Tag: sepsis
Patient-important outcomes in randomized controlled trials in critically ill patients
Patient-important outcomes are rarely primary outcomes in RCTs in critically ill patients published in 2013. Among them, mortality accounted for the majority. We promote the use of patient-important outcomes in critical care... read more
The Artificial Intelligence Clinician Learns Optimal Treatment Strategies for Sepsis in Intensive Care
Sepsis is the third leading cause of death worldwide and the main cause of mortality in hospitals but the best treatment strategy remains uncertain. In particular, evidence suggests that current practices in the administration... read more
Mimics of Sepsis: What do ED Physicians Need to Know?
SIRS and sepsis are common clinical entities. A wide range of estimates for prevalence exists, with 300 to 1000 cases per 100,000 persons per year. Once a septic patient is admitted, more than half will require at least step... read more
Infectious Diseases in the Pediatric ICU
Infants and children are at high risk of acquiring infections and this is most critical on the pediatric intensive care unit, as these infections have serious effects on mortality. Infectious Diseases in the Pediatric Intensive... read more
Metabolic Sepsis Resuscitation
There are roughly two strategies for adjusting the intensity of treatment: Titrated strategy: Treatment intensity is adjusted to match the severity of the disease. Escalation-deescalation strategy: Treatment intensity is... read more
Host Genetic Variants in Sepsis Risk
Published data revealed that host genetic variants have a substantial influence on sepsis susceptibility. However, the results have been inconsistent. We aimed to systematically review the published studies and quantitatively... read more
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
Antibiotics for the Critically Ill Patient
We spend a lot of time obsessing over the finer details of critical care: which fluid is best? which vasopressor is best? will another liter of fluid help? These details are important, but for a septic patient something... read more
Sepsis Incidence and Mortality are Underestimated in Australian ICU Administrative Data
When compared with the reference standard — prospective clinical diagnosis — ANZICS CORE database criteria significantly underestimate the incidence of sepsis and overestimate the incidence of septic shock, and also result... read more
Overuse of troponin? A comprehensive evaluation of testing in a large hospital system
Troponin assays are integral to the diagnosis of acute myocardial infarction (AMI), but there is concern that testing is over utilized and may not conform to published guidelines. We reviewed all testing performed at 14 hospitals... read more
Effect of Thiamine Administration on Lactate Clearance and Mortality in Patients With Septic Shock
Thiamine administration within 24 hours of admission in patients presenting with septic shock was associated with improved lactate clearance and a reduction in 28-day mortality compared with matched controls. Patients who... read more
Early Lactate Measurements Appear to Improve Results for Septic Patients
The study by Churpek and colleagues was designed to evaluate both the frequency of urgent lactate measurements and their association with clinician interventions and mortality. An elevated lactate level means that a patient's... read more
Machine Learning Can Reduce Tests, Improve Treatments for ICU Patients
Researchers from Princeton University are using machine learning to design a system that could reduce the frequency of tests and improve the timing of critical treatments for ICU patients. To create the system, the researchers... read more
Insulin-Treated Diabetes Reduces Dysglycemia-Related Mortality in Sepsis
Patients with sepsis and a pre-existing diagnosis of insulin-treated diabetes (ITD) may show a different relationship between hospital mortality and highest glucose levels and glycemic variability in the first 24 hours than... read more
Norepinephrine in Septic Shock
Norepinephrine (NE) is both an alpha1- and beta1-agonist, and is therefore able to increase vascular tone and contractility. Recent guidelines recommend NE as the first-line vasopressor in septic shock. However, because septic... read more
Terlipressin vs. Norepinephrine As Infusion in Patients With Septic Shock
In this multicentre, randomised, double‑blinded trial, we observed no difference in mortality between terlipressin and NE infusion in patients with septic shock. Patients in the terlipressin group had a higher number of... read more
Principles of Fluid Management and Stewardship in Septic Shock
There are only four major indications for fluid administration in the critically ill: resuscitation, maintenance, replacement and nutrition (enteral or parenteral). In this review, a conceptual framework is presented looking... read more
Effect of Levocarnitine vs Placebo as an Adjunctive Treatment for Septic Shock
In this dose-finding, phase 2 adaptive randomized trial, patients with septic shock and moderate organ dysfunction were treated early in the course of illness with low (6 g), medium (12 g), or high (18 g) doses of levocarnitine... read more
