Tag: septic 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?
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
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
Defining Benefit Threshold for ECMO in Children with Sepsis
This binational study demonstrates that a rapidly available sepsis mortality prediction model can define thresholds for survival benefit in children with septic shock considered for ECMO. Survival on ECMO was associated... read more
Intermittent Hemodialysis for Managing Metabolic Acidosis During Resuscitation of Septic Shock
Favorable changes in physiologic and biochemical variables and norepinephrine dependency were observed after IHD in patients with septic shock complicated by metabolic acidosis during resuscitation. Further studies are needed... read more
A 10-Year Longitudinal Analysis of Protocol-Based Sepsis Management
This 10-year single-center retrospective cohort showed that the use of PB management of severe sepsis and septic shock was associated with a decreased hospital mortality for patients. This mortality benefit was preserved... read more
Epidemiology of Pediatric Severe Sepsis in Main PICU Centers in Southwest China
This multicenter study demonstrates that pediatric severe sepsis is common and is a factor in the high mortality rate that is observed in PICUs in Southwest China. The mortality rate remains high; therefore, improved... read more
Practical Trends in Anesthesia and Intensive Care 2018
This book offers an essential guide to managing the most-debated hot topics of practical interest in anesthesia and intensive care. It reviews the state of the art in issues concerning both intensive care medicine and anesthesia,... read more
Association Between Intravenous Contrast Media Exposure and Non-recovery From Dialysis-requiring Septic AKI
This large observational study did not support an association between intravenous contrast media and adverse in-hospital outcomes in patients with septic dialysis-requiring acute kidney injury (AKI-D). Further studies are... read more
Epidemiology and Costs of Sepsis in the United States
The highest burden of incidence and total costs occurred in the lowest severity sepsis cohort population. Sepsis cases not diagnosed until after admission, and those with increasing severity had a higher economic burden and... read more
Infusion of Prostacyclin vs Placebo for 72-hours in Patients With Septic Shock Suffering From Organ Failure
The purpose of this trial is to investigate the efficacy and safety of continuous intravenous administration of low dose iloprost versus placebo for 72-hours, in up to a total of 380 patients with septic shock suffering from... read more
