Tag: sepsis
Immunotherapy for Sepsis: A Good Idea or Another Dead End?
THE treatment of sepsis remains an intractable problem in critical care. It has been called the “graveyard”1 for pharmaceutical companies in recognition of dozens of negative clinical trials; this reflects multiple distinct... read more
Decatecholaminisation during sepsis
While necessary and life-saving in the early fight or flight reaction to any insult, prolonged adrenergic stress is detrimental and contributes to organ dysfunction. In the largest trial to date, Morelli et al. enrolled septic... read more
The Elevated Troponin: What else besides ACS could cause troponin elevation?
The increased troponin used to be a straight ticket to the cardiology service. Now, the picture isn't so clear. What do you need to consider in the patient with elevated troponin? Cardiac troponins consist of three proteins:... read more
Nine Reasons to Quit Using Normal Saline for Resuscitation
Saline vs. balanced solutions has been a topic of ongoing debate. Two fresh studies will illuminate this: the SMART and SALT-ED trials. This post summarizes current knowledge, beginning with physiology and working our way... read more
Current efforts to fight sepsis aren’t working. We need a bolder approach
Thanks to antibiotics, vaccinations, and public health advances like modern sanitation, it's easy to think that Americans live largely free of the infectious diseases that once took such a toll. That’s partially right:... read more
Immunocompromised Patients with ARDS
Immunosuppression is frequent in patients with acute respiratory distress syndrome (ARDS), and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent... read more
Sepsis Guidelines Spark EM Petition
It took all of one day for emergency physicians to organize opposition after an update to the Surviving Sepsis Campaign Bundle was released online. The day after the new version was released, Scott D. Weingart, MD, the editor-in-chief... read more
Severity of Sepsis-Associated Coagulopathy Predicts Hospital Mortality
atients with sepsis-associated coagulopathy appear to be at heightened risk of death, according to results of a large retrospective cohort study. The risk of death in the study increased with the severity of the sepsis-associated... read more
In vitro comparison of the adsorption of inflammatory mediators by blood purification devices
Septic shock, a leading cause of acute kidney injury, induces release of pro-/anti-inflammatory mediators, leading to increased mortality and poor renal recovery. This is the first in vitro study directly comparing three... read more
The Relationship Between ICU Hypotension and In-hospital Mortality and Morbidity in Septic Patients
Current guidelines recommend maintaining a mean arterial pressure (MAP)≥ 65 mmHg in septic patients. However, the relationship between hypotension and major complications in septic patients remains unclear. We, therefore,... read more
Central venous oxygen desaturation during early sepsis linked to higher mortality
n the ALBIOS trial, persistence of low (... read more
Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score With Excess Hospital Mortality in Adults With Suspected Infection in Low- and Middle-Income Countries
In this retrospective secondary analysis of 9 diverse LMIC cohorts that included 6569 hospitalized adults with suspected infection, a qSOFA score greater than or equal to 2 was significantly associated with increased likelihood... read more
Sepsis patients treated and released from emergency departments do well with outpatient follow-up
National guidelines assume that all patients who're diagnosed with clinical sepsis in an emergency department will be admitted to the hospital for additional care, but new research has found that many more patients are being... read more
Pushing Pressors in the Periphery
The mantra of the Broome Docs site is "bringing great care, out there." And today's topic goes right to the heart of that theme. It is one of my pet topics – so apologies in advance if the rant is too long or detailed.... read more
