Early, Goal-Directed Therapy for Septic Shock

After a single-center trial and observational studies suggesting that early, goal-directed therapy (EGDT) reduced mortality from septic shock, three multicenter trials (ProCESS, ARISE, and ProMISe) showed no benefit. This... read more

Surviving Sepsis Campaign Guidelines: 2016 Update

Ludwig Lin, MD, speaks with Mitchell M. Levy, MD, MCCM, about the release of the "Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016," presented at the 46th Critical Care Congress... read more

Vitamin C and the Ethics of Borrowing data

I was recently amazed to be engaged in a Twitter kerfuffle which generated more than 10,000 Impressions within 24 hours. Passions were running high, libellous comments were being broadcast, and old friendships seemed to be... read more

Predicting and measuring fluid responsiveness with echocardiography

Echocardiography is an essential tool to predict and measure fluid responsiveness, according to a recent article, which provides a practical guide. Ashley Miller and Justin Mandeville outline the physiological basis of fluid... read more

Doctor Turns Up Possible Treatment For Deadly Sepsis

It is hard not to get excited about news of a potentially effective treatment for sepsis, a condition that leads to multiple organ failure and kills more people in the hospital than any other disease. The study, from Eastern... read more

What’s new in the extracorporeal treatment of sepsis?

Clinical research has shown that endotoxin is indeed circulating in the blood of up to 50% of sepsis shock patients and associated with impaired clinical outcome. In view of the pivotal role of endotoxin in sepsis patients,... read more

The ICM research agenda on ICU-acquired weakness

Intensive care unit (ICU)-acquired weakness (ICUAW) develops as a complication of critical illness and may represent the extreme end of a spectrum of weakness that begins with any serious illness regardless of care location.... read more

Preadmission Oral Corticosteroids Are Associated With Reduced Risk of ARDS in Critically Ill Adults With Sepsis

The unadjusted occurrence rate of acute respiratory distress syndrome within 96 hours of ICU admission was 35% among patients who had received oral corticosteroids compared with 42% among those who had not (p = 0.107). In... read more

Vasopressors: Future Research

Margaret Parker, MD, MCCM, speaks with Lakhmir S. Chawla, MD, about future research related to the Congress session "Bench-Pressing in the ICU: Which Vasopressor Agent Should I Choose for My Patient?" which he presented... read more

Presentations of adult septic patients in the prehospital setting as recorded by emergency medical services

The most common keywords related to septic patients’ symptom presentation were: abnormal/ suspected abnormal temperature (64.1.%), pain (38.4%), acute altered mental status (38.2%), weakness of the legs (35.1%), breathing... read more

The biggest killer you may not know

It kills more than bowel, breast and prostate cancer combined. A report in 2015 said four in 10 patients being admitted to accident and emergency units were not being reviewed quickly enough and uncovered delays in giving... read more

Why the New Sepsis Guideline Changed

Recent guidelines for how to best manage septic shock have changed. Gone are recommendations for central venous oxygen saturation monitoring and goal-directed therapy. In is the concept that septic shock be treated as an... read more

Decreased cytokine production by mononuclear cells after severe gram-negative infections

Failure of circulating monocytes for adequate cytokine production is a trait of sepsis-induced immunosuppression; however, its duration and association with final outcome are poorly understood. Defective TNF-α production... read more

Multifaceted educational intervention shortened time to antibiotic administration in children with sepsis

A multifaceted educational intervention shortened time to antibiotic administration in children with severe sepsis and septic shock: ABISS Edusepsis pediatric study. The Surviving Sepsis Campaign (SSC) recommends the administration... read more

In Hospital ICUs, AI Could Predict Which Patients Are Likely to Die

With streams of data coming from equipment that monitors patients’ vital signs, the ICU seems the perfect setting to deploy artificially intelligent tools that could judge when a patient is likely to take a turn for the... read more

Updated Guidelines for Sepsis Management

In 2017 the Society for Critical Care Medicine updated its guidelines for sepsis management. These new guidelines differ significantly from ones in the past in that they no longer recommend protocolized resuscitation and... read more

Hemolytic Uremic Syndrome (HUS): Pearls and Pitfalls

A three-year-old male presents with mom for seven days of fever, diarrhea, and decreased activity. When you walk into the room, you note a listless-appearing boy with pallor. His eyes appear sunken. He is tachycardic, tachypneic,... read more

Wide variations found in evaluation of newborns for sepsis

The evaluation of well-appearing term infants for early-onset sepsis (EOS) varies considerably among hospitals, with some doing extensive work-ups and giving antibiotics while others simply observe and provide newborn routine... read more

MR-proADM Accuracy Superior for Sepsis Mortality Prediction

The use of novel sepsis biomarkers has increased in recent years. However, their prognostic value with respect to illness severity has not been explored. In this work, we examined the ability of mid-regional proadrenomedullin... read more

Sepsis Readmissions Compared With Other Medical Conditions

This study uses data from a US readmissions database to assess whether sepsis hospitalizations account for a higher proportion of unplanned 30-day readmissions than hospitalizations for acute myocardial infarction, heart... read more

Ureteral stents, sepsis and acute kidney injury: Iatrogenic imperfecta!

Case presentation A 62-year-old woman with a past history of placement of bilateral ureteral "JJ" stents, presented to the hospital complaining of fever, chills, abdominal pain, oliguria and was found to be hypotensive.... read more

How survival of cancer patients in critical care has improved in the last 3 decades

Comprehensive care for critically ill patients with cancer is a collaborative effort, and close cooperation between oncology as well as palliative and critical care is essential. Collaborative decision making is a cornerstone... read more