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Guidelines for Intervention in Patients with Chronic Severe Secondary Mitral Regurgitation

International practice guidelines for the care of patients with valvular heart disease were most recently updated in 2017, before the publication of the results of the COAPT and MITRA-FR trials in 2018, and these guidelines were conservative in their recommendations regarding surgery for secondary mitral regurgitation. Continue reading “Guidelines for Intervention in Patients with Chronic Severe Secondary Mitral Regurgitation”

Management of Severe Acute Malnutrition in Infants and Children

This guideline provides global, evidence-informed recommendations on a number of specific issues related to the management of severe acute malnutrition in infants and children, Continue reading “Management of Severe Acute Malnutrition in Infants and Children”

Guidelines for Intensive Care Unit Admission for Severe Community-Acquired Pneumonia (CAP)

The Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) recently reviewed risk factors and developed objective major and minor criteria to identify patients who require direct admission to an Intensive Care Unit (ICU). The most up-to-date definitions use need for invasive mechanical ventilation or septic shock, requiring vasopressors, as absolute indicators for direct admission to an ICU. For patients who do not meet either of these two major criteria, minor criteria have been proposed that are based on CURB-65 and ATS criteria with new additions. For admission to an ICU or high level unit, patients must fulfill at least three of these minor criteria.

Continue reading “Guidelines for Intensive Care Unit Admission for Severe Community-Acquired Pneumonia (CAP)”

Definitions for the Terms Bacteremia, Sepsis, Severe Sepsis, Septic Shock, and Other Related Disorders

A 1992 American College of Chest Physicians/Society of Critical Care Medicine consensus panel defined the following terms which are relevant to the discussion of septic shock:

Infection: Infection is a microbial phenomenon characterized by an inflammatory response to the presence of microorganisms or the invasion of normally sterile host tissue by those organisms.

Bacteremia: Bacteremia refers to the presence of viable bacteria in the blood.

Systemic inflammatory response syndrome: Systemic inflammatory response syndrome (SIRS) is a widespread inflammatory response to a variety of severe clinical insults. This syndrome is clinically recognized by the presence of two or more of the following:

Continue reading “Definitions for the Terms Bacteremia, Sepsis, Severe Sepsis, Septic Shock, and Other Related Disorders”

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