• Tuberculosis and Respiratory Diseases
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• v.82 no.1
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• pp.6-14
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• 2019

Sepsis is a life-threatening condition caused by infection and represents a substantial global health burden. Recent epidemiological studies showed that sepsis mortality rates have decreased, but that the incidence has continued to increase. Although a mortality benefit from early-goal directed therapy (EGDT) in patients with severe sepsis or septic shock was reported in 2001, three subsequent multicenter randomized studies showed no benefits of EGDT versus usual care. Nonetheless, the early administration of antibiotics and intravenous fluids is considered crucial for the treatment of sepsis. In 2016, new sepsis definitions (Sepsis-3) were issued, in which organ failure was emphasized and use of the terms "systemic inflammatory response syndrome" and "severe sepsis" was discouraged. However, early detection of sepsis with timely, appropriate interventions increases the likelihood of survival for patients with sepsis. Also, performance improvement programs have been associated with a significant increase in compliance with the sepsis bundles and a reduction in mortality. To improve sepsis management and reduce its burden, in 2017, the World Health Assembly and World Health Organization adopted a resolution that urged governments and healthcare workers to implement appropriate measures to address sepsis. Sepsis should be considered a medical emergency, and increasing the level of awareness of sepsis is essential.

• Tuberculosis and Respiratory Diseases
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• v.70 no.1
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• pp.51-57
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• 2011

Background: Early recognition and treatment of sepsis would improve patients' outcome. But it is difficult to distinguish between sepsis and non-infectious conditions in the acute phase of clinical deterioration. We studied serum level of procalcitonin (PCT) as a method to diagnose and to evaluate sepsis. Methods: Between 1 March 2009 and 30 September 2009, 178 patients had their serum PCT tested during their clinical deterioration in the medical intensive care unit. These laboratories were evaluated, on a retrospective basis. We classified their clinical status as non-infection, local infection, sepsis, severe sepsis, and septic shock. Then, we compared their clinical status with level of PCT. Results: The number of clinical status is as follows: 18 non-infection, 33 local infection, 39 sepsis, 26 severe sepsis, and 62 septic shock patients. PCT level of non-septic group (non-infection and local infection) and septic group (sepsis, severe sepsis, septic shock) was $0.36{\pm}0.57$ ng/mL and $18.09{\pm}36.53$ ng/mL (p<0.001), respectively. Area under the curve for diagnosis of sepsis using cut-off value of PCT >0.5 ng/mL was 0.841 (p<0.001). Level of PCT as clinical status was statistically different between severe sepsis and septic shock ($^*severe$ sepsis; $4.53{\pm}6.15$ ng/mL, $^*septic$ shock $34.26{\pm}47.10$ ng/mL, $^*p$ <0.001). Conclusion: Level of PCT at clinical deterioration showed diagnostic power for septic condition. The level of PCT was statistically different between severe sepsis and septic shock.

• Proceedings of the PSK Conference
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• 2003.10b
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• pp.127.2-128
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• 2003

Sepsis remains common surgical problems with high morbidity and mortality despite improvement in the management for septic patient. Although hepatocellular dysfunction occurs during sepsis, the mechanism responsible for this remains unclear. In sepsis, a state of severe oxidative stress is encountered, with host endogenous antioxidant defenses overcome. Therefore, the aim of this study was to determine whether specific abnormality exists in cytochrome P450 (CYP)-mediated metabolizing function associated with polymicrobial sepsis and whether role of ascorbic acid (AA) in the alterations during sepsis. (omitted)

• The Journal of Korean Medicine
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• v.44 no.3
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• pp.39-46
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• 2023

Objectives: This research aims to analyze the relationship between Daeseunggi-tang and sepsis in literature. Methods: The main treatment symptoms of Daeseunggi-tang presented in Sanghanron and GeumGweyoryak, the symptoms of Ju-hwang and Nae-ham which correspond to sepsis in Korean Medicine, the symptoms of sepsis presented in the related papers including international guideline and diagnosis criteria of spesis were compared and analyzed. Results: The main treatment symptoms of Daeseunggi-tang were very similar to the symptoms of sepsis, and were almost identical to the symptoms of Ju-hwang and Nae-ham (especially Hwa-ham, Gu-ham), which are the Korean medicine descriptions of sepsis. Conclusions: Based on the above research results, it seems to be possible to use Daeseunggi-tang for the treatment of sepsis.

• Journal of Korean Biological Nursing Science
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• v.22 no.4
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• pp.260-270
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• 2020

Purposes: Sepsis is a critical condition in which nurses should detect clinical manifestations and provide early intervention to prevent unwanted serious conditions in the patients. The initial occurrence and management of sepsis take place in general units, but there is a lack of knowledge in nurses. The purpose of this study was to examine the effects of a case-based sepsis education program and compare the case-based education program with and without smartphone applications. Methods: A quasi-experimental pre-test-post-test design with a control group was used. We provided a case-based education program with and without smartphone applications to the nurses and tested the effects of the program on knowledge, the accuracy of sepsis assessment, and self-efficacy as outcome variables. A total of 60 nurses in general units participated. To test differences in knowledge, the accuracy of sepsis assessment, and self-efficacy regarding sepsis between the groups over time, a mixed-design ANCOVA was used for parametric analysis, and generalized estimating equations (GEE) were used for nonparametric analysis. Results: There were significant differences in knowledge, the accuracy of sepsis assessment, and self-efficacy between the groups and within the groups over time. The intervention groups treated with the case-based education program showed improved outcome variables compared to the control group. There was no difference between case-based education with the smartphone application or without the application. Conclusions: The case-based education improved knowledge, the accuracy of sepsis assessment, and self-efficacy in the care of sepsis by nurses working in the general wards. The results suggest that the case-based education program for nurses was effective and eventually improved patient health outcomes.

• Tuberculosis and Respiratory Diseases
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• v.67 no.6
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• pp.491-498
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• 2009

Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.

• Journal of Ginseng Research
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• v.47 no.3
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• pp.353-358
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• 2023

Sepsis and septic shock affect millions of people worldwide each year with high clinical mortality rates. At present, basic research on sepsis has emerged in an endless stream, but there are few effective clinical translation results. Ginseng, a medicinal and edible representative of Araliaceae plants, contains a variety of biologically active compounds including ginsenosides, alkaloids, glycosides, polysaccharides, and polypeptides. Neuromodulation, anticancer activity, blood lipid regulation, and antithrombotic activity have been linked to ginseng treatment. At present, basic and clinical research have suggested various applications of ginseng in sepsis. In view of the different effects of various ginseng components on the pathogenesis of sepsis, and in order to further understand and develop the possible value of ginseng in sepsis, this manuscript reviews the application of various components of ginseng in the treatment of sepsis in recent years.

• Journal of the Korean Burn Society
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• v.22 no.2
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• pp.38-44
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• 2019

Purpose: The immature granulocyte count has been reported to be a marker of infection and sepsis. The difference in leukocyte subfractions (delta neutrophil index, DNI) in ADVIA 2120 reflects the fraction of circulating immature granulocytes in the blood. This study evaluated the clinical utility of DNI as a severity and prediction marker in critically ill patients with burn sepsis. Methods: One hundred and sixty nine patients admitted to the burn care unit were studied. DNI (the difference in leukocyte subfractions identified by myeloperoxidase and nuclear lobularity channels) was determined using a specific blood cell analyzer. Results: Seventy one patients (42 %) were diagnosed with burn sepsis. DNI was significantly higher in patients with burn sepsis than in patients without (P<0.01). Delta neutrophil index was a better indicator of burn sepsis than C-reactive protein, lactate, white blood cell count, HCO3, base excess, lactate, procalcitonin (odds ratio, 6.31; confidence interval 2.36~16.90; P<0.01). And the receiver operating characteristic curves showed that delta neutrophil index, AUC 0.795 (95% confidence interval, 0.721~0.869; P<0.05) was a better predictor of burn sepsis than lactate, procalcitonin, white blood cell, base excess and abbreviated burn severity index. Conclusion: Delta neutrophil index may be used as a early marker of patients with burn sepsis.

• The Korean Journal of Physiology and Pharmacology
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• v.21 no.5
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• pp.495-507
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• 2017

The effect of clonidine administered intrathecally (i.t.) on the mortality and the blood glucose level induced by sepsis was examined in mice. To produce sepsis, the mixture of D-galactosamine (GaLN; 0.6 g/10 ml)/lipopolysaccharide (LPS; $27{\mu}g/27{\mu}l$) was treated intraperitoneally (i.p.). The i.t. pretreatment with clonidine ($5{\mu}g/5{\mu}l$) increased the blood glucose level and attenuated mortality induced by sepsis in a dose-dependent manner. The i.t. post-treatment with clonidine up to 3 h caused an elevation of the blood glucose level and protected sepsis-induced mortality, whereas clonidine post-treated at 6, 9, or 12 h did not affect. The pre-treatment with oral D-glucose for 30 min prior to i.t. post-treatment (6 h) with clonidine did not rescue sepsis-induced mortality. In addition, i.t. pretreatment with pertussis toxin (PTX) reduced clonidine-induced protection against mortality and clonidine-induced hyperglycemia, suggesting that protective effect against sepsis-induced mortality seems to be mediated via activating PTX-sensitive G-proteins in the spinal cord. Moreover, pretreatment with clonidine attenuated the plasma tumor necrosis factor ${\alpha}$ ($TNF-{\alpha}$) induced by sepsis. Clonidine administered i.t. or i.p. increased $p-AMPK{\alpha}1$ and $p-AMPK{\alpha}2$, but decreased p-Tyk2 and p-mTOR levels in both control and sepsis groups, suggesting that the up-regulations of $p-AMPK{\alpha}1$ and $p-AMPK{\alpha}2$, or down-regulations of p-mTOR and p-Tyk2 may play critical roles for the protective effect of clonidine against sepsis-induced mortality.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.10-16
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• 2018

Background: Vitamin D has been associated with sepsis in pediatric and adult patients. The association with neonates is unclear. This systematic review and meta-analysis examined the effect of neonatal and maternal vitamin D levels on neonatal early-onset sepsis. Methods: We searched studies published up to November 2017 in PubMed/Medline, Embase, and the Cochrane Library databases. All studies that reported 25-hydroxyvitamin D levels in neonates with or without early-onset sepsis were included. Meta-analysis was performed using RevMan 5.3 software. Results: Four studies were eligible. The weighted mean difference of 25-hydroxyvitamin D levels in neonates with early-onset sepsis and controls was -7.27 ng/mL (95% confidence interval = -7.62, -6.92). Maternal vitamin D levels in neonates with early-onset sepsis were significantly lower than those in controls (weighted mean difference -7.24 ng/mL, 95% confidence interval -8.45, -6.03). All neonates with early onset sepsis had vitamin D deficiency (25-hydroxyvitamin D <20 ng/mL). Conclusion: Lower neonatal and maternal 25-hydroxyvitamin D levels were associated with neonatal early-onset sepsis. Vitamin D supplementation during pregnancy may be helpful to prevent neonatal early-onset sepsis. The effects of vitamin D supplementation on early-onset sepsis in neonates warrant further study.