Tag: vasopressors
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
Could the Furosemide Stress Test Clarify Resuscitative Goals?
Imagine that you admit a patient with septic shock. You resuscitate the patient as best you can with inopressors, fluids, and antibiotics. An adequate blood pressure is achieved. A reasonable amount of fluid is administered.... read more
Enteral Nutrition Can Be Given to Patients on Vasopressors
Most all recent studies show Enteral Nutrition (EN) can be delivered safely to patients on vasopressors. In fact, many studies show an outcome benefit of early EN (EEN) in ICU patients who are receiving vasopressors. It... read more
Early Identification of Patients at High Risk of Streptococcus-associated Necrotizing Infections
Two simple and available upon admission clinical predictors of group A streptococcus (GAS) documentation identified among a large cohort of surgically proven necrotizing soft tissue infections (NSTIs). The results show... read more
Update to the Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) Protocol
The analyses described here are those necessary to answer the trial's primary question of whether combined treatment with vitamin C, thiamine and steroids is more effective than placebo in increasing days alive and free from... read more
Vasopressin for Acute Hemorrhage?
Vasoactive medications are one of the pillars of management of shock in Emergency Departments. Inopressors, namely Norepinephrine and Epinephrine, are the two most commonly used pressors in US Emergency Departments, used... read more
Use of Vasopressor Increases the Risk of Mortality in Traumatic Hemorrhagic Shock
Use of vasopressor for traumatic hemorrhagic shock was associated with mortality after controlling for biases (trauma severity; volume of fluid resuscitation). Among 236,698 trauma patients, 3,551 were included in the... read more
Association of Corticosteroid Treatment With Outcomes in Adult Patients With Sepsis
In this meta-analysis of 37 RCTs (including 9564 patients), corticosteroid treatment was significantly associated with reduced 28-day mortality, ICU mortality, and in-hospital mortality among patients with sepsis. However,... read more
Early vs. Delayed Administration of Norepinephrine in Patients with Septic Shock
This study investigated the incidence of delayed norepinephrine administration following the onset of septic shock and its effect on hospital mortality. Our results show that early administration of norepinephrine in... read more
Renal Outcomes of Vasopressin and Its Analogs in Distributive Shock
In patients with distributive shock, vasopressin and its analogs use is associated with a reduced need for renal replacement therapy and lower acute kidney injury (AKI) incidence. These results are supported by high risk... read more
Myocardial Ischemia During Ventilator Weaning
This observational study showed the pulmonary edema (WiPO) occurred in a significant number of critically ill patients who failed a first spontaneous breathing trial (SBT), while cardiac ischemia (WiCI) was less frequent.... read more
Vasoactive Medication and Randomized Clinical Trials
Vasoactive medication is one of the cornerstones in the treatment of critically ill patients in shock. Shock can be defined as a failure of the circulatory system to provide adequate tissue perfusion resulting in cellular... read more
Clinical Assessment of Critically Ill Patients by Whole-body Ultrasonography
Critical care ultrasonography (CCUS) is increasingly advocated and used, and is defined as point-of-care image acquisition, interpretation and clinical application, all performed by the critical care clinician, and directed... read more
AKI in Critically Ill Patients After Noncardiac Major Surgery
Acute kidney injury (AKI) is a common complication of major surgery. However, acute kidney injury occurring within the first 48 hours after surgery (early acute kidney injury) and therefore likely related to the surgery itself... read more
Early Norepinephrine Has Potential for Septic Shock
Standard sepsis algorithms have suggested completing a fluid bolus before starting vasopressors in patients with septic shock, but multiple observational trials have shown an association between early vasopressor use and... read more
Cardiovascular Dynamics in Critically Ill Patients
Although widely used among physicians and frequently present in the literature, the words "stable" and "unstable" to describe cardiovascular dynamics in critically ill patients can have different meanings to different people... read more
More Precise Sepsis Therapy with Distinct Clinical Phenotypes
In this retrospective analysis of data sets from patients with sepsis, 4 clinical phenotypes were identified that correlated with host-response patterns and clinical outcomes, and simulations suggested these phenotypes may... read more
Serum Chloride Levels in Critical Illness – The Hidden Story
Chloride is the principal anion of the extracellular fluid and vital for both serum electroneutrality and acid-base homeostasis. The aim of this review is to investigate the relevance of dyschloremia in the critically... read more
Sepsis Surveillance Using Adult Sepsis Events Simplified eSOFA Criteria Versus Sepsis-3 Sequential Organ Failure Assessment Criteria
Sepsis-3 defines organ dysfunction as an increase in the Sequential Organ Failure Assessment score by greater than or equal to 2 points. However, some Sequential Organ Failure Assessment score components are not routinely... read more
Vasopressors and Inotropes for Shock Syndromes
Vasopressors and inotropes are cornerstones in the management of shock syndromes. Understanding vasopressors' receptor activity and resultant pharmacological response enables clinicians to select the ideal vasopressor(s)... read more
Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons
Variation in the accuracy of claims data for identifying sepsis and organ dysfunction limits their use for comparing hospitals' sepsis rates and outcomes. Using objective clinical data may facilitate more meaningful hospital... read more
