Vitamin C for Sepsis Suffers a Setback. Or a Step-Forward. It’s Complicated

The CITRIS-ALI study found no difference in primary outcomes among patients with sepsis treated with vitamin C versus placebo. But there was a difference in a secondary outcome - overall mortality. When it comes to sepsis... read more

Effect of Vitamin C Infusion on Organ Failure in Patients With Sepsis and ARDS

Effect of Vitamin C Infusion on Organ Failure in Patients With Sepsis and ARDS

In this preliminary study of patients with sepsis and Acute Respiratory Distress Syndrome (ARDS), a 96-hour infusion of vitamin C compared with placebo did not significantly improve organ dysfunction scores or alter markers... read more

Candida Bloodstream Infection Under Veno-arterial ECMO Therapy

Candida Bloodstream Infection Under Veno-arterial ECMO Therapy

Cavayas et al. recently described invasive fungal infections in patients under extra-corporeal membrane oxygenation (ECMO) of the Extracorporeal Life Support Organization registry. They found a 1.2% prevalence of Candida... read more

Accuracy of Quick Sequential Organ Failure Assessment Score to Predict Sepsis Mortality

Accuracy of Quick Sequential Organ Failure Assessment Score to Predict Sepsis Mortality

Overall, quick Sequential Organ Failure Assessment score outperforms systemic inflammatory response syndrome in predicting sepsis outcome, but quick Sequential Organ Failure Assessment score has relative strengths/weaknesses... read more

Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Sepsis

Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Sepsis

Among patients with severe manifestations of sepsis, initiation of empirical antimicrobial therapy significantly reduces the sensitivity of blood cultures drawn shortly after treatment initiation. Of 3,164 participants... read more

Refractory Septic Shock: Our Pragmatic Approach

Refractory Septic Shock: Our Pragmatic Approach

Despite timely intervention, there exists a small subgroup of patients with septic shock who develop progressive multi-organ failure. Seemingly refractory to conventional therapy, they exhibit a very high mortality. Such... read more

Neonatal Early-Onset Sepsis Evaluation

Neonatal Early-Onset Sepsis Evaluation

Twelve years ago, we began a National Institutes of Health–funded study of neonatal early-onset sepsis (EOS) whose goal was to develop multivariate predictive models that could be used by clinicians to evaluate a newborn’s... read more

Mechanical Ventilation-induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes

Mechanical Ventilation-induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes

Diaphragm atrophy developing during mechanical ventilation strongly impacts clinical outcomes. Targeting an inspiratory effort level similar to that of healthy subjects at rest might accelerate liberation from ventilation.... read more

The Complex Kinetics of Blood Endocan During the Time Course of Sepsis and ARDS

The Complex Kinetics of Blood Endocan During the Time Course of Sepsis and ARDS

This study highlights the kinetics of endocan in severe sepsis and acute respiratory distress syndrome (ARDS), thus helping to understand the apparently conflicting results observed in the literature. However, the interpretability... read more

Pediatric Critical Care: A Primer for All Clinicians

Pediatric Critical Care: A Primer for All Clinicians

Pediatric critical care is an emotionally and intellectually demanding field of medicine; however, it is at its core the discipline focused on saving and improving the lives of children affected by acute and chronic illnesses,... read more

Parenteral Anticoagulation Not Associated with Reduced Risk of Ischemic Stroke Among Patients with Atrial Fibrillation During Sepsis

Parenteral Anticoagulation Not Associated with Reduced Risk of Ischemic Stroke Among Patients with Atrial Fibrillation During Sepsis

Among patients with Atrial Fibrillation (AF) during sepsis, parenteral anticoagulation was not associated with reduced risk of ischemic stroke and was associated with higher bleeding rates. Of 113,511 patients hospitalized... read more

Beyond Ventilator-induced Diaphragm Dysfunction

Beyond Ventilator-induced Diaphragm Dysfunction

Respiratory muscles are essential to ensure the vital function of breathing. The diaphragm is a unique respiratory muscle, because it contracts throughout the individual's life span without resting, not even during sleep.... read more

Early Norepinephrine Has Potential for Septic Shock

Early Norepinephrine Has Potential for Septic Shock

Standard sepsis algorithms have suggested completing a fluid bolus before starting vasopressors in patients with septic shock, but multiple observational trials have shown an association between early vasopressor use and... read more

Adjunctive Corticosteroid Treatment in Septic Shock

Adjunctive Corticosteroid Treatment in Septic Shock

Interest in the role of the adrenal cortex in the recovery from an infection dates back nearly 100 yr. More than six decades of research on the role of corticosteroid supplementation as an adjunctive treatment for sepsis... read more