Cost Analysis of Adjunctive Hydrocortisone Therapy for Septic Shock

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

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?

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

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

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

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

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

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

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

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

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

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

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

Delay in Antibiotic Administration Is Associated With Mortality Among Septic Shock Patients With Staphylococcus Aureus Bacteremia

Delay in Antibiotic Administration Is Associated With Mortality Among Septic Shock Patients With Staphylococcus Aureus Bacteremia

The results of this study further support the importance of prompt appropriate antibiotic administration for patients with septic shock. Physicians should consider acting quickly to administer antibiotics with S. aureus... read more