Effect of High-dose Ascorbic Acid on Vasopressor’s Requirement in Septic Shock

Effect of High-dose Ascorbic Acid on Vasopressor’s Requirement in Septic Shock

In this study, administration of high-dose ascorbic acid significantly decreased the requirement for vasopressor's dose and duration in surgical critically ill patients with septic shock. Several mechanisms including anti-oxidant,... read more

Unintended Consequences: Fluid Resuscitation Worsens Shock in an Ovine Model of Endotoxemia

Unintended Consequences: Fluid Resuscitation Worsens Shock in an Ovine Model of Endotoxemia

Fluid resuscitation resulted in a paradoxical increase in vasopressor requirement. Additionally, it did not result in improvements in any of the measured microcirculatory- or organ-specific markers measured. The increase... read more

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest

In adults with out-of-hospital cardiac arrest, the use of epinephrine resulted in a significantly higher rate of 30-day survival than the use of placebo, but there was no significant between-group difference in the rate of... read more

The Myth of Vasopressors and Ischemia

The Myth of Vasopressors and Ischemia

Despite the widespread clinical use, and their well-documented life-saving properties, vasopressors are often maligned, accused of causing ischemia to fingers, toes, mesentery, kidneys, and so forth. Not only is the evidence... read more

Genomics and Pharmacogenomics of Sepsis: So Close and Yet So Far

Genomics and Pharmacogenomics of Sepsis: So Close and Yet So Far

Sapru et al. show in this issue of Critical Care that variants of thrombomodulin and the endothelial protein C receptor, but not protein C, are associated with mortality and organ dysfunction (ventilation-free and organ failure-free... read more

Acute Kidney Injury in Sepsis

Acute Kidney Injury in Sepsis

Acute kidney injury (AKI) and sepsis carry consensus definitions. The simultaneous presence of both identifies septic AKI. Septic AKI is the most common AKI syndrome in ICU and accounts for approximately half of all such... read more

The Septic Shock 3.0 Definition and Trials

Ranjit Deshpande, MD, speaks with James A. Russell, MD, about the article, "The Septic Shock 3.0 Definition and Trials: A Vasopressin and Septic Shock Trial Experience," published in the June 2017 issue of Critical Care Medicine.... read more

Vasopressin vs. norepinephrine for vasoplegic shock after cardiac surgery

Vasopressin vs. norepinephrine for vasoplegic shock after cardiac surgery

Patients in the VANISH trial treated with vasopressin had a lower incidence of renal failure requiring hemodialysis. However, this was a secondary endpoint which seemed to contradict the primary endpoint (defined as a milder... read more