Tag: septic shock
Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock
The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine... read more
Serial Procalcitonin Predicts Mortality in Severe Sepsis Patients
Objectives: To prospectively validate that the inability to decrease procalcitonin levels by more than 80% between baseline and day 4 is associated with increased 28-day all-cause mortality in a large sepsis patient population... read more
Fluid resuscitation in human sepsis: Time to rewrite history
Fluid resuscitation continues to be recommended as the first-line resuscitative therapy for all patients with severe sepsis and septic shock. The current acceptance of the therapy is based in part on long history and familiarity... read more
Evaluating the Validity of Sepsis-3 Criteria in the Emergency Department
In this multicenter prospective cohort study involving 879 patients with suspected infection treated at the emergency department, the qSOFA was better at predicting in-hospital mortality with an area under the receiver operating... read more
Venous congestion: are we adding insult to kidney injury in sepsis?
In critical illness, septic shock is a contributing factor in nearly half of all cases of acute kidney injury (AKI). Traditional approaches to prevention of organ dysfunction in early sepsis have focused on prevention of... read more
The impact of emergency department crowding on early interventions and mortality in patients with severe sepsis
Critically ill patients require significant time and care coordination in the emergency department (ED). We hypothesized that ED crowding would delay time to intravenous fluids and antibiotics, decrease utilization of protocolized... read more
Relative Bradycardia in Patients With Septic Shock Requiring
Relative bradycardia in patients with septic shock is associated with lower mortality, even after adjustment for confounding. Our data support expanded investigation into whether inducing relative bradycardia will benefit... read more
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
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
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
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
Hydrocortisone Fails to Prevent Septic Shock
Hydrocortisone failed to reduce the risk of septic shock in severe sepsis patients in recent research, though its authors held out hope that a larger study could show a better result. Current guidelines recommend hydrocortisone... read more
Six myths promoted by the new surviving sepsis guidelines
The Rivers trial and the Surviving Sepsis Campaign popularized sepsis protocols, which saved lives. Massive accomplishment. However, that doesn’t validate the individual components of early goal-directed therapy. Any protocol... read more
Management of Sepsis and Septic Shock
The best approach for hemodynamic therapy for sepsis has become more uncertain as evidence has accumulated. This extends even to the degree to which clinicians should use intravenous fluids as a foundation for resuscitation... read more
Effect of Omega 3 polyunsaturated fatty acids in major burn patients
The inclusion of ω-3 PUFAs in a low fat diet in ICU burned patients was associated with significant clinical benefits compared to a conventional low fat diet, with lower rates of severe sepsis, septic shock and pyloric dysfunction.... read more
Impact of transfusion on patients with sepsis admitted in ICU
Red blood cell transfusion (RBCT) threshold in patients with sepsis remains a matter of controversy. A threshold of 7 g/dL for stabilized patients with sepsis is commonly proposed, although debated. The aim of the study was... read more
Plasma cytokine levels predict response to corticosteroids in septic shock
Plasma concentration of selected cytokines is a potential predictive biomarker to identify septic shock patients that may benefit from treatment with corticosteroids.... read more
Sepsis-3 definitions predict ICU mortality in a low-middle-income country
The medical records of 957 patients were retrieved from a prospectively collected database. Serum lactate improved accuracy for values higher than 4 mmol/L in the no-dysfunction and septic shock groups.... read more
Impact of a high loading dose of amikacin in patients with severe sepsis or septic shock
With a loading dose of 30 mg/kg of amikacin, concentration was potentially suboptimal. The pharmacodynamic target (60 mg/L < C max < 80 mg/L) recommended by French guidelines was reached in 41.8% of patients and was... read more
Hydrocortisone treatment in early sepsis-associated acute respiratory distress syndrome
In sepsis-associated ARDS, hydrocortisone treatment was associated with a significant improvement in pulmonary physiology, but without a significant survival benefit.... read more
