Septic Shock in the Prehospital Setting

Septic shock (SS) is a potential life-threatening condition in which an early identification and immediate therapy stand out as the main cornerstones to improve survival chance; in this context, emergency medical services... read more

Protocolized Fluid Balance Neutralization During CRRT

Bitker et al. report the GO NEUTRAL randomized clinical trial results, which investigated fluid balance neutralization guided by functional hemodynamic monitoring (FHM) protocol versus a standard of care in critically ill... read more

Guide to the Most Common Internal Medicine Workups and Diseases: An evidenced based guide for all healthcare providers regarding common hospital based workups and diseases seen in Internal Medicine

Guide to the Most Common Internal Medicine Workups and Diseases: An evidenced based guide for all healthcare providers regarding common hospital based workups and diseases seen in Internal Medicine

This guide was created to simplify, yet cover in detail, the most COMMON workups and diseases seen in the field of Internal Medicine. It is perfect for any 3rd or 4th year medical student, intern or resident, physician assistant,... read more

Adjusting risk of AKI for Time on Controlled Mechanical Ventilation in ARDS

The authors expressed concerns that the study did not account for certain key covariates, such as septic shock, right heart failure, or hypoxemia, which are believed to influence the development of AKI. We would like... read more

UFNET Fluid Removal Strategy Secured by Hemodynamic Monitoring vs. Standard of Care in patients with CRRT

An early and active UFNET strategy secured by an advanced hemodynamic protocol using dynamic indices of preload dependence had the capacity to control H72 FB in an ICU population of patients with acute circulatory failure,... read more

Sex Differences in the Outcome of Critically Ill COVID-19 Patients

Among patients admitted to ICU for severe COVID-19, males experienced higher severity of illness and more frequent intervention than females. Ultimately, the hazard of death was moderately elevated in males compared to females... read more

Feeding Challenges in the ICU

For critically ill patients, timely nutritional support can aid recovery and reduce mortality risk. But what about a patient in septic shock who is receiving vasopressor therapy, or one who requires prone positioning or extracorporeal... read more

Non-invasive vs. Arterial Pressure Monitoring in the Pre-hospital Critical Care Environment

Non-invasive blood pressure measurements are often inaccurate within the pre-hospital critical care setting, particularly in patients with hemodynamic instability which are the group in which the accuracy of vital signs is... read more

Complex Infusion Volumes Interaction and Confounding Factors with Lactate Clearance in Septic Shock

A recent article by Ahlstedt et al. published in Intensive Care Medicine examining the impact of restrictive fluid management on lactate clearance in septic shock patients within the intensive care unit (ICU) piqued our interest.... read more

Vasoconstriction in Septic Shock

Septic shock is associated with endothelial dysfunction leading to arterial and venous dilation, alterations in regional blood flow distribution, and microcirculatory disturbances. Fluids and vasopressors are the key... read more

Cardiac Arrest Following Prone Positioning

The complications that can arise from the prone position are often underestimated. Proceduralists, surgeons, and anesthesiologists need to be thoroughly knowledgeable about the common physiological changes that can occur... read more

Hydrocortisone, Ascorbic Acid, and Thiamine Combination Therapy Efficacy for the Management of Sepsis and Septic Shock

In this systematic review, we found that hydrocortisone, ascorbic acid, and thiamine (HAT) regimen may be useful for reducing the duration of vasopressor use and improve organ functions in patients with sepsis and septic... read more

Prior Exposure to ACEi Increased Cardiovascular Response to Angiotensin-II

Prior Exposure to ACEi Increased Cardiovascular Response to Angiotensin-II

Prior exposure to RAS-inhibiting medications was associated with an altered RAS profile and cardiovascular response to angiotensin-II treatment in patients with catecholamine-refractory vasodilatory shock. ACE-inhibitor... read more

Vasopressor Reduction Effect of Polymyxin B Hemoperfusion

Vasopressor Reduction Effect of Polymyxin B Hemoperfusion

This study aimed to evaluate the effect of polymyxin B hemoperfusion (PMX-HP) in patients with peritonitis-induced septic shock who still required high dose vasopressors after surgical source control. A total of 338 patients... read more

Fluid Boluses May Improve CRT

Fluid Boluses May Improve CRT

Several studies have validated capillary refill time (CRT) as a marker of tissue hypoperfusion, and recent guidelines recommend CRT monitoring during septic shock resuscitation. Therefore, it is relevant to further explore... read more

Methylene Blue in Sepsis and Septic Shock

Methylene Blue in Sepsis and Septic Shock

This systematic review and meta-analysis evaluated the effect of MB in three RCTs. They found that MB treatment significantly reduced time to vasopressor discontinuation, days on mechanical ventilation, and length of ICU... read more

Hydroxocobalamin Treatment for Vasoplegia-associated Shock

Hydroxocobalamin Treatment for Vasoplegia-associated Shock

Vasoplegia is generally defined as prolonged vasodilation due to a pathological decrease in systemic vascular resistance, which causes persistent hypotension even in the setting of normal or increased cardiac output. Vasoplegia... read more