2018
A review of micronutrients in sepsis: the role of thiamine, l-carnitine, vitamin C, selenium and vitamin D
Belsky JB, Wira CR, Jacob V, Sather JE, Lee PJ. A review of micronutrients in sepsis: the role of thiamine, l-carnitine, vitamin C, selenium and vitamin D. Nutrition Research Reviews 2018, 31: 281-290. PMID: 29984680, DOI: 10.1017/s0954422418000124.Peer-Reviewed Original ResearchConceptsVitamin CLife-threatening organ dysfunctionRole of micronutrientsCurrent available dataSeptic patientsOrgan dysfunctionSeptic shockVitamin DVitamin D.Clinical trialsRole of thiamineThiamine deficiencySepsisHuman studiesHost responseConclusion statementsCellular dysfunctionNormal physiologyMetabolic demandsCarnitinePotential roleDysfunctionPresent reviewCellular turnoverPivotal role
2017
Evaluation of a novel 5-group classification system of sepsis by vasopressor use and initial serum lactate in the emergency department
Swenson KE, Dziura JD, Aydin A, Reynolds J, Wira CR. Evaluation of a novel 5-group classification system of sepsis by vasopressor use and initial serum lactate in the emergency department. Internal And Emergency Medicine 2017, 13: 257-268. PMID: 28132131, DOI: 10.1007/s11739-017-1607-y.Peer-Reviewed Original ResearchConceptsInitial serum lactate levelSerum lactate levelsEmergency departmentLactate elevationVasoplegic shockLactate levelsCryptic shockVasopressor useInfected patientsShock mortalityHigh-risk ED patientsGroup mortality rateInitial serum lactateVasopressor-dependent patientsIdentifiable risk factorsSepsis-3 definitionRisk-stratify patientsHigh-risk subgroupsInitial lactate levelProximal phaseVasopressor dependenceVasopressor requirementHospital outcomesED patientsSerum lactate
2016
Composition of the Sepsis Definitions Task Force
Wira CR, Swenson KE. Composition of the Sepsis Definitions Task Force. JAMA 2016, 316: 460-460. PMID: 27458964, DOI: 10.1001/jama.2016.6371.Peer-Reviewed Original Research
2015
Goal-Directed Therapy for Sepsis: Has the Beast Been Slain or Do Questions Remain?
Wira CR, Swenson K. Goal-Directed Therapy for Sepsis: Has the Beast Been Slain or Do Questions Remain? Connecticut Medicine 2015, 79: 97-9. PMID: 26244208.Peer-Reviewed Original Research
2014
Early Identification and Management of Patients with Severe Sepsis and Septic Shock in the Emergency Department
Keegan J, Wira CR. Early Identification and Management of Patients with Severe Sepsis and Septic Shock in the Emergency Department. Emergency Medicine Clinics Of North America 2014, 32: 759-776. PMID: 25441033, DOI: 10.1016/j.emc.2014.07.002.Peer-Reviewed Original ResearchThe Shock Index as a Predictor of Vasopressor Use in Emergency Department Patients with Severe Sepsis
Wira CR, Francis MW, Bhat S, Ehrman R, Conner D, Siegel M. The Shock Index as a Predictor of Vasopressor Use in Emergency Department Patients with Severe Sepsis. Western Journal Of Emergency Medicine 2014, 15: 60-66. PMID: 24696751, PMCID: PMC3952891, DOI: 10.5811/westjem.2013.7.18472.Peer-Reviewed Original ResearchConceptsSevere sepsisEmergency departmentVasopressor useCardiovascular collapseOrgan failureElevation groupEscalation of careEmergency department patientsCross-sectional studySepsis registryVasopressor dependenceED admissionDepartment patientsInitial presentationShock indexED patientsRisk stratificationLeading causeUseful modalityPatientsSepsisDisease escalationEarly identificationMean numberHigh rateMeta-analysis of Protocolized Goal-Directed Hemodynamic Optimization for the Management of Severe Sepsis and Septic Shock in the Emergency Department
Wira CR, Dodge K, Sather J, Dziura J. Meta-analysis of Protocolized Goal-Directed Hemodynamic Optimization for the Management of Severe Sepsis and Septic Shock in the Emergency Department. Western Journal Of Emergency Medicine 2014, 15: 51-59. PMID: 24696750, PMCID: PMC3952890, DOI: 10.5811/westjem.2013.7.6828.Peer-Reviewed Original Research
2011
Etomidate use in severe sepsis and septic shock patients does not contribute to mortality
Ehrman R, Wira C, Lomax A, Hayward A, Marcelin J, Ellis T, Przyklenk K, Volturo G, Mullen M. Etomidate use in severe sepsis and septic shock patients does not contribute to mortality. Internal And Emergency Medicine 2011, 6: 253-257. PMID: 21394520, DOI: 10.1007/s11739-011-0553-3.Peer-Reviewed Original ResearchConceptsUse of etomidateSeptic shock patientsSevere sepsisEtomidate useShock patientsSeptic shockEtomidate groupSevere sepsis/septic shock patientsSepsis/septic shock patientsUniversity tertiary care referral centerIntensive care unit lengthRetrospective multi-center studyTertiary care referral centerMechanical ventilation daysAPACHE II scoreUse of corticosteroidsRetrospective chart reviewMulti-center studyHospital mortalityII scorePrimary endpointVentilation daysAdrenal insufficiencyChart reviewPatient demographics
2009
Surviving sepsis in low-income and middle-income countries: new directions for care and research
Becker JU, Theodosis C, Jacob ST, Wira CR, Groce NE. Surviving sepsis in low-income and middle-income countries: new directions for care and research. The Lancet Infectious Diseases 2009, 9: 577-582. PMID: 19695494, DOI: 10.1016/s1473-3099(09)70135-5.Peer-Reviewed Original ResearchConceptsSepsis managementMiddle-income countriesBurden of sepsisPrevalence of HIVAppropriate antibiotic useTreatment of sepsisRecognition of sepsisEvidence-based interventionsSepsis careSystemic inflammationComorbid conditionsTreatment algorithmAntibiotic useTreatment responseSepsisHealth personnelMost LMICsAccurate diagnosisInvasive technologiesLMICsCareLaboratory testingResource-limited environmentsHIVInflammation