Tag: sepsis

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

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

qSOFA Performance Score as Prognostic Tool in Infected Patients Outside the ICU

A positive qSOFA score had high specificity outside the ICU in early detection of in-hospital mortality, acute organ dysfunction, and ICU admission, but low sensitivity may have limitations as a predictive tool for adverse... read more

Ideas for Future Intensive Care

Progress toward determining the true worth of ongoing practices or value of recent innovations can be glacially slow when we insist on following the conventional stepwise scientific pathway. Moreover, a widely accepted but... read more

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

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

Phenotyping: Need to Identify Subgroups of ARDS Patients

The consensus definitions of acute respiratory distress syndrome (ARDS) mainly rely on feasible clinical criteria, which help to group patients together for inclusion in clinical trials and for clinical management. This generates... read more

Vasopressors and Inotropes for Shock Syndromes

Vasopressors and inotropes are cornerstones in the management of shock syndromes. Understanding vasopressors' receptor activity and resultant pharmacological response enables clinicians to select the ideal vasopressor(s)... read more

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

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

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

Practical Management of Invasive Candidiasis in Critically Ill Patients

The heterogeneity of this patient population necessitated the creation of a mixed working group comprising experts in clinical microbiology, infectious diseases and intensive care medicine, all chosen on the basis of their... read more

Sepsis Sub-phenotypes by Temperature Trajectories

In this "Breathe Easy Critical Perspective" podcast, Dr. Dominique Pepper interviews Dr. Siva Bhavani. They discuss sepsis sub-phenotypes by temperature trajectories. Dr. Bhavani is a senior fellow in Pulmonary and Critical... read more

Thiamine Deficiency: Pearls and Pitfalls

Although thiamine would not be isolated until 1911, the clinical syndrome of thiamine deficiency was recognized as far back as 2700 BC, when the term "beriberi", meaning "wasted wasted" was first coined in China. Nearly 5,000... read more

Defining Sepsis on the Wards

The aim of this study is to look at the prevalence (commonness) of sepsis across acute hospitals (hospitals with an emergency department) across Wales using the currently used and new definitions of sepsis. Sepsis is a major... read more

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

Antibiotics for Sepsis

Antibiotics for Sepsis - Does Each Hour Really Count? Or is it Incestuous Amplification? - by Prof Mervyn Singer "Each hour's delay in initiating antibiotics costs lives" is a doctrine that has attained quasi religious status.... read more

Similar Metabolic, Innate Immunity, and Adipokine Profiles in Adult and Pediatric Sepsis vs. SIRS

Sepsis presents with similar profiles in adult and pediatric patients, characterized by enhanced inflammatory hormonal response and by repressed innate immunity, metabolism, and myocardial contractility. These features early... read more

Clinician Perception of a Machine Learning–Based Early Warning System Designed to Predict Severe Sepsis and Septic Shock

In general, clinical perceptions of Early Warning System 2.0 were poor. Nurses and providers differed in their perceptions of sepsis and alert benefits. These findings highlight the challenges of achieving acceptance of predictive... read more

In-hospital Mortality Associated with the Misdiagnosis or Unidentified Site of Infection at Admission

Rapid detection, early resuscitation, and appropriate antibiotic use are crucial for sepsis care. Accurate identification of the site of infection may facilitate a timely provision of appropriate care. We aimed to investigate... read more

Angiotensin II For Septic Shock Treatment

Angiotensin II has been studied for many years and has consistently shown to increase MAP. This medication adds a new mechanism of action to the vasopressor arsenal that is already used for septic shock. Angiotensin II should... read more

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