesc X / Roca, Oriol / Ferrer, Ricard

    Critical care (London, England)

    2021  Volume 25, Issue 1, Page(s) 235

    MeSH term(s) Adult ; Aged ; COVID-19/complications ; COVID-19/mortality ; COVID-19/therapy ; Female ; Humans ; Male ; Middle Aged ; Pneumonia, Ventilator-Associated/etiology ; Pneumonia, Ventilator-Associated/mortality ; Propensity Score ; Respiration, Artificial/adverse effects ; Respiration, Artificial/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Spain
    Language English
    Publishing date 2021-07-06
    Publishing country England
    Document type Letter
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-021-03654-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5517: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article: Evidence for the Application of Sepsis Bundles in 2021

    Plata-Menchaca, Erika P. / Ruiz-Rodríguez, Juan Carlos / Ferrer, Ricard

    Seminars in Respiratory and Critical Care Medicine

    (Sepsis and Septic Shock)

    2021  Volume 42, Issue 05, Page(s) 706–716

    Abstract: Sepsis represents a severe condition that predisposes patients to a high risk of death if its progression is not ended. As with other time-dependent conditions, the performance of determinant interventions has led to significant survival benefits and ... ...

    Series title Sepsis and Septic Shock
    Abstract Sepsis represents a severe condition that predisposes patients to a high risk of death if its progression is not ended. As with other time-dependent conditions, the performance of determinant interventions has led to significant survival benefits and quality-of-care improvements in acute emergency care. Thus, the initial interventions in sepsis are a cornerstone for prognosis in most patients. Even though the evidence supporting the hour-1 bundle is perfectible, real-life application of thoughtful and organized sepsis care has improved survival and quality of care in settings promoting compliance to evidence-based treatments. Current evidence for implementing the Surviving Sepsis Campaign bundles for early sepsis management is moving forward to better approaches as more substantial evidence evolves.
    Keywords sepsis ; surviving sepsis campaign bundles ; sepsis management ; sepsis bundles
    Language English
    Publishing date 2021-09-20
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 1183617-9
    ISSN 1098-9048 ; 1069-3424
    ISSN (online) 1098-9048
    ISSN 1069-3424
    DOI 10.1055/s-0041-1733899
    Database Thieme publisher's database

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    Zs.A 1555: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  7. Article ; Online: Blood purification in sepsis and COVID-19: what´s new in cytokine and endotoxin hemoadsorption.

    Ruiz-Rodríguez, Juan Carlos / Plata-Menchaca, Erika P / Chiscano-Camón, Luis / Ruiz-Sanmartin, Adolf / Ferrer, Ricard

    Journal of Anesthesia, Analgesia and Critical Care (Online)

    2022  Volume 2, Issue 1, Page(s) 15

    Abstract: Sepsis and COVID-19 are two clinical conditions that can lead to a dysregulated inflammatory state causing multiorgan dysfunction, hypercytokinemia, and a high risk of death. Specific subgroups of critically ill patients with particular characteristics ... ...

    Abstract Sepsis and COVID-19 are two clinical conditions that can lead to a dysregulated inflammatory state causing multiorgan dysfunction, hypercytokinemia, and a high risk of death. Specific subgroups of critically ill patients with particular characteristics could benefit from rescue treatment with hemoadsorption. There is a lack of adequately designed randomized controlled trials evaluating the potential benefits of cytokine or endotoxin hemoadsorption. Critically ill COVID-19 patients with severe acute respiratory failure poorly responsive to conventional treatment could be candidates to receive cytokine hemoadsorption in the presence of high levels of interleukin 6. This treatment can also be suitable for patients with refractory septic shock and hypercytokinemia. In the context of high endotoxin activity, hemoadsorption with polymyxin B could improve clinical parameters and the prognosis of patients with refractory septic shock. Predictive enrichment, using biomarkers or other individual features, identifies potential responders to cytokine, endotoxin, or sequential hemoadsorption. Besides, recognizing the particular subsets of patients likely to respond to one or both types of hemoadsorption will aid the design of future studies that accurately validate the effectiveness of these therapies.
    Language English
    Publishing date 2022-04-04
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2731-3786
    ISSN (online) 2731-3786
    DOI 10.1186/s44158-022-00043-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Antibiotic treatment in patients with sepsis: a narrative review.

    Plata-Menchaca, Erika P / Ferrer, Ricard / Ruiz Rodríguez, Juan Carlos / Morais, Rui / Póvoa, Pedro

    Hospital practice (1995)

    2020  Volume 50, Issue 3, Page(s) 203–213

    Abstract: Sepsis is a medical emergency and life-threatening condition due to a dysregulated host response to infection, with unacceptably high morbidity and mortality. Similar to acute myocardial infarction or cerebral vascular accident, sepsis is a severe and ... ...

    Abstract Sepsis is a medical emergency and life-threatening condition due to a dysregulated host response to infection, with unacceptably high morbidity and mortality. Similar to acute myocardial infarction or cerebral vascular accident, sepsis is a severe and continuous time-dependent condition. Thus, in the case of sepsis, early and adequate administration of antimicrobials must be a priority, ideally within the first hour of diagnosis, simultaneously with organ support.As a consequence of the emergence of multidrug-resistant pathogens, the choice of antimicrobials should be performed according to the local pathogen patterns of resistance. Individual antimicrobial optimization is essential to achieve adequate concentrations of antimicrobials, to reduce adverse effects, and to ensure successful outcomes, as well as preventing the emergence of multidrug-resistant pathogens. The loading dose is the administration of an initial higher dose of antimicrobials, regardless of the presence of organ dysfunction. Further doses should be implemented according to pharmacokinetics/pharmacodynamics of antimicrobials and should be adjusted according to the presence of renal or liver dysfunction. Extended or continuous infusion of beta-lactams and therapeutic drug monitoring can help to achieve therapeutic levels of antimicrobials. Duration and adequacy of treatment must be reviewed at regular intervals to allow effective de-escalation and administration of short courses of antimicrobials for most patients. Antimicrobial stewardship frameworks, leadership, focus on the optimal duration of treatments, de-escalation, and novel diagnostic stewardship approaches will help us to improve patients the process of care and overall quality of care.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Antimicrobial Stewardship ; Drug Monitoring ; Humans ; Sepsis/drug therapy ; Shock, Septic
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2020-07-20
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2570453-9
    ISSN 2377-1003 ; 2154-8331 ; 8750-2836
    ISSN (online) 2377-1003
    ISSN 2154-8331 ; 8750-2836
    DOI 10.1080/21548331.2020.1791541
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 890: Show issues Location:
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  9. Article ; Online: External ventriculostomy-associated infection reduction after updating a care bundle.

    Rojas-Lora, Mariel / Corral, Luisa / Zabaleta-Carvajal, Ivan / López-Ojeda, Pau / Fuentes-Mila, Verónica / Romera-Peregrina, Iluminada / Lerma-Briansò, Cristina / Plata-Menchaca, Erika / Pavón, Alba / Sabater, Joan / Cabellos, Carmen

    Annals of clinical microbiology and antimicrobials

    2023  Volume 22, Issue 1, Page(s) 59

    Abstract: Background: Despite the clinical benefits of external ventricular drains (EVD), these devices can lead to EVD-related infections (EVDRI). The drainage insertion technique and standardized guidelines can significantly reduce the risk of infection, mainly ...

    Abstract Background: Despite the clinical benefits of external ventricular drains (EVD), these devices can lead to EVD-related infections (EVDRI). The drainage insertion technique and standardized guidelines can significantly reduce the risk of infection, mainly caused by gram-positive bacteria. However, gram-negative microorganisms are the most frequent causative microorganisms of EVDRI in our hospital. We aimed to determine whether a new bundle of measures for the insertion and maintenance of a drain could reduce the incidence of EVDRI. This cohort study of consecutive patients requiring EVD from 01/01/2015 to 12/31/2018 compared the patients' characteristics before and after introducing an updated protocol (UP) for EVD insertion and maintenance in 2017.
    Results: From 204 consecutive patients, 198 requiring EVD insertion were included (54% females, mean age 55 ± 15 years). The before-UP protocol included 87 patients, and the after-UP protocol included 111 patients. Subarachnoid (42%) and intracerebral (24%) hemorrhage were the main diagnoses at admission. The incidence of EVDRI fell from 13.4 to 2.5 episodes per 1000 days of catheter use. Gram-negative bacteria were the most frequent causative microorganisms. Previous craniotomy remained the only independent risk factor for EVDRI. EVDRI patients had increased mechanical ventilation durations, hospital and ICU stays, and percutaneous tracheostomy requirements.
    Conclusions: A care bundle focusing on fewer catheter sampling and more accurate antiseptic measures can significantly decrease the incidence of EVDRI. After implementing the management protocol, a decreased incidence of infections caused by gram-negative and gram-positive bacteria and reduced ICU and hospital lengths of stay were observed.
    MeSH term(s) Female ; Humans ; Adult ; Middle Aged ; Aged ; Male ; Ventriculostomy/adverse effects ; Ventriculostomy/methods ; Cohort Studies ; Patient Care Bundles ; Drainage/methods ; Gram-Positive Bacteria ; Retrospective Studies
    Language English
    Publishing date 2023-07-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2097873-X
    ISSN 1476-0711 ; 1476-0711
    ISSN (online) 1476-0711
    ISSN 1476-0711
    DOI 10.1186/s12941-023-00612-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: An approach to antibiotic treatment in patients with sepsis.

    Martínez, María Luisa / Plata-Menchaca, Erika P / Ruiz-Rodríguez, Juan Carlos / Ferrer, Ricard

    Journal of thoracic disease

    2019  Volume 12, Issue 3, Page(s) 1007–1021

    Abstract: Sepsis is a medical emergency and life-threatening condition due to a dysregulated host response to infection, which is time-dependent and associated with unacceptably high mortality. Thus, when treating suspicious or confirmed cases of sepsis, ... ...

    Abstract Sepsis is a medical emergency and life-threatening condition due to a dysregulated host response to infection, which is time-dependent and associated with unacceptably high mortality. Thus, when treating suspicious or confirmed cases of sepsis, clinicians must initiate broad-spectrum antimicrobials within the first hour of diagnosis. Optimizing antibiotic use is essential to ensure successful outcomes and to reduce adverse antibiotic effects, as well as preventing drug resistance. All likely pathogens involved should be considered to provide an appropriate antibiotic coverage. Clinicians must investigate on the previous risk of multidrug-resistant (MDR) pathogens, and the principle of individualized dosing should replace the principle of standard dosing. The loading dose is an initial higher dose of an antibiotic for all patients, yet an individualized treatment approach for further doses should be implemented according to pharmacokinetics (PK)/pharmacodynamics (PD) and the presence of renal/liver dysfunction. Extended or continuous infusion of beta-lactams and therapeutic drug monitoring (TDM) can help to achieve therapeutic levels of antimicrobials. Reevaluation of duration and appropriateness of treatment at regular intervals are also necessary. De-escalation and shortened courses of antimicrobials must be considered for most patients, except in some justified circumstances. Leadership, teamwork, antimicrobial stewardship (AS) frameworks, guideline's recommendations on the optimal duration of treatments, de-escalation, and novel diagnostic stewardship approaches will help us to improve patients' quality of care.
    Language English
    Publishing date 2019-05-13
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd.2020.01.47
    Database MEDical Literature Analysis and Retrieval System OnLINE

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