State-Mandated Protocolized Sepsis Care Associated with Decrease in Sepsis Mortality

State-Mandated Protocolized Sepsis Care Associated with Decrease in Sepsis Mortality

Beginning in 2013, New York State implemented regulations mandating that hospitals implement evidence-based protocols for sepsis management, as well as report data on clinical outcomes to the state government. This study... read more

Moving Vulnerable Patients Around Hospital Can Increase Infections

Moving Vulnerable Patients Around Hospital Can Increase Infections

Researchers at Overlook Medical Center released a report stating that transporting patients increases the risk of hospital-acquired infections. The study focused on ICU patients being treated for strokes, aneurysm ruptures... read more

Speedy sepsis care slows in-hospital mortality

Speedy sepsis care slows in-hospital mortality

Sepsis and septic shock patients treated within 3 hours had lower in-hospital mortality rates than those treated between hours 3 and 12, based on data from nearly 50,000 adult patients. The findings were presented at an international... read more

Effective Sepsis Detection with Peripheral Blood Monocyte Distribution

Effective Sepsis Detection with Peripheral Blood Monocyte Distribution

This study evaluated the diagnostic accuracy of peripheral blood monocyte distribution width alone and in combination with white blood cells (WBCs) count for early sepsis detection in the emergency department. An monocyte... read more

Metabolic sepsis resuscitation: the evidence behind Vitamin C

Metabolic sepsis resuscitation: the evidence behind Vitamin C

Sepsis resuscitation generally focuses on hemodynamics. Rivers of ink have been spilled writing about oxygen delivery and fluid responsiveness. This is clearly important, but it's possible that our focus on easily... read more

Well: Healing Our Beautiful, Broken World from a Hospital in West Africa

Well: Healing Our Beautiful, Broken World from a Hospital in West Africa

Sarah Thebarge, a Yale-trained physician assistant, nearly died of breast cancer at age twenty-seven, but that did not end her deeply felt spiritual calling to medical missions in Africa. Risking her own health, she moved... read more

A hospital-wide intervention replacing ceftriaxone with cefotaxime to reduce rate of HAI in the ICU

A hospital-wide intervention replacing ceftriaxone with cefotaxime to reduce rate of HAI in the ICU

Over the last decades, the incidence of healthcare-associated infections (HAI) caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) involved in poor outcomes has dramatically increased worldwide.... read more

Procalcitonin-Guided Antimicrobial Therapy in Critical Care

Procalcitonin-Guided Antimicrobial Therapy in Critical Care

Procalcitonin guidance for antibiotic cessation improves short-term mortality in ICU patients. Previous meta-analyses showed that procalcitonin-guided antimicrobial management, compared with standard care, resulted in less... read more

Steroids in Septic Shock – Four Misconceptions and One Truth

Steroids in Septic Shock – Four Misconceptions and One Truth

The utility of steroids in sepsis has been debated passionately for decades. There is hope that steroids might improve mortality, but also fear that they could increase infectious complications. Practice varies widely. What... read more

The association between intravenous fluid resuscitation and mortality in older emergency department patients with suspected infection

The association between intravenous fluid resuscitation and mortality in older emergency department patients with suspected infection

Recent studies suggest that hypotension thresholds in current guidelines might be too low for older patients due to arterial stiffening, possibly leading to insufficient fluid resuscitation. We compared intravenous (IV) fluid... read more

Poor Communication Between Physicians and Nurses Linked to Patient Catheter Issues

Poor Communication Between Physicians and Nurses Linked to Patient Catheter Issues

Communication is contextual, and improving physician-nurse communication about appropriate catheter use may require innovations that address the identified contextual barriers. Several barriers to communication between physicians... read more

Sepsis: Personalization vs. Protocolization?

Sepsis: Personalization vs. Protocolization?

The history of intensive care has been littered with too many false dawns. Old management dogma, now derided, have been replaced by new and equally resolute convictions, many of which will, in time, undoubtedly follow a similar... read more

Get Well Soon: History’s Worst Plagues and the Heroes Who Fought Them

Get Well Soon: History’s Worst Plagues and the Heroes Who Fought Them

A witty, irreverent tour of history's worst plagues―from the Antonine Plague, to leprosy, to polio―and a celebration of the heroes who fought them. In 1518, in a small town in Alsace, Frau Troffea began dancing and... read more

Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons

Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons

Variation in the accuracy of claims data for identifying sepsis and organ dysfunction limits their use for comparing hospitals' sepsis rates and outcomes. Using objective clinical data may facilitate more meaningful hospital... read more