The Great Lactate Debate

The Great Lactate Debate

Over the last half-decade, there has been a distinct shift in the approach to lactate elevation. The long-held belief that elevated serum lactate requires tissue or cellular hypoxia has fallen away. Indeed, in sepsis, tissues... read more

Sepsis Patients can be Risk Stratified at the Time of Diagnosis

Sepsis Patients can be Risk Stratified at the Time of Diagnosis

Multicenter Meta-Analysis Reveals Sepsis Patients can be Risk Stratified at the Time of Diagnosis Demonstrating Potential to Improve Critical Care Medicine on a Global Scale. For this study, the team identified a large collection... read more

Comparison of European ICU patients in 2012 (ICON) versus 2002 (SOAP)

Comparison of European ICU patients in 2012 (ICON) versus 2002 (SOAP)

Over the 10‑year period between 2002 and 2012, the proportion of patients with sepsis admitted to European ICUs remained relatively stable, but the severity of disease increased. In multilevel analysis, the odds of ICU... read more

Sepsis Reduces Bone Strength Before Morphologic Changes Are Identifiable

Sepsis Reduces Bone Strength Before Morphologic Changes Are Identifiable

In a rodent sepsis model, trabecular bone strength is functionally reduced within 24 hours and is associated with a reduction in collagen and mineral elastic modulus. This is likely to be the result of altered biomechanical... read more

On Diagnosing Sepsis

On Diagnosing Sepsis

Two years ago, a panel appointed by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine, referred to as a consensus conference, proposed a new definition for sepsis and new diagnostic... read more

R.E.B.E.L. EM – Fluid Responsiveness and the Six Guiding Principles of Fluid Resuscitation

R.E.B.E.L. EM – Fluid Responsiveness and the Six Guiding Principles of Fluid Resuscitation

Fluid resuscitation is a crucial aspect of emergency and critical care. Since the advent of the concept of early goal-directed therapy, we have placed a huge emphasis on aggressive fluid resuscitation in patients with severe... read more

Polymyxin B‑immobilised Hemoperfusion and Mortality in Critically Ill Patients with Sepsis/Septic Shock

Polymyxin B‑immobilised Hemoperfusion and Mortality in Critically Ill Patients with Sepsis/Septic Shock

Sepsis and septic shock originate from a dysregulated immune response to pathogens and cause millions of deaths worldwide. Endotoxin, a principal component of the outer membrane of Gram-negative bacteria, is a potent trigger... read more

Sepsis Incidence: A Population-Based Study

Sepsis Incidence: A Population-Based Study

The incidence of sepsis with organ dysfunction is higher than most previous estimates independent of definition. The inclusion of all inpatients started on intravenous antibiotic treatment of sepsis in a population makes... read more

Pharmacokinetics of meropenem in septic patients on sustained low-efficiency dialysis

Pharmacokinetics of meropenem in septic patients on sustained low-efficiency dialysis

The aim of the study was to describe the population pharmacokinetics (PK) of meropenem in critically ill patients receiving sustained low-efficiency dialysis (SLED). We found a relevant PK variability for meropenem in patients... read more

Predictors, Prevalence, and Outcomes of Early Crystalloid Responsiveness Among Initially Hypotensive Patients With Sepsis and Septic Shock

Predictors, Prevalence, and Outcomes of Early Crystalloid Responsiveness Among Initially Hypotensive Patients With Sepsis and Septic Shock

Two in three hypotensive sepsis patients were responsive to initial fluid resuscitation. Heart failure, hypothermia, immunocompromise, hyperlactemia, and coagulopathy were associated with the refractory phenotype. Fluid resuscitation... read more

Prompt Administration of Antibiotics and Fluids in the Treatment of Sepsis

Prompt Administration of Antibiotics and Fluids in the Treatment of Sepsis

We conclude that antibiotic therapy is highly time sensitive, and efforts should be made to deliver this critical therapy as early as possible in sepsis, perhaps extending into the first point of medical contact outside the... read more

AI Can Predict Sepsis to Save Lives

AI Can Predict Sepsis to Save Lives

Emory University researchers have created a "Sepsis Expert" algorithm that works in real time to predict the onset of sepsis, the deadly condition that often takes hold in healthcare settings. Banking on information from... read more

Managing Sepsis and Septic Shock Current Guidelines and Definitions

Managing Sepsis and Septic Shock Current Guidelines and Definitions

While sepsis defies simple definition, it's generally understood to be a clinical syndrome caused by infection that may have profound adverse physiologic consequences. Although its precise incidence is unknown, sepsis is... read more

Differences in Impact of Definitional Elements on Mortality Precludes International Comparisons of Sepsis Epidemiology

Differences in Impact of Definitional Elements on Mortality Precludes International Comparisons of Sepsis Epidemiology

Within a sepsis cohort, we illustrate case-mix heterogeneity using definitional elements (infection source and organ dysfunction). In the context of improving outcomes, we illustrate differential secular trends in impact... read more