Tag: septic shock
ACEP Task Force on Septic Shock Should Replace the Surviving Sepsis Campaign
The critical care community has long been plagued by a series of antiquated, overbearing guidelines created by the Surviving Sepsis Campaign (SSC). The campaign was originally sponsored by Eli Lilly and Edwards Life Sciences,... read more
Prior Exposure to Angiotensin II Receptor Blockers in Patients With Septic Shock to Individualize Mean Arterial Pressure Target?
Our results suggest that patients with septic shock and chronic hypertension treated with angiotensin II receptor blocker may benefit from a high mean arterial pressure target to reduce the risk of acute kidney injury occurrence. We... read more
The Association of Platelet Decrease Following CRRT Initiation and Increased Rates of Secondary Infections
Platelet count drop by greater than 40% following continuous renal replacement therapy (CRRT) initiation is associated with an increased risk of secondary infection, particularly in patients with thrombocytopenia at the time... read more
Adjuvant therapeutic plasma exchange in septic shock
The hallmark of sepsis is a pathological host response to an infection that may lead to organ dysfunction, shock and high mortality. Besides numerous circulating mediators initiating inflammation, vascular barrier breakdown... read more
External Corroboration That Corticosteroids May Be Harmful to Septic Shock Endotype A Patients
This exploratory analysis provides further evidence that corticosteroid exposure may be associated with increased mortality among septic shock endotype A patients. We previously reported gene expression-based endotypes... read more
Early prediction of impending septic shock in children using age-adjusted Sepsis-3 criteria
Sepsis is a syndrome which afflicts both adults and children, with many disease courses and diverse outcomes. Understanding of sepsis pathophysiology has changed over time; the Sepsis-3 criteria define sepsis in adults as... read more
Factors Associated to ICU Mortality in Critically Ill Patients Infected with COVID-19 in Spain
Older COVID-19 patients with higher APACHE II scores on admission, those who developed AKI grades II or III and/or septic shock during ICU stay had an increased risk-of-death. ICU mortality was 31%. A total of 663 patients... read more
VA-ECMO to Rescue Sepsis-induced Cardiogenic Shock
Patients with sepsis-induced cardiomyopathy with cardiogenic shock have a high mortality. This study assessed venoarterial extracorporeal membrane oxygenation (VA-ECMO) support for sepsis-induced cardiogenic shock refractory... read more
Shedding Light on a Hidden Source of Septic Shock with POCUS
Septic shock has a high mortality rate, estimated to be higher than 40% [1], increasing as time passes without appropriate treatment. Hence, correct diagnosis of the cause of sepsis is essential to provide correct antibiotic... read more
Cost Analysis of Adjunctive Hydrocortisone Therapy for Septic Shock
Using adjunctive hydrocortisone therapy yields a significant monetized benefit based on inputs from the Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock and Activated Protein C and Corticosteroids... read more
An Evidence-Based Approach to Pressors in Shock
The evaluation and treatment of patients with cardiovascular shock is a cornerstone of emergency care. Unfortunately, the literature behind the use of vasoactive medications in cardiovascular shock is inconsistent. A Cochrane... read more
Are Phenotypes a Magic Bullet for Sepsis?
There's a constant battle in medicine between practice styles—standardization and customization. Standardization is order sets and doing the same thing for every patient every time because it (hopefully) delivers better... read more
Transpulmonary Thermodilution Detects Rapid and Reversible Increases in Lung Water Induced by PEEP in ARDS
In ARDS patients, changing the positive end-expiratory pressure (PEEP) level induced parallel, small and reversible changes in EVLW. These changes were not due to an artefact of the TPTD technique and were likely due to the... read more
Broad Spectrum Vasopressors
We propose the notion of "broad spectrum vasopressors" wherein patients with septic shock are started on multiple vasopressors with a different mechanism of action simultaneously while the vasopressor sensitivity is assessed.... read more
Critical Care / ICU, Fluids, Electrolytes and Nutrition
Filled with detailed work-ups, treatments, pearls, illustrations, differential diagnosis and references. Everything you ever needed to know about critical care and nutrition issues in an easy to read and navigate format created... read more
Epinephrine Challenge in Sepsis: An Empiric Approach to Catecholamines
The critical care world is obsessed with fluid. Meanwhile, little attention has been given to the concepts of vasopressor responsiveness and vasopressor challenge. This is a missed opportunity, because vasopressor challenges... read more
Effect of Vitamin C and Thiamine on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock
A 2020 randomized trial reported no difference in duration of time alive and free of vasopressor administration at 7 days among intensive care unit (ICU) patients with septic shock assigned to vitamin C, thiamine, and hydrocortisone... read more
Life Following Pediatric Septic Shock
Margaret M. Parker, MD, MCCM, and Jerry J. Zimmerman, MD, PhD, FCCM, talk about the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock. This... read more
Imaging Changes of Severe COVID-19 Pneumonia in Advanced Stage
The imaging changes of acute stage from a case of 75-year-old male patient with severe COVID-19 pneumonia combined acute respiratory distress syndrome (ARDS), septic shock, and multiple organ dysfunction syndrome (MODS) who... read more
Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children
A large cohort of international experts was able to achieve consensus regarding many recommendations for the best care of children with sepsis, acknowledging that most aspects of care had relatively low quality of evidence... read more
WHO Guidelines Regarding Fluid Administration for Coronarvirus Are Dangerously Misguided
Portions of the current WHO guidelines regarding fluid management are dangerously misguided. The first two recommendations suggest limiting fluid administration in patients with ARDS and patients who aren't shocked, to... read more
Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock
In patients with septic shock, treatment with intravenous vitamin C, hydrocortisone, and thiamine, compared with intravenous hydrocortisone alone, did not significantly improve the duration of time alive and free of vasopressor... read more
