Abstract:
INTRODUCTION:Despite numerous advances in medicine, the mortality rate of severe sepsis and septic shock remains high, 30-50%. New therapy strategies include: early goal-directed therapy, fluid replacement, early and appropriate antimicrobials, source of infection control, use of corticosteroids, vasopressors and inotropic therapy, use of recombinant activated protein C, tight glucose control, low-tidal-volume mechanical ventilation. They have been shown to improve the outcomes. The adequacy and speed of treatment influence the outcome, too. OBJECTIVE:The objective was to evaluate if new therapy strategies had been integrated in our routine practice. METHOD:Patients with severe sepsis or septic shock, who were treated in the Intensive Care Unit (ICU) over a ten-month period, were analysed retrospectively. The descriptive epidemiological method was applied. Central venous catheterization, central venous pressure, antibiotics, fluid resuscitation, mechanical ventilation, vasopressors, corticosteroids, blood administration, deep vein thrombosis prophylaxis, stress ulcer prophylaxis, glucose control, were evaluated. RESULTS:27 patients were analysed. Patient characteristics were: age, 49.9 years (18-77) with 30-day in-hospital mortality rate of 48.1%. All patients received broad-spectrum antibiotics. Blood cultures were obtained in 85.2% patients. Adequate antimicrobial treatment was applied to 59.3% and 74.1% patients had central venous pressure monitoring. Average central venous pressure was 8.47 +/- 5.6 mm Hg (-2-20). Aggressive fluid therapy was given to 33.3% of the cases and 66.7% of the patients with septic shock received vasoactive drugs while 29.6% received corticosteroids. Red blood cell transfusions were applied in 59.3% of patients. All patients received stress ulcer prophylaxis, and 37% of them deep vein thrombosis prophylaxis. The average value of morning glucose was 9.11 +/- 5.03 mmol/l (3.7-22.0). 63% of patients were mechanically ventilated. Blood lactate was not determined. CONCLUSION:Evidence-based clinical guidelines for management of severe sepsis and septic shock have not been implemented in a widespread, systematic way in the ICU of the Clinical Centre, Kragujevac. Institutional acceptance of this protocol, and education of clinicians may improve survivability for patients with sepsis.
journal_name
Srp Arh Celok Lekjournal_title
Srpski arhiv za celokupno lekarstvoauthors
Jevdjić J,Surbatović M,Drakulić-Miletić S,Vukićević Vdoi
10.2298/sarh0806248jsubject
Has Abstractpub_date
2008-05-01 00:00:00pages
248-52issue
5-6eissn
0370-8179issn
2406-0895journal_volume
136pub_type
杂志文章abstract:INTRODUCTION:Reduced compound glutathione (GSH) in the lens has the function to protect the thiol group of lens proteins, and as a substrate of glutathione peroxidase (GPx) and glutathione S-transferase (GST). Protein containing thiol groups is significant for the normal function of lens epithelium, i.e. enzymes Na-K-A...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1210563k
更新日期:2012-09-01 00:00:00
abstract:INTRODUCTION:According to the literature, a fusiform aneurysm located in the cerebellopontine angle (CPA) is an extremely rare condition. CASE OUTLINE:We report a case of a 59-year-old patient with initial dizziness and left-sided sensorineural hearing loss that had gradually developed over six months. Vertebrobasilar...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1512731z
更新日期:2015-11-01 00:00:00
abstract:Introduction:Intensive treatment protocols used for non-Hodgkin lymphoma in children lead to eventfree survival rates ranging from 80% to 90%. However, the results are less successful in developing countries. Lymphoblastic lymphoma (LBL) is the second most frequent type of lymphoma in children, contributing with about ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2016-07-01 00:00:00
abstract::Among the numerous variables measured by the electrocardiogram during exercise little attention has been paid to the "septal" Q wave. We examined changes of the "septal" Q wave amplitude during exercise in 43 patients with chest pain. Coronary arteriography showed significant changes in 23 patients and normal arteries...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:INTRODUCTION:Psychiatric treatment in developed countries has significantly changed in the last few decades, with a significant shortening of the duration of hospitalization. Numerous West European countries are undertaking health system reforms to improve treatment efficiency. OBJECTIVE:The aim of the study was to pr...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2011-12-01 00:00:00
abstract::The authors present their views of the most frequent difficulties and possible oversights in the diagnosis of chronic secretory otitis on the basis of the treatment of 950 children in all departments. An insidious, subclinical and long-lasting course of chronic secretory otitis, the age of this population and very oft...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::The paper is aimed at illustrating the importance of nonspecific and specific bronchoprovokative tests for diagnosing allergic bronchial asthma by pathophysiologic mechanisms of hyperiritability of airways and making of specific "schok tissue". Besides we tried to explain these exeptional cases which we encounter in o...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:Gilbert's syndrome represents the most frequent hereditary disorder of bilirubin metabolism. It occurs in 2-7% of subjects in general population, and is manifested by mild unconjugated hyperbilirubinaemia of benign nature. OBJECTIVE:The study was conducted in order to analyse our experience related to the...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0706317r
更新日期:2007-05-01 00:00:00
abstract:INTRODUCTION:The cardiovascular changes (vascular structure changes, hypertrophy of the left ventricle) contribute to both the increased cardiovascular morbidity and the mortality of essential hypertension. Therefore, modern treatment strategies should not only target blood pressure (BP) reduction but also normalize ca...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,随机对照试验
doi:10.2298/sarh0604106t
更新日期:2006-03-01 00:00:00
abstract::The authors studied the effect of working conditions and harmful organic solvents on the frequency of gynaecological diseases and menstrual disorders in 138 women. The experimental group consisted of 88 women exposed to evaporation and increased concentrations of organic solvents, and the control group was composed of...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:INTRODUCTION:Retinopathy of prematurity (ROP) is a multifactorial disease that occurs most frequently in very small and very sick preterm infants, and it has been identified as the major cause of childhood blindness. OBJECTIVE:The aim of this study was to evaluate ROP incidence and risk factors associated with varying...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2011-07-01 00:00:00
abstract::The ileal pouch-anal operation is the best procedure because it liberates the patient from ulcerative colitis i.e. from diseased mucosa of the large intestine. The ileal pouch forms a new reservoir for the storage of feces. Symptomatic pouch inflammation (pouchitis) appeared in 7-40% of the patients. The authors descr...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::Chiari pelvic osteotomy is a surgical procedure having been performed for almost sixty years in patients with the insufficient coverage of the femoral head. It is most frequently used in young patients with dysplastic acetabular sockets as a part of developmental hip dysplasia. Even though performance of the Chiari os...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:10.2298/sarh1310710s
更新日期:2013-09-01 00:00:00
abstract:INTRODUCTION:Prevalence of sensorineural hearing loss is 1-3 per 1,000 newborns. Transient evoked otoacoustic emission (TEOAE) and automated auditory brain stem responses (AABR) are most frequently used methods in newborn hearing screening programmes. OBJECTIVE:The aim of this study was to examine hearing function in ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0706264b
更新日期:2007-05-01 00:00:00
abstract:INTRODUCTION:Ankylosing spondylitis is a chronic progressive autoimmune inflammatory disorder involving mainly the axial skeleton and larger peripheral joints that progressively limits spinal mobility and may lead to irreversible structural changes and consequently to impaired physical function and reduced quality of l...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0910524m
更新日期:2009-09-01 00:00:00
abstract:INTRODUCTION:Thermal changes can occur on the external root surface when root-end cavity preparation is performed, which may damage periodontal ligament cells and alveolar bone. OBJECTIVE:The purpose of this study was to evaluate the temperature changes during preparation of the root-end cavities at 1 and 3 mm to the ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1310597b
更新日期:2013-09-01 00:00:00
abstract::During the last several decades, cochlear implant has been fully recognized in treatment of severe hearing loss. Development of modern technology enabled inconceivable possibilities of technical qualities of the device as well as development of usable coding strategies, which led to extraordinary results in patient re...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0410302k
更新日期:2004-09-01 00:00:00
abstract::The aim of the study was to establish the frequency of tubular dysfunction in 59 patients with nephrolithiasis, of whom 52 had unilateral and 7 bilateral calculosis. Before the study urinary infection was cured in all patients. Renal function was normal in all subjects. Hypercalcaemia was present in 8 patients, and hy...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract:INTRODUCTION:The development of effective medications makes pharmacological therapy of BPH the dominant mode of treatment today. It improves urinary symptoms and prevents disease progression while producing side effects on male sexual function. OBJECTIVE:The aim of the study is to present the effects of BPH pharmacolo...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1506284s
更新日期:2015-05-01 00:00:00
abstract::From a historic point of view, epilepsy and its eponyms were in an ontogenetic symbiosis throughout their history. Epilepsy is a disease with a history of eponyms presenting the frame of mind of both streetwise as well as skilled "authors" about its origin and nature. From ancient times the names for epilepsy, archety...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 历史文章,杂志文章
doi:
更新日期:1996-05-01 00:00:00
abstract::The aim of the present study was to evaluate the state of bone mass in obese individuals. Osteocalcin (OC) and parathormone (PTH) were measured (by RIA) in the sera of 137 obese, 32 premenopausal women, 65 postmenopausal women and 40 males, as well as in 28 controls, non-obese individuals. Values of OC and PTH were si...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:INTRODUCTION:Campylobacter jejuni and Campylobacter coli represent one of the main causes of bacterial diarrhoea in humans. Although the disease is usually mild and self-limiting, severe chronic sequelae may occur, such as reactive arthritis, Guillain-Barré and Miller Fisher syndromes. Serotyping is used as an epidemio...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1012721m
更新日期:2010-11-01 00:00:00
abstract:INTRODUCTION:QT dispersion (QTd) is a measure of non-homogeneous repolarisation of the myocardium and is used as an indicator of arrhythmogenicity. OBJECTIVE:The aim of this study was to assess the relation between QT dispersion, left ventricle systolic function and frequency of ventricular arrhythmias in coronary pat...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0708395s
更新日期:2007-07-01 00:00:00
abstract::Chronic renal failure (CRF) is almost always associated with high arterial blood pressure. Adequate control of hypertension slows down the progression of the disease, Inhibitors of angiotenzin-converting enzyme (ACE inhibitors) have proved to be very efficacious in decreasing high blood pressure. The aim of this study...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0204087t
更新日期:2002-03-01 00:00:00
abstract:INTRODUCTION:Classically, coarctation of the aorta has been divided into infantile and adult forms. The vascular malformation responsible for coarctation is a defect of the vessel intima and media giving rise to a prominent posterior infolding ("the posterior shelf") which, in some cases, may extend around the entire c...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh04s1066v
更新日期:2004-10-01 00:00:00
abstract:INTRODUCTION:Term breech presentation occurs in 3-4% of all deliveries. Most obstetricians are completely sure how to end delivery when the foetus is in breech presentation, by caesarean section as the only option. OBJECTIVE:The main goal of the paper was to present the method of delivery for term breech presentation ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1104155d
更新日期:2011-03-01 00:00:00
abstract::In order to standardize language of medicine, it is essential to have a good command of ancient Greek and Latin. We cannot deny a huge impact of ancient Greek medicine on medical terminology. Compounds of Greek origin related to terms for organs, illnesses, inflammations, surgical procedures etc. have been listed as e...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0710606m
更新日期:2007-09-01 00:00:00
abstract::In every patient with congestive heart failure there is a secondary neurohumoral response including increase in serum noradrenaline, renin, angiotensin, aldosteron and antidiuretic hormone or arginine-vasopressin values. Plasma and urine noradrenaline levels are increased proportionally to the severity of ventricular ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract:INTRODUCTION:Cesarean delivery is the most common obstetric surgery today. Improvement of operative techniques, anaesthesia, care and transfusion has contributed to the safety of the procedure and expansion of indications. The operative technique usually consists of opening the abdominal wall by inferior transverse inc...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,随机对照试验
doi:10.2298/sarh08s2109v
更新日期:2008-05-01 00:00:00
abstract:INTRODUCTION:Dyspnoea is a characteristic symptom of chronic obstructive pulmonary disease (COPD), which impairs everyday functioning of patients. OBJECTIVE:The aim of our study was to evaluate the relationship between the degree of dyspnoea of COPD patients and their health-related quality of life. METHOD:We measure...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0710547g
更新日期:2007-09-01 00:00:00