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

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

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

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

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

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

Effects of Polymyxin B Hemoperfusion on Mortality in Patients With Severe Sepsis and Septic Shock

Several studies have reported a survival benefit for polymyxin B hemoperfusion treatment in patients with severe sepsis and septic shock. However, recently, a propensity-matched analysis and a randomized controlled trial... read more

Clinical Experience With IV Angiotensin II Administration

Angiotensin II is an endogenous hormone with vasopressor and endocrine activities. This is a systematic review of the safety of IV angiotensin II. Adverse events associated with angiotensin II were infrequent; however, exacerbation... read more

Optimal Timing of RRT in Patients with AKI in the Context of Sepsis

Among 620 patients enrolled in AKIKI, 494 (80%) had sepsis and 413 (67%) septic shock. This can help to suggest recommendations in septic patients with AKI. AKIKI showed no significant difference in mortality between early... read more

Detecting impaired myocardial relaxation in sepsis with a novel tissue Doppler parameter

Left ventricular diastolic dysfunction is associated with mortality outcomes in severe sepsis and septic shock. There are ongoing issues with diagnosing diastolic dysfunction in this cohort, partly owing to the poor applicability... read more

Resuscitating Sepsis – How I do it after Albios

Watch "Resuscitating Sepsis - How I do it after Albios" by Luciano Gattinoni.... read more

Evaluating Transfusion Strategies

Cancer patients are at increased risk of septic shock. Therefore, Bergamin et al set out to assess whether a restrictive strategy of red blood cell (RBC) transfusion reduces 28-day mortality when compared with a liberal strategy... read more

COPD can increase risk of developing sepsis

People with COPD have a higher than average risk of developing lung infections, such as pneumonia, which then puts them at higher risk for developing sepsis. Sepsis and septic shock can result from an infection anywhere in... read more

Sepsis E-alert System with Response Team Improves Outcomes

According to a new study, the use of a multifaceted intervention including an electronic sepsis alert (e-alert) system with sepsis response team was associated with improvement in care processes of sepsis and septic shock... read more

Potential survival benefit of polymyxin B hemoperfusion in patients with septic shock

The purpose of this study was to investigate whether polymyxin B hemoperfusion (PMX-HP) improves the survival of patients with septic shock. Our results strongly suggest that PMX-HP reduces all-cause hospital mortality and... read more

Management of Septic Shock

The results of the PRISM trials confirm that early intervention strategies, including early detection of sepsis, risk stratification, early administration of antibiotics, and appropriate fluid resuscitation, improve the outcomes... read more

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