Lactate Clearance versus ScvO2 Monitoring in Severe Sepsis
Resuscitation targets in severe sepsis include: preload, e.g. CVP; afterload, e.g. MAP; tissue oxygen delivery; end point controversial: ScvO2 vs lactate clearance
Tag sepsis
Septic encephalopathy
Septic encephalopathy is brain dysfunction mediated by the septic inflammatory response, independent of other co-existent causes such as liver or renal dysfunction
Steroids and Septic Shock Literature Summaries
Bone R.C. et al (1987) “A controlled clinical trial of high dose methylprednisolone in the treatment of severe sepsis and septic shock” NEJM, 317:653-658 PMID 3306374 RCT n = 382 with sepsis and organ dysfunction methylprednisolone (30mg/kg) vs placebo-> no…
Septic cardiomyopathy
Reviewed and revised 11 November 2016 OVERVIEW Septic cardiomyopathy is a common feature of severe sepsis syndromes and results in impaired intrinsic cardiac contractility First described by Parker et al in 1984 Incidence varies in studies, most report 20-60% incidence…
Sepsis Definitions and Diagnosis
The original definitions of sepsis and related conditions (SIRS, severe sepsis and septic shock) are now more than 20 years old (Sepsis- 1 originated from the ACCP/SCCM consensus meeting in 1991 and Sepsis 2 from 2001)
Sepsis Biomarkers
Reviewed and revised 20 December 2015 OVERVIEW At least 178 different sepsis biomarkers have been described in the published medical literature, reflecting the complex pathophysiology of sepsis e.g. coagulation, complement, contact system activation, inflammation, and apoptosis also biomarkers of complications, e.g.…
Unresolved sepsis
When a 'septic' patient fails to improve despite initial therapy, it is important to 'stop and think' and systematically consider the multiple possible reasons why 'the antibiotic is not working'
Intubation, Hypotension and Shock
A modified rapid sequence intubation (RSI) approach is usually preferred in hypotensive, shocked patients
LITFL Review 293
Welcome to the 293rd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs