Antifungal Treatment in the ICU

Antifungal Treatment in the ICU

Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in critically ill patients. Almost 80% of IFIs are due to Candida spp., which are the third most common isolated microorganisms in the intensive... read more

Mimics of Sepsis: What do ED Physicians Need to Know?

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

Metabolic Sepsis Resuscitation

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

Antibiotics for the Critically Ill Patient

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

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

Effect of Thiamine Administration on Lactate Clearance and Mortality in Patients With Septic Shock

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

Norepinephrine in Septic Shock

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

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

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

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

Long-term outcomes in patients with septic shock transfused at a lower versus a higher haemoglobin threshold

Long-term outcomes in patients with septic shock transfused at a lower versus a higher haemoglobin threshold

Long-term mortality rates and HRQoL did not differ in patients with septic shock and anaemia who were transfused at a haemoglobin threshold of 7 g/dl versus a threshold of 9 g/dl. We may reject a more than 3 % increased hazard... read more

Septic Shock: Innovative Treatment Options in the Wings

Septic Shock: Innovative Treatment Options in the Wings

Vitamin C, angiotensin-II, and methylene blue are emerging options on the cutting edge of refractory septic shock treatment that require more investigation, but nevertheless appear promising, Rishi Rattan, MD, said at the... read more

The impact of age on the innate immune response and outcomes after severe sepsis/septic shock in trauma and surgical ICU patients

The impact of age on the innate immune response and outcomes after severe sepsis/septic shock in trauma and surgical ICU patients

Aged, critically ill surgical patients have greater organ dysfunction and incidence of adverse clinical outcomes after sepsis. Biomarker profiles suggest an immunophenotype of persistent immunosuppression and catabolism.... read more

Patterns of Early Crystalloid Resuscitation Provided to Sepsis and Septic Shock Patients

Patterns of Early Crystalloid Resuscitation Provided to Sepsis and Septic Shock Patients

Patterns and Outcomes Associated With Timeliness of Initial Crystalloid Resuscitation in a Prospective Sepsis and Septic Shock Cohort. Crystalloid was initiated significantly later with comorbid heart failure and renal failure,... read more