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

Critical Care / ICU, Fluids, Electrolytes and Nutrition

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

Sepsis

Written by an international group of experts in the field, Sepsis, Third Edition is a valuable resource that provides the most practical information for clinicians and practitioners who treat this complication in the ICU.... read more

Sepsis

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