Antibiotics, Immunosuppressive Drugs and the Downfall of the Human Immune System

Antibiotics, Immunosuppressive Drugs and the Downfall of the Human Immune System

Today I'll discuss two more factors that can debilitate the human immune system (allowing the microbiome to better cause disease). They are antibiotics (when used too frequently) and immunosuppressive drugs: two of the most... read more

Mechanical Ventilation Enhances Extrapulmonary Sepsis-induced Lung Injury

Mechanical Ventilation Enhances Extrapulmonary Sepsis-induced Lung Injury

These data show for the first time that otherwise noninjurious mechanical ventilation can exacerbate acute lung injury (ALI) due to extrapulmonary sepsis underscoring a potential interactive contribution of common events... read more

A Positive Fluid Balance is an Independent Prognostic Factor in Patients with Sepsis

A Positive Fluid Balance is an Independent Prognostic Factor in Patients with Sepsis

Intravenous fluid administration is an essential component of sepsis management, but a positive fluid balance has been associated with worse prognosis. We analyzed whether a positive fluid balance and its persistence over... read more

Why Most Diagnostic Procedures Aren’t Beneficial

Why Most Diagnostic Procedures Aren’t Beneficial

We often assume that diagnostic procedures will help patients. A lot of training goes into learning how to do these procedures. Procedures are dramatic. We like performing them. Patients are impressed, perceiving that we... read more

Mortality and Cardiovascular and Respiratory Morbidity in Individuals with Impaired FEV1 (PURE)

Mortality and Cardiovascular and Respiratory Morbidity in Individuals with Impaired FEV1 (PURE)

The associations between the extent of forced expiratory volume in 1 s (FEV1) impairment and mortality, incident cardiovascular disease, and respiratory hospitalisations are unclear, and how these associations might vary... read more

CRRT for Sepsis-induced Acute Kidney Injury

CRRT for Sepsis-induced Acute Kidney Injury

Sepsis-induced acute kidney injury (SI-AKI) represents the first cause of AKI in ICUs, and renal replacement therapy (RRT) is frequently applied in advanced AKI stages. The debate between 'rescue' indications for RRT start... read more

Neutrophil Extracellular Traps (NETs) Exacerbate Severity of Infant Sepsis

Neutrophil Extracellular Traps (NETs) Exacerbate Severity of Infant Sepsis

Neutrophil extracellular traps (NETs) are innate defense mechanisms that are also implicated in the pathogenesis of organ dysfunction. However, the role of NETs in pediatric sepsis is unknown. This study reveals a hitherto... read more

Expanding the Differential for Hypotension in the Pediatric Patient

Expanding the Differential for Hypotension in the Pediatric Patient

As many ED practitioners are aware, food allergies are common in the first 2 years of life, with a prevalence cited between 1-10% of the population. Most food allergies are IgE-mediated hypersensitivity reactions. Food protein-induced... read more

A Rare Group of White Blood Cells May Be the Secret to Prevent Sepsis

A Rare Group of White Blood Cells May Be the Secret to Prevent Sepsis

Basophils are evolutionarily conserved in vertebrates, despite their small numbers and short life span, suggesting that they have beneficial roles in maintaining health. However, these roles are not fully defined. Here we... read more

Vitamin C: Should We Supplement?

A short course of intravenous vitamin C in pharmacological dose seems a promising, well tolerated, and cheap adjuvant therapy to modulate the overwhelming oxidative stress in severe sepsis, trauma, and reperfusion after ischemia.... read more

Septic Shock: Innovative Treatment Options in the Wings

Septic Shock: Innovative Treatment Options in the Wings

Vitamin C, angiotensin-II, and methylene blue are emerging options on the cutting edge of refractory septic shock treatment that require more investigation, but nevertheless appear promising, Rishi Rattan, MD, said at the... read more

Angiotensin converting enzyme defects in shock: implications for future therapy

Angiotensin converting enzyme defects in shock: implications for future therapy

Patients who develop vasodilatory shock, particularly when caused by an inflammatory condition like sepsis or pancreatitis, have evidence of significant endothelial injury as manifested by coagulation disorders and increased... read more

Effect of Human Recombinant Alkaline Phosphatase on 7-Day Creatinine Clearance in Patients With Sepsis-Associated AKI

Effect of Human Recombinant Alkaline Phosphatase on 7-Day Creatinine Clearance in Patients With Sepsis-Associated AKI

In this randomized, double-blind, placebo-controlled, dose-finding adaptive phase 2a/2b trial enrolling 301 adults, the optimal therapeutic dose of recombinant alkaline phosphatase was 1.6 mg/kg. Treatment with this dose... read more

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD

Among adults with COPD at high risk of exacerbation treated with inhaled corticosteroids, the addition of low-dose theophylline, compared with placebo, did not reduce the number COPD exacerbations over a 1-year period. The... read more