Adjunctive Glucocorticoid Therapy in Patients with Septic Shock

Among patients with septic shock undergoing mechanical ventilation, a continuous infusion of hydrocortisone did not result in lower 90-day mortality than placebo. We randomly assigned patients with septic shock who were undergoing... read more

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock

Should We Manage All Septic Patients Based on a Single Definition?

It is indisputable from the biological and clinical perspectives that not all cases of sepsis are the same. On the contrary, most have great many differences, that is, different portals of entry, clinical manifestations,... read more

Should We Manage All Septic Patients Based on a Single Definition?

Hypothermia in Sepsis – The CASS Trial

Sepsis and especially septic shock (no matter what definition you use) is a recipe for multi-organ dysfunction and poor prognosis. In the past few years, we saw a lot of failed attempts trying to find something that could... read more

Hypothermia in Sepsis – The CASS Trial

I survived sepsis eight times. But can care workers spot this deadly illness?

Care staff are increasingly likely to see sepsis, but there is no standard training to make them aware of the symptoms to look out for in clients. There is a golden hour for the treatment of sepsis, when someone can be saved... read more

I survived sepsis eight times. But can care workers spot this deadly illness?

Sepsis Early Warning Score Adopted in UK

Every NHS hospital trust in England will be asked to adopt a new clinical system for assessing acutely ill patients. The National Early Warning Score (NEWS), developed by the Royal College of Physicians (RCP) in 2012, has... read more

Sepsis Early Warning Score Adopted in UK

Initial Crystalloid Resuscitation in Sepsis and Septic Shock

Ludwig Lin, MD, speaks with Daniel E. Leisman, BS, about the article, "Patterns and Outcomes Associated With Timeliness of Initial Crystalloid Resuscitation in a Prospective Sepsis and Septic Shock Cohort," published in Critical... read more

Delay Within the 3-Hour Surviving Sepsis Campaign Guideline on Mortality for Patients With Severe Sepsis and Septic Shock

The guideline recommendations showed that shorter delays indicates better outcomes. There was no evidence that 3 hours is safe; even very short delays adversely impact outcomes. Findings demonstrated a new approach to incorporate... read more

Delay Within the 3-Hour Surviving Sepsis Campaign Guideline on Mortality for Patients With Severe Sepsis and Septic Shock

FDA Approves Angiotensin-II for Septic Shock

The FDA approved angiotensin-II (Giapreza) as a new intravenous vasopressor for septic shock and other forms of distributive shock. The first new FDA-approved vasopressor in decades, angiotensin-II could significantly change... read more

FDA Approves Angiotensin-II for Septic Shock

Hypovitaminosis C and vitamin C deficiency in critically ill patients despite recommended enteral and parenteral intakes

Critically ill patients have low vitamin C concentrations despite receiving standard ICU nutrition. Septic shock patients have significantly depleted vitamin C levels compared with non-septic patients, likely resulting from... read more

Hypovitaminosis C and vitamin C deficiency in critically ill patients despite recommended enteral and parenteral intakes

The Septic Shock 3.0 Definition and Trials

Ranjit Deshpande, MD, speaks with James A. Russell, MD, about the article, "The Septic Shock 3.0 Definition and Trials: A Vasopressin and Septic Shock Trial Experience," published in the June 2017 issue of Critical Care Medicine.... read more

The Timing of Early Antibiotics and Hospital Mortality in Sepsis

Prior sepsis studies evaluating antibiotic timing have shown mixed results. Objective: To evaluate the association between antibiotic timing and mortality among sepsis patients receiving antibiotics within 6 hours of emergency... read more

The Timing of Early Antibiotics and Hospital Mortality in Sepsis

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

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

Platelets and Multi-Organ Failure in Sepsis

Platelets have received increasing attention for their role in the pathophysiology of infectious disease, inflammation, and immunity. In sepsis, a low platelet count is a well-known biomarker for disease severity and more... read more

Platelets and Multi-Organ Failure in Sepsis

A Better Way to Detect Sepsis in Kids in the ED

We have been interested in this question for a long time here at CHOP and have done several interventions over the past several years to try to improve our ability to recognize children with septic shock. When we started... read more

A Better Way to Detect Sepsis in Kids in the ED

Cellular Immunotherapy for Septic Shock

The infusion of freshly cultured allogenic bone marrow derived MSCs into participants with septic shock up to a dose of 3 million cells per kg (250 million cells) appears safe. Ages of participants in the interventional versus... read more

Cellular Immunotherapy for Septic Shock

Sepsis National Hospital Inpatient Quality Measure

The Center for Medicare and Medicaid Services adopted the Early Management Bundle, Severe Sepsis/Septic Shock (SEP-1) performance measure to the Hospital Inpatient Quality Reporting Program in July 2015 to help address the... read more

Sepsis National Hospital Inpatient Quality Measure

Septic shock with no diagnosis at 24 hours: a pragmatic multicenter prospective cohort study

The lack of a patent source of infection after 24 hours of management of shock considered septic is a common and disturbing scenario. A multicenter observational cohort study in ten intensive care units (ICU) in France.... read more

Septic shock with no diagnosis at 24 hours: a pragmatic multicenter prospective cohort study

Restricting volumes of resuscitation fluid in adults with septic shock after initial management

A protocol restricting resuscitation fluid successfully reduced volumes of resuscitation fluid compared with a standard care protocol in adult ICU patients with septic shock.... read more

Restricting volumes of resuscitation fluid in adults with septic shock after initial management

Noninvasive Ventilation in Patients With Hematologic Malignancy

Two-thirds of patients with Hematologic Malignancy and respiratory failure failed Noninvasive Ventilation (NIV) and required endotracheal intubation, and had high subsequent mortality. Patients who failed NIV had higher Paco2,... read more

Noninvasive Ventilation in Patients With Hematologic Malignancy

The Lactate Dilemma

After a long and exhausting discussion with an inferior human being, a cardiologist, which happens to be an old friend, I decided to write some thoughts about lactate. So, I'll do like I do in my lectures, which is state... read more

The Lactate Dilemma

Selepressin – An Effective Substitute for Norepinephrine

Selepressin, a novel selective vasopressin V1A agonist, is an effective substitute for norepinephrine in a phase IIa randomized, placebo-controlled trial in septic shock patients. Vasopressin is widely used for vasopressor... read more

Selepressin – An Effective Substitute for Norepinephrine

Muscle Oxygenation as Indicator of Shock Severity

The aim of this pilot study was to evaluate the potential of a new noninvasive optical measurement of muscle oxygenation (MOx) to identify shock severity in patients with suspected sepsis. We demonstrate that noninvasive... read more

Muscle Oxygenation as Indicator of Shock Severity