CRT-targeted Fluid Resuscitation vs. Lactate-targeted in Septic Shock

Capillary refill time (CRT)-targeted fluid resuscitation in septic shock was not superior to a lactate-targeted one on early fluid administration or fluid balances. However, it was associated with comparable effects on regional... read more

Public Sepsis Awareness Campaigns Should Be Created Based on Local Data

Although public knowledge of sepsis and its mortality is generally low, some countries have high awareness and knowledge, and as such, any public awareness campaigns should be created based on local data. This will also... read more

Practical Issues Updates in Anesthesia and Intensive Care

This book describes the state of the art concerning some of the most hotly debated topics in anesthesia and intensive care and is at the same time intended to serve as a useful practical guide that will assist in improving... read more

Practical Issues Updates in Anesthesia and Intensive Care

Hemodynamic Management Challenges of Septic Shock

Sepsis is one of the main causes of admission to the Intensive Care Unit (ICU). It is defined as a life-threatening organ dysfunction, caused by dysregulated host response to infection (Singer et al. 2016). Septic shock... read more

Sepsis is scurvy? Vitamin C, Thiamine, and Steroids

I have avoided commenting on vitamin C for sepsis, because commentary seemed rather unnecessary. The hype was obviously ridiculous. The chances of it helping were clearly low. The evidence of benefit was negligible. Others... read more

Septic Shock and Vasopressor Initiation: Why Earlier is Better

An overview of vasopressor management, current evidence and when to initiate vasopressor therapy for best possible patient outcome. Vasopressor management is a cornerstone in the haemodynamic management of septic shock... read more

Arterial pH with Hemodynamic Response Association to Vasopressin in Patients with Septic Shock

Compared with higher arterial pH, patients with septic shock and low arterial pH had lower odds of vasopressin response and higher catecholamine doses after vasopressin initiation. Similar to other vasopressors, the clinical... read more

Intravenous Vitamin C Administration to Septic Shock Patients

Our pilot study indicated that intravenous vitamin C did not provide significant decreases in the mean dose or duration of vasopressor infusion. Further research that takes into account the potential impact of intervention... read more

Coupled Plasma Filtration and Adsorption for Septic Shock Treatment

Early deaths are likely related to the ongoing CPFA treatment, for reasons that if identified could allow some deaths to be prevented. We hypothesize a connection to hemodynamic instability consequent on renal replacement... read more

Plasma Hyaluronan, Hyaluronidase Activity and Endogenous Hyaluronidase Inhibition in Sepsis

Elevated plasma hyaluronan levels coincided with a concomitant decrease in effective plasma HYAL activity and increase of endogenous plasma HYAL inhibition both in experimental and clinical sepsis. In acute pancreatitis,... read more

Evaluating Vitamin C in Septic Shock

Vitamin C monotherapy failed to significantly reduce mortality in septic shock patients as hypothesized. Our findings do not support its routine clinical use for this purpose. Of 124 subjects receiving study drug and included... read more

MIF But Not MIF-2 Recruits Inflammatory Macrophages in an Experimental Polymicrobial Sepsis Model

Excessive inflammation drives the progression from sepsis to septic shock. Macrophage migration inhibitory factor (MIF) is of interest because MIF promoter polymorphisms predict mortality in different infections, and anti-MIF... read more

Quantifying the Burden of Viral Sepsis During the COVID-19 Pandemic and Beyond

Coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in millions of deaths worldwide and countless more admissions to hospitals and ICUs. Since... read more

Respiratory Drive in Sepsis and Septic Shock Patients: Modulation by High-flow Nasal Cannula

Patients with sepsis and septic shock of extrapulmonary origin present elevated respiratory drive and effort, which can be effectively reduced by high-flow nasal cannula. 25 nonintubated patients with extrapulmonary sepsis... read more

Descriptors of Sepsis Using the Sepsis-3 Criteria

We successfully operationalized the Sepsis-3 criteria to an electronic health record dataset to describe the characteristics of critical care patients with sepsis. This may facilitate sepsis research using electronic health... read more

Vasopressor Initiation within 1 Hour of Fluid Loading is Associated with Increased Mortality in Septic Shock Patients

Vasopressor initiation within 1 hour of fluid loading was associated with higher 28-day mortality in patients with septic shock. The median time from the initial fluid bolus to vasopressor was shorter in the early group... read more

Outcome After Intubation for Septic Shock with Respiratory Distress and Hemodynamic Compromise

Intubation within 24 h of sepsis was not associated with hospital mortality but resulted in fewer 28-day hospital-free days. Although intubation remains a high-risk procedure, we did not identify an increased risk in mortality... read more

Predict Sepsis-Associated Vasopressor Use in the ICU

Domain adaptation improved performance of a model predicting sepsis-associated vasopressor use during external validation. 40 retrospectively collected features from the electronic medical records of adult ICU patients... read more

Burden of Post-Sepsis Morbidity Higher Than Previously Thought

A recent cohort study published in JAMA based on data from 116,507 survivors of hospital-treated sepsis in Germany sheds light on the heavy burden of long-term effects of sepsis, the most severe complication of infections. The... read more

Effect of Adjunctive Vitamin C, Glucocorticoids, and Vitamin B1 on Sepsis

We aimed to compare the effects of vitamin C, glucocorticoids, vitamin B1, combinations of these drugs, and placebo or usual care on longer-term mortality in adults with sepsis or septic shock. MEDLINE, Embase, CENTRAL, ClinicalTrials.gov... read more

Can Early Cytokine Profile Discriminate Between GPB and GNB?

Sepsis is a principal cause of death in critical care units worldwide and consumes considerable healthcare resources. The aim of our study was to determine whether the early cytokine profile can discriminate between Gram-positive... read more

Difference in Sepsis Patients Outcomes Between First and Second-Hit Infections

Our study identifies a fundamental difference in patient outcomes between first-hit and second-hit bacterial infections, which may be due to genetic, microbiological, immunological, and environmental factors. This finding... read more