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Article ; Online: The authors reply.

Plata-Menchaca, Erika P / Ferrer, Ricard

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
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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
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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
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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
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Zs.A 5517: Show issues

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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

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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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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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
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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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Article: Vitamin C deficiency in critically ill COVID-19 patients admitted to intensive care unit.

Chiscano-Camón, Luis / Ruiz-Rodriguez, Juan Carlos / Plata-Menchaca, Erika P / Martin, Laura / Bajaña, Ivan / Martin-Rodríguez, Cristina / Palmada, Clara / Ferrer-Costa, Roser / Camos, Silvia / Villena-Ortiz, Yolanda / Ribas, Vicent / Ruiz-Sanmartin, Adolf / Pérez-Carrasco, Marcos / Ferrer, Ricard

Frontiers in medicine

2023 Volume 10, Page(s) 1301001

Abstract: Objectives: To determine vitamin C plasma kinetics, through the measurement of vitamin C plasma concentrations, in critically ill Coronavirus infectious disease 2019 (COVID-19) patients, identifying eventually the onset of vitamin C deficiency.: ... ...

Abstract	Objectives: To determine vitamin C plasma kinetics, through the measurement of vitamin C plasma concentrations, in critically ill Coronavirus infectious disease 2019 (COVID-19) patients, identifying eventually the onset of vitamin C deficiency. Design: Prospective, observational, single-center study. Setting: Intensive Care Unit (ICU), Vall d'Hebron University Hospital, Barcelona. Study period from November 12th, 2020, to February 24th, 2021. Patients: Patients who had a severe hypoxemic acute respiratory failure due to COVID-19 were included. Interventions: Plasma vitamin C concentrations were measured on days 1, 5, and 10 of ICU admission. There were no vitamin C enteral nor parenteral supplementation. The supportive treatment was performed following the standard of care or acute respiratory distress syndrome (ARDS) patients. Measurement: Plasma vitamin C concentrations were analyzed using an ultra-performance liquid chromatography (UPLC) system with a photodiode array detector (wavelength set to 245 nm). We categorized plasmatic levels of vitamin C as follows: undetectable: < 1,5 mg/L, deficiency: <2 mg/L. Low plasma concentrations: 2-5 mg/L; (normal plasma concentration: > 5 mg/L). Main results: Forty-three patients were included (65% men; mean age 62 ± 10 years). The median Sequential Organ Failure Assessment (SOFA) score was 3 (1-4), and the Acute Physiology and Chronic Health disease Classification System (APACHE II) score was 13 (10-22). Five patients had shock. Bacterial coinfection was documented in 7 patients (16%). Initially all patients required high-flow oxygen therapy, and 23 (53%) further needed invasive mechanical ventilation during 21 (± 10) days. The worst PaO Conclusion: This observational study showed vitamin C plasma levels were undetectable on ICU admission in 86% of patients with acute respiratory failure due to COVID-19 pneumonia requiring respiratory support. This finding remained consistent throughout the study period.
Language	English
Publishing date	2023-12-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2023.1301001
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Article: Precision medicine in sepsis and septic shock: From omics to clinical tools.

Ruiz-Rodriguez, Juan Carlos / Plata-Menchaca, Erika P / Chiscano-Camón, Luis / Ruiz-Sanmartin, Adolfo / Pérez-Carrasco, Marcos / Palmada, Clara / Ribas, Vicent / Martínez-Gallo, Mónica / Hernández-González, Manuel / Gonzalez-Lopez, Juan J / Larrosa, Nieves / Ferrer, Ricard

World journal of critical care medicine

2022 Volume 11, Issue 1, Page(s) 1–21

Abstract: Sepsis is a heterogeneous disease with variable clinical course and several clinical phenotypes. As it is associated with an increased risk of death, patients with this condition are candidates for receipt of a very well-structured and protocolized ... ...

Abstract	Sepsis is a heterogeneous disease with variable clinical course and several clinical phenotypes. As it is associated with an increased risk of death, patients with this condition are candidates for receipt of a very well-structured and protocolized treatment. All patients should receive the fundamental pillars of sepsis management, which are infection control, initial resuscitation, and multiorgan support. However, specific subgroups of patients may benefit from a personalized approach with interventions targeted towards specific pathophysiological mechanisms. Herein, we will review the framework for identifying subpopulations of patients with sepsis, septic shock, and multiorgan dysfunction who may benefit from specific therapies. Some of these approaches are still in the early stages of research, while others are already in routine use in clinical practice, but together will help in the effective generation and safe implementation of precision medicine in sepsis.
Language	English
Publishing date	2022-01-09
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2220-3141
ISSN	2220-3141
DOI	10.5492/wjccm.v11.i1.1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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