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

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

How to Deal with Severe Acute Pancreatitis in the Critically Ill

How to Deal with Severe Acute Pancreatitis in the Critically Ill

Management of severe acute pancreatitis (SAP) is multimodal with emphasis on monitoring, adequate fluid resuscitation, avoiding prophylactic use of antibiotics, cause-directed procedures or treatment, and organ support. There... read more

Study of the Effects of Epinephrine on Cerebral Oxygenation and Metabolism During Cardiac Arrest and Resuscitation by Hyperspectral Near-Infrared Spectroscopy

Study of the Effects of Epinephrine on Cerebral Oxygenation and Metabolism During Cardiac Arrest and Resuscitation by Hyperspectral Near-Infrared Spectroscopy

Epinephrine administration by bolus resulted in transient improvements in cerebral oxygenation and metabolism, whereas continuous epinephrine infusion did not, compared with placebo. Future studies are needed to evaluate... read more

Measuring Lactate vs. Capillary Refill in Guiding Resuscitation in Shock

Measuring Lactate vs. Capillary Refill in Guiding Resuscitation in Shock

Capillary refill is as least as good as measuring lactate in guiding resuscitation efforts in septic shock. Moreover, using a lactate-driven resuscitation strategy led to use of more pressors and more IV fluid administration... read more

Association of Age With Short-term and Long-term Mortality Among Patients Discharged From ICUs in France

Association of Age With Short-term and Long-term Mortality Among Patients Discharged From ICUs in France

Results of this study suggest that aging was associated with an increased risk of mortality in the 3 years after hospital discharge that included an ICU admission, with a sharp increase in those 80 years and older. However,... read more

Closed Chest Compressions in Traumatic Cardiac Arrest

Closed Chest Compressions in Traumatic Cardiac Arrest

This study demonstrated that fluid resuscitation with whole blood is significantly better than resuscitation with compressions alone or with normal saline. It further showed that there was no difference between whole blood... read more

Fluid Responsiveness in Sepsis

Fluid Responsiveness in Sepsis

Fluid challenge is a common practice in the ICU. It is one of the most important resuscitation manoeuvres of acute circulatory failure management in critically ill patients. Adequate fluid resuscitation is very important... read more

Initial Arterial pH as a Predictor of Neurologic Outcome After Out-of-hospital Cardiac Arrest

Initial Arterial pH as a Predictor of Neurologic Outcome After Out-of-hospital Cardiac Arrest

Lower pH after out-of-hospital cardiac arrest (OHCA) has been associated with worsening neurologic outcome, with ... read more

Is Pre-hospital Coagulation Management in Trauma Feasible?

Is Pre-hospital Coagulation Management in Trauma Feasible?

Coagulation management remains a formidable challenge in severely bleeding trauma patients. A strong rationale suggests starting treatment of trauma-induced coagulopathy in the pre-hospital phase. The burden of trauma is... read more

Characteristics, Management, and In-hospital Mortality Among Patients with Severe Sepsis in ICU in Japan

Characteristics, Management, and In-hospital Mortality Among Patients with Severe Sepsis in ICU in Japan

Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed... read more

Lactate-Guided Resuscitation Only Encourages Over-Resuscitation and Downstream Harms

Lactate-Guided Resuscitation Only Encourages Over-Resuscitation and Downstream Harms

The Centers for Medicare and Medicaid Services and the Surviving Sepsis Campaign both rushed to offer guidance on the appropriate management strategies for patients presenting with septic shock. In both cases, a lactate-guided... read more

Outcomes of Critically Ill Patients Who Received Cardiopulmonary Resuscitation

Outcomes of Critically Ill Patients Who Received Cardiopulmonary Resuscitation

Although overall survival of ICU patients was 15.9%, patients requiring pressors and who experienced a CPA in an ICU were half as likely to survive to discharge and to be discharged home than patients not taking pressors.... read more

The Great Debate Between Balanced and Unbalanced Crystalloids Continues

The Great Debate Between Balanced and Unbalanced Crystalloids Continues

This meta-analysis contributes very little to the current discussion mainly because of the heterogeneity of included studies. The use of fluid type in different pathologies isn't really what we need, but rather tailored use... read more