We have shared several posts on sodium bicarbonate over the years, but this is a great opportunity to revisit the latest Surviving Sepsis Campaign recommendations. The guideline suggests against using sodium bicarbonate solely to improve hemodynamics or reduce vasopressor requirements in adults with septic shock. On the other hand, it suggests considering sodium bicarbonate in […]
Continue ReadingHow much fluid should we give before starting vasopressors in septic shock? Should we continue to administer large fluid boluses, or should we start vasopressors earlier without waiting to see the full response to intravenous fluids? A recent study published in NEJM sought to answer this question by randomizing nearly 1,000 patients with septic shock […]
Continue ReadingA retrospective study published in the Critical Care journal investigated the impact of intravenous thiamine administration on clinical outcomes in septic patients. The study evaluated key parameters, including lactate clearance and overall mortality. Link to article
Continue Readingin a recent article that published in JAMA, Qiam et al. found among 2,511 patients who received antibiotic treatment, it was determined that treatment with piperacillin-tazobactam did not lead to a higher occurrence of acute kidney injury or mortality. Conversely, treatment with cefepime was associated with an increased risk of neurological dysfunction. Link to article […]
Continue ReadingJAMA Published The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) by Physicians from USA, Germany, France, Australia, Canada, Netherlands, and Belgium. The reason for this new definition is the limitation of sensitivity and specificity of SIRS criteria, too much focus on inflammation cascade, and too many terms that really does not make […]
Continue ReadingSIRS criteria an immune response to infection can be diagnosed by ( 96.8<Temp>100.4, HR>90, RR>20 and 4K<WBC>12k). A new study in 172 ICUs among 109,663 patients with infection and
Continue ReadingSurviving Sepsis Campaign updated its guideline regarding new evidence (ProCESS, ARISE, ProMIS). It is required to do a series of actions within first 3 hours and 6 hours of patient presentation(time of triage):
Continue ReadingWe were always told that Don’t underestimate triage or field vital signs! Now, we have a study that shows 25 % of patients presenting to ED with sepsis will progress to septic shock within 3 days.
Continue ReadingNEJM published a study regarding appropriate MAP among patients with septic shock. Originally MAP of 65 was a target but the Surviving Sepsis Campaign guideline was recommending patients with HTN, may have benefit for higher
Continue ReadingJournal of Emergency Medicine published an article with title of “Effective Antibiotic Treatment Prescribed by Emergency Physicians in Patients Admitted to the Intensive Care Unit With Severe Sepsis or Septic Shock” in Dec,2011.
Continue ReadingHow do we measure the fluid status in a patient with shock? This usually measures with CVP or Ultrasound. CVP measurement is possible when we have a central line(subclavian or intra-jugular). Ultrasound brought a quick assessment of volume status or fluid
Continue Reading2008 Pocket Guides, Surviving Sepsis Campaign Guideline
Continue Reading