Podcasts about Septic shock

Show notes at pharmacyjoe.com/episode1042. In this episode, I'll discuss early vs delayed norepinephrine use in patients with septic shock. The post 1042: Early Norepinephrine Use in Septic Shock is Associated with Reduced Mortality appeared first on Pharmacy Joe.

Dr. Harish Kinni, a triple-board-certified emergency medicine and critical care physician and assistant professor at the Mayo Clinic, provides an overview of the fundamentals of ventilator care for emergency department professionals. We will review key modes that we should know, the variables to set, how to adjust them for your patient's needs, and provide troubleshooting tips and tricks for when things suddenly go awry. This is sure to be one of the most helpful chapters of Always on EM, but don't let it take your breath away! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Swart P, Nijbroek SGLH, Paulus F, Neto AS, Schultz MJ. Sex Differences in Use of Low Tidal Volume Ventilation in COVID-19-Insights From the PRoVENT-COVID Study. Front Med (Lausanne). 2022 Jan 3;8:780005. doi: 10.3389/fmed.2021.780005. PMID: 35300177; PMCID: PMC8923734. McNicholas BA, Madotto F, Pham T, Rezoagli E, Masterson CH, Horie S, Bellani G, Brochard L, Laffey JG; LUNG SAFE Investigators and the ESICM Trials Group. Demographics, management and outcome of females and males with acute respiratory distress syndrome in the LUNG SAFE prospective cohort study. Eur Respir J. 2019 Oct 17;54(4):1900609. doi: 10.1183/13993003.00609-2019. PMID: 31346004. Swart P, Deliberato RO, Johnson AEW, Pollard TJ, Bulgarelli L, Pelosi P, de Abreu MG, Schultz MJ, Neto AS. Impact of sex on use of low tidal volume ventilation in invasively ventilated ICU patients-A mediation analysis using two observational cohorts. PLoS One. 2021 Jul 14;16(7):e0253933. doi: 10.1371/journal.pone.0253933. PMID: 34260619; PMCID: PMC8279424. Evans, Laura1; Rhodes, Andrew2; Alhazzani, Waleed3; Antonelli, Massimo4; Coopersmith, Craig M.5; French, Craig6; Machado, Flávia R.7; Mcintyre, Lauralyn8; Ostermann, Marlies9; Prescott, Hallie C.10; Schorr, Christa11; Simpson, Steven12; Wiersinga, W. Joost13; Alshamsi, Fayez14; Angus, Derek C.15; Arabi, Yaseen16; Azevedo, Luciano17; Beale, Richard18; Beilman, Gregory19; Belley-Cote, Emilie20; Burry, Lisa21; Cecconi, Maurizio22; Centofanti, John23; Coz Yataco, Angel24; De Waele, Jan25; Dellinger, R. Phillip26; Doi, Kent27; Du, Bin28; Estenssoro, Elisa29; Ferrer, Ricard30; Gomersall, Charles31; Hodgson, Carol32; Hylander Møller, Morten33; Iwashyna, Theodore34; Jacob, Shevin35; Kleinpell, Ruth36; Klompas, Michael37; Koh, Younsuck38; Kumar, Anand39; Kwizera, Arthur40; Lobo, Suzana41; Masur, Henry42; McGloughlin, Steven43; Mehta, Sangeeta44; Mehta, Yatin45; Mer, Mervyn46; Nunnally, Mark47; Oczkowski, Simon48; Osborn, Tiffany49; Papathanassoglou, Elizabeth50; Perner, Anders51; Puskarich, Michael52; Roberts, Jason53; Schweickert, William54; Seckel, Maureen55; Sevransky, Jonathan56; Sprung, Charles L.57; Welte, Tobias58; Zimmerman, Janice59; Levy, Mitchell60. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Critical Care Medicine 49(11):p e1063-e1143, November 2021. | DOI: 10.1097/CCM.0000000000005337  Fan E, Del Sorbo L, Goligher EC, Hodgson CL, Munshi L, Walkey AJ, Adhikari NKJ, Amato MBP, Branson R, Brower RG, Ferguson ND, Gajic O, Gattinoni L, Hess D, Mancebo J, Meade MO, McAuley DF, Pesenti A, Ranieri VM, Rubenfeld GD, Rubin E, Seckel M, Slutsky AS, Talmor D, Thompson BT, Wunsch H, Uleryk E, Brozek J, Brochard LJ; American Thoracic Society, European Society of Intensive Care Medicine, and Society of Critical Care Medicine. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2017 May 1;195(9):1253-1263. doi: 10.1164/rccm.201703-0548ST. Erratum in: Am J Respir Crit Care Med. 2017 Jun 1;195(11):1540. doi: 10.1164/rccm.19511erratum. PMID: 28459336. Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, Oczkowski S, Levy MM, Derde L, Dzierba A, Du B, Aboodi M, Wunsch H, Cecconi M, Koh Y, Chertow DS, Maitland K, Alshamsi F, Belley-Cote E, Greco M, Laundy M, Morgan JS, Kesecioglu J, McGeer A, Mermel L, Mammen MJ, Alexander PE, Arrington A, Centofanti JE, Citerio G, Baw B, Memish ZA, Hammond N, Hayden FG, Evans L, Rhodes A. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med. 2020 Jun;48(6):e440-e469. doi: 10.1097/CCM.0000000000004363. PMID: 32224769; PMCID: PMC7176264. Wang W, Scharfstein D, Wang C, Daniels C, Needham D, Brower R, NHLBI ARDS Clinical Network. Estimating the Causal Effect of Low Tidal Volume Ventilation on Survival in Patients with Acute Lung Injury. J R Stat Soc Ser C Appl Stat. 2011. PMC: PMC3197806 Brower RG, Thompson BT, NIH/NHLBI/ARDSNetwork. Tidal volumes in acute respiratory distress syndrome--one size does not fit all. Crit Care Med. 2006. Hager DN, Krishman JA, Hayden D, Brower RG, ARDSNet NIH / NHLBI. Tidal Volume Reduction in Patients with acute Lung Injury When Plateau Pressures Are Not High. Am J Resp Crit Care Med. 2005. Rubenfeld GD, Cooper C, Carter G, Thompson BT, Hudson LD. Barriers to providing lung protective ventilation to patients with acute lung injury. Crit Care Med. 2004. Chatburn RL, El-Khatib M, Mireles-Cabodevila E. A taxonomy for mechanical ventilation: 10 fundamental maxims. Respir Care. 2014 Nov;59(11):1747-63. doi: 10.4187/respcare.03057. Epub 2014 Aug 12. PMID: 25118309. Guo L, Wang W, Zhao N, Guo L, Chi C, Hou W, Wu A, Tong H, Wang Y, Wang C, Li E. Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis. Crit Care. 2016 Jul 22;20(1):226. doi: 10.1186/s13054-016-1396-0. PMID: 27448995; PMCID: PMC4957383. Rice TW, Wheeler AP, Bernard GR, Hayden DL, Schoenfeld DA, Ware LB, NIH NHLBI ARDS Network. Comparison of the Sp02/FI02 Ratio and the PaO 2/FI02 in Patients with Acute Lung Injury or ARDS. Chest. 2007. Zhang G, Burla MJ, Caesar BB, Falank CR, Kyros P, Zucco VC, Strumilowska A, Cullinane DC, Sheppard FR. Emergency Department SpO2/FiO2 Ratios Correlate with Mechanical Ventilation and Intensive Care Unit Requirements in COVID-19 Patients. West J Emerg Med. 2024 May;25(3):325-331. doi: 10.5811/westjem.17975. PMID: 38801037; PMCID: PMC11112664.   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

TODAY ON THE ROBERT SCOTT BELL SHOW: Federal Nutrition Guidelines, Gov. Abbott Elevates MAHA, Weight Loss Jab Cancer, Expert Class Rise and Fall, Heloderma, Michael Boldin, Tenth Amendment Center, Founders Warned of Corruption, Methylene Blue for Septic Shock, Unapproved GMO Rice, Bug Diet Push Back and MORE! https://robertscottbell.com/federal-nutrition-guidelines-gov-abbott-elevates-maha-weight-loss-jab-cancer-expert-class-rise-and-fall-heloderma-michael-boldin-tenth-amendment-center-founders-warned-of-corruption-methylene/ Please read this disclaimer carefully before you (“you”, “your”) use our [Your Website URL] website (“website”, “service”) operated by the [Your Business Name] (“operator”, “us”, “we”, “our”). Purpose and Character The use of copyrighted material on the website is for non-commercial, educational purposes, and is intended to provide benefit to the public through information, critique, teaching, scholarship, or research. Nature of Copyrighted Material Weensure that the copyrighted material used is for supplementary and illustrative purposes and that it contributes significantly to the user's understanding of the content in a non-detrimental way to the commercial value of the original content. Amount and Substantiality Our website uses only the necessary amount of copyrighted material to achieve the intended purpose and does not substitute for the original market of the copyrighted works. Effect on Market Value The use of copyrighted material on our website does not in any way diminish or affect the market value of the original work. We believe that our use constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the U.S. Copyright Law. If you believe that any content on the website violates your copyright, please contact us providing the necessary information, and we will take appropriate action to address your concern.

Send us a textNorepinephrine versus Dopamine for Septic Shock in Neonates: A Randomized Controlled Trial.Mazhari MYA, Priyadarshi M, Singh P, Chaurasia S, Basu S.J Pediatr. 2025 Jul;282:114599. doi: 10.1016/j.jpeds.2025.114599. Epub 2025 Apr 17.PMID: 40252959 Clinical Trial.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Episode Notes In this episode of the DASON Digest podcast, DASON clinical pharmacist liaison Dr. Angelina Davis talks with us about a national retrospective cohort study comparing the effects of cefepime versus piperacillin-tazobactam on the development of severe acute kidney injury in patients with septic shock. The article for this episode can be found here: https://pubmed.ncbi.nlm.nih.gov/39657005/ For more information about DASON, please visit: https://dason.medicine.duke.edu/

In this epsiode, we discuss the clinical presentation and management of a patient with ascending cholangitis.

Show notes at pharmacyjoe.com/episode1024. In this episode, I'll discuss the use of adjuvant midodrine in patients with septic shock. The post 1024: Adjuvant Midodrine Lowers Norepinephrine Dose But Not Length of Stay in Patients With Septic Shock appeared first on Pharmacy Joe.

Thanks to Dr. Abhinav Totapally who is a pediatric intensivist at Nicklaus Children's Hospital in Miami and Dr. Brian Bridges, the Division Chief of Pediatric Critical Care Medicine at the Medical University of South Carolina in Charleston for joining us for this series. Check out their paper published in PCCM in January 2025Learning Objectives:By the end of this podcast, listeners should be able to discuss:The rationale supporting and the limitations of using VA ECMO for children with refractory septic shock.Patient selection in the use of VA ECMO for children with refractory septic shock.The benefits and risks of common cannulation strategies for VA ECMO in children with refractory septic shock.An expert approach to supporting children with refractory septic shock on VA ECMO.Reference:Totapally A, Stark R, Danko M, Chen H, Altheimer A, Hardison D, Malone MP, Zivick E, Bridges B. Central or Peripheral Venoarterial Extracorporeal Membrane Oxygenation for Pediatric Sepsis: Outcomes Comparison in the Extracorporeal Life Support Organization Dataset, 2000-2021. Pediatr Crit Care Med. 2025 Jan 23.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Asad E. Patanwala, PharmD, MPH, and Brian L. Erstad, PharmD, join CHEST Journal Podcast Moderator Alice Gallo De Moraes, MD, FCCP, to discuss their research into the effect of albumin administration on the need for renal replacement therapy and mortality in patients with septic shock and renal impairment. DOI: 10.1016/j.chest.2024.10.012 Disclaimer: The purpose of this activity is to expand the reach of CHEST content through awareness, critique, and discussion. All articles have undergone peer review for methodologic rigor and audience relevance. Any views asserted are those of the speakers and are not endorsed by CHEST. Listeners should be aware that speakers' opinions may vary and are advised to read the full corresponding journal article(s) for complete context. This content should not be used as a basis for medical advice or treatment, nor should it substitute the judgment used by clinicians in the practice of evidence-based medicine.

Thanks to Dr. Abhinav Totapally who is a pediatric intensivist at Nicklaus Children's Hospital in Miami and Dr. Brian Bridges, the Division Chief of Pediatric Critical Care Medicine at the Medical University of South Carolina in Charleston for joining us for this series. Check out their paper published in PCCM in January 2025Learning Objectives:By the end of this podcast, listeners should be able to discuss:The rationale supporting and the limitations of using VA ECMO for children with refractory septic shock.Patient selection in the use of VA ECMO for children with refractory septic shock.The benefits and risks of common cannulation strategies for VA ECMO in children with refractory septic shock.An expert approach to supporting children with refractory septic shock on VA ECMO.Reference:Totapally A, Stark R, Danko M, Chen H, Altheimer A, Hardison D, Malone MP, Zivick E, Bridges B. Central or Peripheral Venoarterial Extracorporeal Membrane Oxygenation for Pediatric Sepsis: Outcomes Comparison in the Extracorporeal Life Support Organization Dataset, 2000-2021. Pediatr Crit Care Med. 2025 Jan 23.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

For this episode we are joined by EBM guru, Dr. Brian Locke, who deftly breaks down all of our statistics questions. Is half dose DOAC as good as full dose DOAC for preventing VTE, and does it reduce bleeding risk? Can procalcitonin reduce duration of antibiotics for infections without compromising mortality rates? Can LLMs like GPT-4 help physicians manage patients better? Can reinforcement learning models predict when to start vasopressin in patients with septic shock? What is the risk of resuming anticoagulation in patients with atrial fibrillation and prior intracerebral hemorrhage? Is high flow nasal cannula as good as non-invasive ventilation for different types of respiratory failure? We answer all these questions and more!Half Dose DOAC for Long Term VTE Prevention (RENOVE)Biomarker-Guided Antibiotic Duration (ADAPT-Sepsis)GPT-4 Assistance for Physician PerformanceOptimal Vasopressin Initiation for Septic Shock (OVISS)DOACs for A fib after ICH (PRESTIGE-AF)High Flow Nasal Cannula vs NIV for Respiratory Failure (RENOVATE)Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope License code: NP8HLP5WKGKXFW2R

In this World Shared Practice Forum Podcast, Dr. Graeme MacLaren shares his expert insight on the outcomes of central versus peripheral cannulation techniques for Extracorporeal Membrane Oxygenation (ECMO) in pediatric patients with refractory septic shock as published in the February issue of Pediatric Critical Care Medicine. The discussion focuses on the implications of ECMO modality choices, the conditions affecting cannulation strategy, and how institutional resources can impact patient outcomes. LEARNING OBJECTIVES - Differentiate between central and peripheral venoarterial ECMO strategies in pediatric septic shock - Analyze key papers in the literature to provide context for decision-making around ECMO deployment in refractory septic shock - Identify factors influencing the success and outcome of ECMO in refractory pediatric septic shock cases - Apply considerations for patient selection and institutional resource availability in ECMO planning AUTHORS Graeme MacLaren, MBBS, MSc, FRACP, FCICM, FCCM, FELSO Director of Cardiothoracic Intensive Care, National University Hospital, Singapore Clinical Director of ECMO, National University Heart Centre, Singapore Adjunct Professor, Department of Surgery, National University of Singapore Past President, Extracorporeal Life Support Organization Jeffery Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: March 24, 2025. ARTICLES REFERENCED 1) MacLaren, Graeme MBBS, MSc, FELSO, FCCM. Cannulation Strategies for Extracorporeal Membrane Oxygenation in Children With Refractory Septic Shock. Pediatric Critical Care Medicine ():10.1097/PCC.0000000000003707, February 10, 2025. | DOI: 10.1097/PCC.0000000000003707 2) Totapally A, Stark R, Danko M, et al. Central or Peripheral Venoarterial Extracorporeal Membrane Oxygenation for Pediatric Sepsis: Outcomes Comparison in the Extracorporeal Life Support Organization Dataset, 2000-2021. Pediatr Crit Care Med. Published online January 23, 2025. doi:10.1097/PCC.0000000000003692 3) Schlapbach LJ, Chiletti R, Straney L, et al. Defining benefit threshold for extracorporeal membrane oxygenation in children with sepsis-a binational multicenter cohort study. Crit Care. 2019;23(1):429. Published 2019 Dec 30. doi:10.1186/s13054-019-2685-1 4) Bréchot N, Hajage D, Kimmoun A, et al. Venoarterial extracorporeal membrane oxygenation to rescue sepsis-induced cardiogenic shock: a retrospective, multicentre, international cohort study. Lancet. 2020;396(10250):545-552. doi:10.1016/S0140-6736(20)30733-9 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/at/84gbxthfmhvp7v9fsnjb87mh/0320425_WSP_MacLaren_Transcript.pdf Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. CITATION MacLaren G, Burns JP. Pediatric ECMO Cannulation Strategies in Refractory Septic Shock. 03/2025. OPENPediatrics. https://soundcloud.com/openpediatrics/pediatric-ecmo-cannulation-strategies-in-refractory-septic-shock-by-g-maclaren-openpediatrics.

Editor's Summary by JAMA Deputy Editors Linda Brubaker, MD, and Preeti Malani, MD, MSJ, for articles published from March 15-21, 2025.

Show notes at pharmacyjoe.com/episode1010. In this episode, I’ll discuss the use of dexmedetomidine to reduce vasopressor resistance in refractory septic shock. The post 1010: Does Dexmedetomidine Improve Vasopressor Sensitivity in Refractory Septic Shock? appeared first on Pharmacy Joe.

Send us a Text Message (please include your email so we can respond!)Episode 60! We jump to SCCM where we talk about 2 late breakers - PROACTIVE or "Propranolol As an Anxiolytic to Reduce the Use of Sedatives for Critically Ill Adults Receiving Mechanical Ventilation" by Downar et al and "Acetylsalicylic Acid Treatment in Patients With Sepsis and Septic Shock" by Almeida et al both published in CCM in 2025. PROACTIVE (pubmed): https://pubmed.ncbi.nlm.nih.gov/39982178/PROACTIVE (CCM): https://pmc.ncbi.nlm.nih.gov/articles/PMC11801419/ASA in sepsis (pubmed): https://pubmed.ncbi.nlm.nih.gov/39982179/ASA in sepsis (CCM): https://journals.lww.com/ccmjournal/fulltext/2025/02000/acetylsalicylic_acid_treatment_in_patients_with.2.aspxIf you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Neste episódio, conversamos sobre Sepse e a importância do antibótico. Salientamos pontos importantes, fatores de risco e dicas para escolha da terapia correta, principalmente no contexto de gram negativos MDR. Este é o terceiro episódio da nossa série especial realizada em parceria com a Pfizer, em que trazemos discussões que conectam ciência e prática clínica para enfrentar desafios no combate às infecções.

Reference: Sanchez-Pinto, L.N., et al. Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. JAMA 2024​​. Guest Skeptic: Prof. Damian Roland is a Consultant at the University of Leicester NHS Trust and Honorary Professor for the University of Leicester's SAPPHIRE group. He specializes in Paediatric Emergency Medicine and is a passionate […] The post SGEM #463: Like the Legend of the Phoenix… Criteria for Sepsis first appeared on The Skeptics Guide to Emergency Medicine.

Kennedy Concannon, PharmD discusses the use of thiamine in septic shock.   For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes.  You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on X @MayoMedE   

Dr Tom Waterfield and Dr Constantinos Kanaris talking about Septic Shock. This talk is part of the Paediatric Emergencies 2024 event. To get your CME certificate for watching the video please visit https://www.paediatricemergencies.com/conference/paediatric-emergencies-2024/ #PaediatricEmergencies #PaediatricEmergencies2024 #Sepsis

Show notes at pharmacyjoe.com/episode967. In this episode, I'll discuss moderate vs low and high volume IV fluid resuscitation in sepsis and septic shock. The post 967: Goldilocks and the Three Fluid Resuscitation Strategies for Sepsis and Septic Shock appeared first on Pharmacy Joe.

Autonomic dysfunction and tachycardia are strongly linked to poor outcomes in septic shock, contributing to high mortality rates. In the upcoming podcast, we explore whether β-blockade with landiolol for up to 14 days can reduce organ failure, as measured by the Sequential Organ Failure Assessment (SOFA) score, in critically ill patients with tachycardia and septic shock who have been on high-dose norepinephrine for over 24 hours. Dr. Tony Whitehouse, interviewed by two NEXT representatives, discusses the key findings of the STRESS-L Randomized Clinical Trial.

In this episode of Critical Matters, Dr. Zanotti discusses the use of intravenous albumin in critical care. He is joined by D. Jeannie Callum, Director of Transfusion Medicine and Professor of Pathology and Molecular Medicine at Queens University in Ontario, Canada. Dr. Callum's research focuses on blood utilization, hemostasis in the bleeding patient, and transfusion-related errors. She has received numerous awards and published extensively. Dr. Callum is the lead author of “Use of Intravenous Albumin: A Guidelines from the International Collaboration for Transfusion Medicine Guidelines,” published earlier this year in CHEST. Additional Resources: Use of Intravenous Albumin. A Guideline from the International Collaboration for Transfusion Medicine Guidelines. CHEST 2024: https://journal.chestnet.org/article/S0012-3692(24)00285-X/fulltext International Collaboration for Transfusion Medicine Guidelines Website: https://www.ictmg.org/ Ten myths about albumin. M Joannidis, et al. Intensive Care Med 2022: https://pubmed.ncbi.nlm.nih.gov/35247060/ A comparison of albumin and saline for fluid resuscitation in the intensive care unit. SAFE Study Investigators. N Engl J Med 2004: https://pubmed.ncbi.nlm.nih.gov/15163774/ Albumin Replacement in Patients with Severe Sepsis or Septic Shock. ALBIOS Study Investigators. N Engl J .Med 2014: https://www.nejm.org/doi/full/10.1056/NEJMoa1305727 Books mentioned in this episode: Ending Medical Reversal: Improving Outcomes, Saving Lives. By Vinayak K. Prasad: https://bit.ly/4dAimRa The Time Machine. By H.G. Wells: https://amzn.to/4eK4apG

In this episode of the Saving Lives Podcast, we dive into the DecatSepsis trial, exploring the role of dexmedetomidine in reducing mortality and managing septic shock. Discover how this sedative could help mitigate the harmful effects of the hyperadrenergic state in septic patients. The Vasopressor & Inotrope Handbook I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. If you're in the US, you can order ⁠⁠A SIGNED & PERSONALIZED COPY for $29.99⁠⁠ or via ⁠⁠AMAZON for $32.99⁠⁠ (for orders in or outside the US). Ebook versions are available via ⁠⁠AMAZON KINDLE for $9.99⁠⁠, ⁠⁠APPLE BOOKS⁠⁠, and ⁠⁠GOOGLE PLAY⁠⁠. ¡Excelentes noticias! Mi libro ha sido traducido al español y está disponible a traves de ⁠⁠AMAZON⁠⁠. Las versiones electrónicas están disponibles para su compra for solo $9.99 en ⁠⁠AMAZON KINDLE⁠⁠, ⁠⁠APPLE BOOKS⁠⁠ y ⁠⁠GOOGLE PLAY⁠⁠. Citation Ezz Al-Regal AR, Ramzy EA, Allah Atia AA, Emara MM. Dexmedetomidine for Reducing Mortality in Patients With Septic Shock A Randomized Controlled Trial (DecatSepsis). Chest. 2024 Jul 14:S0012-3692(24)04601-4. doi: 10.1016/j.chest.2024.06.3794. Epub ahead of print. PMID: 39004217. --- Support this podcast: https://podcasters.spotify.com/pod/show/eddyjoemd/support

Dr. Harven DeShield is the CEO and Co-Founder of Vivacelle Bio, which is developing a nanoparticle-based treatment called VBI-S to address the underlying causes of septic shock. The treatment works by efficiently redistributing nitric oxide to help regulate blood pressure and improve organ function, reducing the need for traditional vasopressor treatments. Vivacelle is also developing a product to help address hemorrhagic shock and minimize reperfusion injury. Harven explains, "There are seven aspects to septic shock - actually eight. So, first, you have an infection. You have to have an infection, whether it is a bacterial, virus, or fungus. And then, eventually, they give you fluids—your blood pressure drops. And so, they try to correct that by giving you fluids. And when the fluids fail, then you transition from sepsis to septic shock." "Then, you are also dealing with the fact that they put you on vasopressors once you get into septic shock. When they put you on vasopressors, that creates another whole realm of problems, which I can get into later. But, essentially, they have some serious toxicity effects, including reducing cardiac output. It causes cardiac arrhythmia and blood clots and can even lead somebody to go into hemorrhagic shock. So, you have the infection problems, you have the relative and absolute hypovolemia problem." "Our product, for example, works within, and I'm using phase 2a - we see results in as little as 90 minutes, in terms of, at least, correcting the blood pressure. And it really can be very severe, and time is of the essence. There used to be something they called the "golden hour”.  This means you have an hour, depending on how low your blood pressure is. Now, some people call it the "platinum ten minutes". #VivacelleBio #SepticShock #Sepsis #Hypovolemia #UrgentCareTreatment vivicellebio.com Download the transcript here

Dr. Harven DeShield is the CEO and Co-Founder of Vivacelle Bio, which is developing a nanoparticle-based treatment called VBI-S to address the underlying causes of septic shock. The treatment works by efficiently redistributing nitric oxide to help regulate blood pressure and improve organ function, reducing the need for traditional vasopressor treatments. Vivacelle is also developing a product to help address hemorrhagic shock and minimize reperfusion injury. Harven explains, "There are seven aspects to septic shock - actually eight. So, first, you have an infection. You have to have an infection, whether it is a bacterial, virus, or fungus. And then, eventually, they give you fluids—your blood pressure drops. And so, they try to correct that by giving you fluids. And when the fluids fail, then you transition from sepsis to septic shock." "Then, you are also dealing with the fact that they put you on vasopressors once you get into septic shock. When they put you on vasopressors, that creates another whole realm of problems, which I can get into later. But, essentially, they have some serious toxicity effects, including reducing cardiac output. It causes cardiac arrhythmia and blood clots and can even lead somebody to go into hemorrhagic shock. So, you have the infection problems, you have the relative and absolute hypovolemia problem." "Our product, for example, works within, and I'm using phase 2a - we see results in as little as 90 minutes, in terms of, at least, correcting the blood pressure. And it really can be very severe, and time is of the essence. There used to be something they called the "golden hour”.  This means you have an hour, depending on how low your blood pressure is. Now, some people call it the "platinum ten minutes". #VivacelleBio #SepticShock #Sepsis #Hypovolemia #UrgentCareTreatment vivicellebio.com Listen to the podcast here

Dr. Jayshil Patel is an associate professor at the Medical College of Wisconsin and a board certified physician in internal medicine, pulmonary medicine, and critical care medicine. His particularly research […]

Britt shares her story of overcoming incredible odds after facing the life-threatening condition of septic shock. Sepsis shock is a life-threatening condition, and surviving it is a testament to strength, resilience, and the incredible support of medical professionals. Britt shares her experience, the critical moments that defined her survival, and the long road to recovery. This video sheds light on the dangers of sepsis, the importance of early detection, and the hope that exists even in the darkest of times. Links: https://www.sepsis.org (Sepsis Alliance) https://www.cdc.gov/sepsis/about/index.html (CDC - About Sepsis) https://www.nigms.nih.gov/education/fact-sheets/Pages/sepsis.aspx (National Institute of General Medical Sciences)  If you have a unique story you'd like to share on the podcast, please fill out this form: https://forms.gle/ZiHgdoK4PLRAddiB9 or send an email to wereallinsanepodcast@gmail.com Business Inquiries please contact: weareallinsane@outloudtalent.com

Host Elizabeth H. Mack, MD, MS, FCCM, is joined by Luregn J. Schlapbach, MD, PhD, FCICM, to discuss the Pediatric Critical Care Medicine article, "Resuscitation With Early Adrenaline Infusion for Children With Septic Shock: A Randomized Pilot Trial" (Harley A, et al. Pediatr Crit Care Med. 2024 Feb;25:106-117). The study found that a fluid-sparing algorithm for children presenting with septic shock using early adrenaline is feasible. Dr. Schlapbach is a professor and chief of intensive care and neonatology at the University Children's Hospital in Zurich, Switzerland.

Casual conversational sentences in Canto and Mando for topics in medical and non-medical settings. sister video (#37) https://www.youtube.com/@notnowigottago/videos soundtrack Lo-Fi Hip Hop Mix by Alex-Productions (No Copyright Music) Free Music, you can find Alex on Soundcloud and YouTube

Joel M. Dulhunty, MD, PhD, Royal Brisbane and Women's Hospital, and Jason A. Roberts, BPharm, PhD, University of Queensland Centre for Clinical Research, join JAMA Deputy Editor Preeti Malani, MD, MSJ, to discuss the BLING trial that assessed continuous vs intermittent β-lactam antibiotic infusions in patients with sepsis or septic shock. Related Content: Continuous vs Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis Prolonged vs Intermittent Infusions of β-Lactam Antibiotics in Adults With Sepsis or Septic Shock

We know what to do with the patient who is sick and hypotensive.  But what about the patient who is sick but not hypotensive?  Or the patient who is hypotensive but not sick?References for the papers mentioned in the podcast on use of midodrine in the ED:Puissant et al (2022). Wait, What? Oral Midodrine Instead of Pressors for Septic Shock? Annals of Emergency Medicine;80(4):S94Zada et al (2024). Midodrine in Early Septic Shock. Critical Care Medicine 52(1):S708Lal et al (2021). Oral Midodrine Administration During the First 24 Hours of Sepsis to Reduce the Need of Vasoactive Agents: Placebo-Controlled Feasibility Clinical Trial. Critical Care Explorations 3(5):e0382Additional content and educational resources at ICUedu.org

Trial of the Week: SEPSISPAM Special Guest: Katherine Spezzano, PharmD, MBA, BCCCP @KatSpazPharmD   Katherine Spezzano joins to discuss the April Trial of the Week “High versus Low Blood-Pressure Target in Patients with Septic Shock” the SEPSISPAM study, published in NEJM in 2014. We set the scene by reviewing the concept of autoregulation, guideline recommendations, and pre-SEPSISPAM research assessing BP goals in sepsis. Then we do a deep dive into the SEPSISPAM trial of the week. Would we see these same results with other vasopressors? Did each group meet their BP goal range? How do we balance AKI prevention and longer ICU LOS? What do our guidelines recommend now? Trial fun facts, alternate trial acronym ideas, and much more!   Reference list: https://pharmacytodose.files.wordpress.com/2024/04/sepsispam-trial-of-the-week-references.pdf   PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Dr. Zanotti is joined by Dr. Stephen Pastores to discuss the 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia, published by the Society of Critical Care Medicine. Dr. Pastores is Program Director for Critical Care Medicine and Vice-Chair of Education for the Department of Anesthesiology and Critical Care Medicine at Memorial Sloan Kettering Cancer Center. In addition, Dr. Pastores is a professor of anesthesiology and medicine at Weill Cornell Medical College in New York, NY. Additional resources: 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia. Crit Care Medicine 2024: https://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=9900&issue=00000&article=00275&type=Fulltext Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. ADRENAL Trial. N Engl J Med 2018. https://www.nejm.org/doi/full/10.1056/NEJMoa1705835 Hydrocortisone plus Fludrocortisone for Adults with Septic Shock. APROCCHSS Clinical Trial. N Engl J of Med 2018: https://www.nejm.org/doi/full/10.1056/NEJMoa1705716 Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomized controlled trial. The Lancet 2020: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(19)30417-5/abstract Hydrocortisone in Severe Community-Acquired Pneumonia. CAPE-COD Trial. N Eng J Med 2023: https://www.nejm.org/doi/full/10.1056/NEJMoa2215145 Books mentioned in this episode: Elon Musk. By Walter Isaacson: https://bit.ly/3PVXWsG The Autumn Ghost: How the Battle Against a Polio Epidemic Revolutionized Modern Medical Care. By Hannah Wunsch: https://bit.ly/4avevns

Dr. John Fleetham chats with Dr. Bijan Teja and Dr. Nicholas Bosch about their article, "Effectiveness of Fludrocortisone Plus Hydrocortisone Versus Hydrocortisone Alone in Septic Shock: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials." 

In this World Shared Practice Forum Podcast, authors of the newly released publication, International Consensus Criteria for Pediatric Sepsis and Septic Shock, review their research and findings for treating and caring for children with sepsis and septic shock. They discuss how using the novel Phoenix Sepsis Score guided the development of this new globally applicable research model. LEARNING OBJECTIVES Upon listening to this presentation, learners will be able to: - Describe the goals and development of the new Phoenix Sepsis Score - Discuss how clinicians can apply the score in clinical practice and for research endeavors - Explain the challenges and limitations of using the Phoenix Sepsis score in lower-resource settings AUTHORS Luregn Schlapbach, MD, PhD, Prof, FCICM Head, Department of Intensive Care and Neonatology University Children's Hospital in Zurich, Switzerland Scott Watson, MD, MPH Professor of Pediatrics University of Washington School of Medicine Associate Division Chief Division of Pediatric Critical Care Medicine Seattle Children's Hospital Claudio Flauzino de Oliveira, MD, PhD Researcher Latin American Sepsis Institute Halden Scott, MD, MSCS Director of Research Section of Pediatric Emergency Medicine University of Colorado School of Medicine Children's Hospital Colorado Tellen Bennett, MD, MS Professor of Biomedical Informatics and Pediatrics Vice Chair of Clinical Informatics Department of Biomedical Informatics University of Colorado School of Medicine Attending Physician Pediatric Intensive Care Unit Children's Hospital Colorado Traci Wolbrink, MD, MPH Senior Associate in Critical Care Medicine; Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Associate Professor of Anesthesia Harvard Medical School DATES Initial publication date: March 26, 2024. ARTICLES REFERENCED Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock https://jamanetwork.com/journals/jama/fullarticle/2814296 Global Study of Disease https://pubmed.ncbi.nlm.nih.gov/31954465/ Sepsis-3 https://jamanetwork.com/journals/jama/fullarticle/2492881 Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Schlapbach LJ, Bennett TD, de Oliveira CF, Scott HF, Watson RS, O'Hara JE, Wolbrink TA. New Phoenix Pediatric Sepsis Criteria. 03/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/new-phoenix-pediatric-sepsis-criteria.

If you practice in emergency medicine you probably live on the look out for sepsis.  You likely follow the 2016 Sepsis-3 guidelines for adults which really was a paradigm shift from an infection-associated SIRS, to infection-associated organ dysfunction with the SOFA score or sequential organ failure assessment score of at least 2 points in patients with suspected infection. However, the definition of sepsis in kids was not updated at that time in part because SOFA was not studied in children. That means that our current pediatric guidelines are from 2005! Good news though! The Phoenix sepsis criteria for sepsis and septic shock in children were derived and validated by the international SCCM Pediatric Sepsis Definition Task Force and we interviewed two of the task force members to help us operationalize it on our podcast. Connect with us on social media @empulsepodcast or at ucdavisem.com Host: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Dr. Halden Scott, Associate Professor of pediatrics a the university of Colorado and pediatric emergency physician at the children's hospital Colorado Dr. Fran Balamuth, Associate professor of pediatrics at Perlman school of medicine at the university of Pennsylvania, attending physician in the ED at CHOP, co-director of the pediatric sepsis program at CHOP Resources: The Phoenix sepsis criteria for sepsis and septic shock in children. Schlapbach LJ, Watson RS, Sorce LR, Argent AC, Menon K, Hall MW, Akech S, Albers DJ, Alpern ER, Balamuth F, Bembea M, Biban P, Carrol ED, Chiotos K, Chisti MJ, DeWitt PE, Evans I, Flauzino de Oliveira C, Horvat CM, Inwald D, Ishimine P, Jaramillo-Bustamante JC, Levin M, Lodha R, Martin B, Nadel S, Nakagawa S, Peters MJ, Randolph AG, Ranjit S, Rebull MN, Russell S, Scott HF, de Souza DC, Tissieres P, Weiss SL, Wiens MO, Wynn JL, Kissoon N, Zimmerman JJ, Sanchez-Pinto LN, Bennett TD; Society of Critical Care Medicine Pediatric Sepsis Definition Task Force. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024 Feb 27;331(8):665-674. doi: 10.1001/jama.2024.0179. PMID: 38245889; PMCID: PMC10900966. ***** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Learning Objectives:By the end of this podcast, listeners should be able to discuss:The limitations of prior definitions of pediatric sepsis and the rationale for creating the Phoenix Sepsis Criteria.The methods and key outcomes used for deriving the Phoenix Sepsis Criteria.How to diagnose sepsis using the Phoenix Sepsis Criteria. General limitations of the Phoenix Sepsis Criteria.Next steps in implementing the Phoenix Sepsis Criteria and the direction it provides for future research.About our Guest: L. Nelson Sanchez-Pinto, MD, is a Pediatric intensivist at Lurie Children's Hospital of Chicago, where he is also an Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. Dr. Sanchez-Pinto co-led an international group of researchers in the Society of Critical Care Medicine Pediatric Sepsis Definition Task Force for the Development and Validation of the new Phoenix Criteria for Pediatric Sepsis and Septic Shock that was featured at the recent 2024 SCCM conference. Support the showSupport the show

Learning Objectives:By the end of this podcast, listeners should be able to discuss:The limitations of prior definitions of pediatric sepsis and the rationale for creating the Phoenix Sepsis Criteria.The methods and key outcomes used for deriving the Phoenix Sepsis Criteria.How to diagnose sepsis using the Phoenix Sepsis Criteria. General limitations of the Phoenix Sepsis Criteria.Next steps in implementing the Phoenix Sepsis Criteria and the direction it provides for future research.About our Guest: L. Nelson Sanchez-Pinto, MD, is a Pediatric intensivist at Lurie Children's Hospital of Chicago, where he is also an Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. Dr. Sanchez-Pinto co-led an international group of researchers in the Society of Critical Care Medicine Pediatric Sepsis Definition Task Force for the Development and Validation of the new Phoenix Criteria for Pediatric Sepsis and Septic Shock that was featured at the recent 2024 SCCM conference. Support the show

Show notes at pharmacyjoe.com/episode893. In this episode, I’ll discuss adding fludrocortisone to hydrocortisone to treat patients with septic shock. The post 893: Should Fludrocortisone Always Be Added to Hydrocortisone in Patients With Septic Shock? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode893. In this episode, I’ll discuss adding fludrocortisone to hydrocortisone to treat patients with septic shock. The post 893: Should Fludrocortisone Always Be Added to Hydrocortisone in Patients With Septic Shock? appeared first on Pharmacy Joe.

Dr. Casey Clements spent two hours breaking down the history and influences in sepsis care over the past three decades and going through the best practices in today's emergency medicine. Do you know how Sepsis is defined currently? What is the difference between SEP - 1 and surviving sepsis campaign? What is the role of steroids or vitamin C? Can you resuscitate these patients with albumin? These and so many more questions will be answered in this two part series. So join Venk like vancomycin, and Alex (aka Zosyn) and Casey "not-cidal" Clements in these amazing episodes.   CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS SOFA Score: Vincent JL, MOreno R, Takala J, et al. The SOFA (Sepsis-related organ failure assessment) score to describe organ dysfunction / failure. On Behalf of the working group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996 Jul;22(7):707-10 Vincent JL, de Mendonca A, Cantraine F, et al. Use of the SOFA score to assess the incidence of organ dysfunction / failure in intensive care units: results of a multicenter, prospective study. Working group on ‘sepsis-related problems' of the European Society of Intensive Care Medicine. Crit Care Med. 1998;26(11):1793-1800 Ferreira FL, Bota DP, Bross A, Merlot C, Vincent JL. Serial evaluation of the SOFA score to predict outcomes in critically ill patients. JAMA. 2001 Oct 10;286(14):1754-8 Cardenas-Turanzas M, Ensor J, Wakefield C, Zhang K, Wallace SK, Price KJ, Nates JL. Cross-validation of a sequential organ failure assessment score-based model to predict mortality in patients with cancer admitted to the intensive care unit. J Crit Care. 2012 Dec;27(6):673-80 qSOFA score Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):762-774 Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a new definition and assessing new clinical criteria for septic shock: For the Third International Consensus Definitions for Sepsis and SEptic Shock (Sepsis-3). JAMA. 2016;315(8):775-787 Freund Y, Lemachatti N, Krastinova E, et al. Prognostic accuracy of Sepsis-3 Criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department. JAMA. 2017;317(3):301-308 Raith EP, Udy AA, Bailey M, et al. Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA. 2017;317(3):290-300 Comparing Prognostic scores Henning DJ, Puskarich MA, Self WH, Howell MD, Donnino MW, Yealy DM, Jones AE, Shapiro NI. An Emergency Department validation of the SEP-3 Sepsis and Septic Shock definitions and comparison with 1992 consensus definitions. Ann Emerg Med. 2017 Oct;70(4):544-552 IDSA concern Rhee C, Chiotos K, Cosgrove SE, Heil EL, Kadri SS, Kalil AC, Gilbert DN, Masur H, Septimus EJ, Sweeney DA, Strich JR, Winslow DL, Klompas M. Infectious diseases society of america position paper: Recommended revisions to the National Severe Sepsis and Septic Shock early management bundle (SEP-1) Sepsis Quality Measure. Clin Infect Dis. 2021 Feb 16;72(4):541-552 About Barcelona Declaration Slade E, Tamber PS, Vincent JL. The Surviving Sepsis Campaign: raising awareness to reduce mortality. Crit Care. 2003;7:1-2 1- hour surviving sepsis bundle guidance Freund Y, Khoury A, Mockel M, et al. European Society of Emergency Medicine position paper on the 1-hour sepsis bundle of the Surviving Sepsis Campaign: expression of concern. Eur J Emerg Med. 2019 Aug;26(4):232-233 Early Goal Directed Therapy Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. NEJM. 2001 Nov 8;345(19):1368-77 SEP - 1 Quality Measure National Quality Forum Measure submission and evaluation worksheet 5.0 for NQF #0500 Severe Sepsis and Septic Shock: Management Bundle, last updated Date: Oct 05, 2012. Website link Accessed 01-31-2024: https://www.qualityforum.org/Projects/i-m/Infectious_Disease_Endorsement_Maintenance_2012/0500.aspx  National Quality Forum: NQF Revises Sepsis Measure. Website link accessed 01-31-2024: https://www.qualityforum.org/NQF_Revises_Sepsis_Measure.aspx  Faust JS, Weingart SD. The Past, Present, and Future of the Centers for Medicare and Medicaid Services Quality Measure SEP-1 - the early management bundle for severe sepsis / septic shock. Emerg Med Clin N Am. 2017; 35:219-231 Affordable care act Patient Protection and Affordable Care Act, Public Law 148, U.S. Statutes at Large 124 (2010):119-1024. Website link accessed 01-31-2024: https://www.govinfo.gov/app/details/STATUTE-124/STATUTE-124-Pg119/summary.  Fluids for sepsis in concerning populations Pence M, Tran QK, Shesser R, Payette C, Pourmand A. Outcomes of CMS-mandated fluid administration among fluid-overloaded patients with sepsis: A systematic review and meta-analysis. Am J Emerg Med. 2022 May:55:157-166 Zadeh AV, Wong A, Crawford AC, Collado E, Larned JM. Guideline-based and restricted fluid resuscitation strategy in sepsis patients with heart failure: A systematic review and meta-analysis. Am J Emerg Med. 2023 Nov:73:34-39   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs  

La Sociedad de Medicina de Cuidado Crítico (Society for Critical Care Medicine, o SCCM) publicó en la revista JAMA la actualización a la definición de sepsis pediátrica en pacientes menores de 18 años. La revisión del 2016 que dio paso a la 3era definición por consenso solo aplicó a pacientes adultos. En este otro episodio del ECCpodcast discuto la definición de sepsis en pacientes adultos. Como especie, nuestra fisiología no ha evolucionado. Lo que ha evolucionado es nuestro entendimiento de la condición y por ende la forma en que definimos qué es sepsis. Definición Sepsis 3.0 del 2016 Sepsis no es solamente una infección severa. Sepsis es fallo orgánico asociado a una infección, debido a una respuesta anormal del cuerpo a la infección. Para definir el fallo orgánico, se utilizó la puntuación SOFA (Sequential Organ Failure Assessment) (también llamado Sepsis-Related Organ Failure Assessment y Systemic Organ Failure Assessment). Shock séptico fue definido como un paciente con que requiere vasopresores para mantener una presión arterial media de 65 mmHg y lactato mayor de 2 mmol/L. Debido a que la definición incluye números que aplican solamente a adultos, es necesario definirlos en el contexto de pacientes pediátricos. Debido a que la definición de Sepsis 3.0 aplica solamente a los pacientes adultos, la definición operante de sepsis pedíátrica incluía (hasta ahora) los criterios del síndrome de respuesta inflamatoria sistémica (SIRS por sus siglas en inglés). Ya sabemos, de la definición de Sepsis 3.0, que los criterios de SIRS tienen serias limitaciones a la hora de definir sepsis. No significa que no sea útiles como signos de alerta de que un paciente pudiera requerir atención médica de emergencia, pero no necesariamente están asociados a resultados adversos en pacientes pediátricos. Por lo tanto, desde que se publicó la definición de Sepsis 3.0 en el 2016 estamos esperando la definición de sepsis pediátrica. Poder hacer esto requiere el mismo rigor científico que para la contraparte adulta, pero al fin se completó y aquí lo tenemos. Conceptualmente hablando, sepsis en adultos y pediátricos es muy parecido. De hecho, desde el 2016, muchos estamos usando el fallo orgánico en el marco de referirnos a alguien con sepsis indistintamente de la edad. La razón es simple: el concepto de sepsis es que sepsis no es solamente la respuesta normal a una infección, sino una respuesta anormal que está causando una amenaza a la vida. El hecho de que el paciente tenga un fallo orgánico distal al punto de la infección original refleja la naturaleza sistémica del proceso que lleva a la sepsis. ¿Los niños son adultos pequeños? Obviamente hay diferencias entre los adultos y pediátricos: Signos vitales normales varían según la edad. Sistema inmune varía según la edad Comorbilidades son diferentes Así es que cuando se define la condición en pacientes pediátricos hay que utilizar números diferentes. Los números de la puntuación SOFA no aplican a los pediátricos. By Dr. Julio Javier Gamazo del RioServicio de Urgencias. Hospital Universitario de GaldakaoDr. Jesús Álvarez ManzanaresServicio de Urgencias. Hospital Universitario Río HortegaDr. Juan González del CastilloServicio de Urgencias. Hospital Universitario Clínico San Carlos - http://semes.org/sites/default/files/archivos/Los-Nuevos-Criterios-De-Sepsis.pdf, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=54877568 Puntuación de Sepsis Pediátrica de Phoenix En pacientes con infección, se define sepsis pediátrica cuando el paciente pediátrico tiene al menos 2 puntos en la Escala de Sepsis Pediátrica de Phoenix, que consiste en un agregado de fallo cardiovascular, respiratorio, neurológico y de coagulación. Es importante señalar que esta escala sirve en pacientes con una infección sospechada o confirmada. No es una escala que se puede utilizar en otro contexto que no sea la evaluación de un paciente pediátrico con infección. JAMA. Published online  January 21, 2024. doi:10.1001/jama.2024.0179 Aplica a pacientes de 18 años o menos, pero no aplica a recién nacidos, o neonatos que hayan nacido menores de 37 semanas de gestación. Toda recomendación hecha en base a evidencia obtenida de pacientes adultos tiene que ser investigada en una población pediátrica antes de concluir que es aplicable. Shock séptico = sepsis + disfunción cardiovascular La disfunción cardiovascular se puede medir funcionalmente como un paciente con al menos 1 punto en los criterios cardiovasculares. Es decir, un paciente pediátrico que tenga criterios de sepsis (2 puntos o más en la Escala de Sepsis Pediátrica) de los cuales al menos 1 punto provenga de los criterios cardiovasculares: Hipotensión severa para la edad Lactato > 5 mmol/L Uso de medicamentos vasoactivos Poniéndolo todo junto JAMA. Published online  January 21, 2024. doi:10.1001/jama.2024.0179 Generalizabilidad El artículo de la nueva definición detalla la sensibilidad de la nueva definición en contextos de altos recursos versus bajos recursos. Es decir, la nueva definición de sepsis pediátrica es más fácil de medir en lugares de bajos recursos en comparación a la puntuación SOFA para adultos. La Puntuación de Sepsis de Phoenix incluye criterios como la disfunción de la coagulación que pudieran no estar disponibles fácilmente en escenarios de bajos recursos, pero los autores concluyen que existe suficiente redundancia con los demás criterios para mantener una sensibilidad adecuada. La Escala de Sepsis Pediátrica de Phoenix utiliza evalúa solamente 4 órganos. Sin embargo, existe otra variante que es la Escala Phoenix-8 que evalúa otros órganos. Estas evaluaciones adicionales pudieran no estar disponibles en lugares de bajos recursos, pero no deja de ser criterios adicionales a considerar al evaluar pacientes que requieran algún apoyo multisistémico. Para más información sobre la validación de los Criterios de Sepsis Pediátrica de Phoenix, vea este otro artículo publicado simultáneamente a la nueva definición. Limitación La Puntuación de Sepsis Pediátrica de Phoenix es una forma de definir que el paciente ya tiene sepsis. No es una herramienta para identificar el paciente en riesgo de desarrollar sepsis. Entonces, es importante recordar que solamente porque un paciente NO cumpla con los criterios de la Puntuación de Sepsis de Phoenix no significa que no requiere atención agresiva a la infección. Referencias Sanchez-Pinto LN, Bennett TD, DeWitt PE, et al. Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. JAMA. Published online January 21, 2024. doi:10.1001/jama.2024.0196 Schlapbach LJ, Watson RS, Sorce LR, et al. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA. Published online January 21, 2024. doi:10.1001/jama.2024.0179

In this episode, Adyn, Dr. Nathan Freeman, and Will discuss some of the biggest aspects of pediatric sepsis, and specifically early identification and management of septic shock. Everything from basic recognition of sick to pressors of choice and standard dosing is discussed by the three. Early identification and management is key to improving the morbidity, mortality and length of stay of some of these challenging patients.   As always if you have any question or want to give feedback to our team, please contact us at mceseducation@umc.edu

Miracles happen every day, and when your last name is quite literally Miracle, you have to believe it! As author and speaker Gary Miracle describes it, his life caught up to his name in 2020 when an infection nearly killed him after going into septic shock and caused him to lose his arms and legs. His incredible story reached the world when the Grammy-nominated Christian band “MercyMe” shared it through their music video “Say I Won't.” Now Gary sits down with Nine-time Emmy winner David Sams to chat about his personal story of survival, relationship with lead singer Bart Millard, and new outlook on life. Gary's book, “No More Bad Days” is an inspiration for anyone who has experienced loss or trauma. #GaryMiracleSpeaks #MercyMe #NoMoreBadDays #SayIWont #DavidSams #KeepTheFaith #ContagiousInfluencer

Alyssa Nilsen shares how what started as a perfect delivery of her baby girl, turned into a body infection where her heart started failing. She talks about what it was like to have to say goodbye to her newborn in the hospital and be life-flighted to another hospital. She was told that she most likely wouldn't survive the surgery that they needed to do. She woke up the next week to a hysterectomy, a thick scar on her abdomen, pneumonia, and more pain from the events her body had gone through. We talk about what her recovery journey has been like with not only physical therapy, but checking on her mental health. Alyssa has a podcast with her husband as well called "Love, The Nilsen's." She talks about how her family gave her strength to endure this big trial. Alyssa and her husband's Podcast https://podcasts.apple.com/us/podcast/love-the-nilsens/id1633716693

Hailey Thompson, PharmD shares SHOCKing updates on the use of corticosteroids in septic shock. For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes. You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Show notes at pharmacyjoe.com/episode855. In this episode, I’ll discuss the effect of phenylephrine push prior to continuous infusion norepinephrine in patients with septic shock. The post 855: Effect of phenylephrine push prior to continuous infusion norepinephrine in patients with septic shock appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode855. In this episode, I’ll discuss the effect of phenylephrine push prior to continuous infusion norepinephrine in patients with septic shock. The post 855: Effect of phenylephrine push prior to continuous infusion norepinephrine in patients with septic shock appeared first on Pharmacy Joe.

September is Sepsis Awareness Month, so host Sarah Lorenzini is throwing it back to one of the earliest Rapid Response RN podcast episodes with guest Yesha APRN. This episode tells the story of a patient with sepsis, and it's one of Sarah's favorite episodes because it exemplifies all of the classic signs and symptoms of sepsis as well as the important role the nurse plays in caring for septic patients.Last week, you learned about fluid resuscitation and the potential harm of fluid overload in the treatment of sepsis. In this episode, you'll hear how Sarah and Yesha's patient responded to fluid boluses and what made them advocate for a different treatment approach.Sarah then goes deeper into the pathophysiology of sepsis, indicators of sepsis using SIRS criteria and the qSOFA score, and more indicators any nurse can test without a tool. You'll also find out how to treat a patient with sepsis, which diagnostics to run, and what you can do to promote a return to homeostasis in your patient.Tune in to learn the signs and symptoms of sepsis and septic shock, and how to facilitate early detection. Plus, hear Yesha's takeaways from this patient story that will benefit all nurses in their treatment of sepsis!Topics discussed in this episode:Yesha's nursing journey and updates on her careerHow Yesha's patient presented and his response to fluid administrationWhat made her decide to call a rapid response nurse, SarahSarah's assessment of the patient and how they treated himThe pathophysiology of sepsisSIRS criteria and qSOFA score for prediction of sepsisWhat happens in the “septic inflammatory cascade of awfulness”How to detect sepsis earlyTreatment and management of a sepsis patientRead the article, “Fluid selection & pH-guided fluid resuscitation” by Dr. Josh Farkas, here:https://emcrit.org/ibcc/fluid/Mentioned in this episode:AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course! Rapid Response and Rescue Intro CourseIf you would like to check out Sarah's 1hr, 1 CE course, go to: http://www.rapidresponseandrescue.com To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

On this month's EM Quick Hits podcast: Anand Swaminathan on the role of methylene blue in septic shock, Nour Khatib on jaw dislocation reduction techniques, Hans Rosenberg on a phenotypic approach to Crohn's disease emergencies, Gil Yehudaiff on evidence based analgesics in renal colic, Brit Long on the importance of inhaled steroids for asthma, and Andrew Petrosoniak on the "lethal diamond" in polytrauma patients and the current state of hypocalcemia in bleeding trauma patients... The post EM Quick Hits 51 – Methylene Blue in Septic Shock, TMJ Dislocation, Crohn's Disease, Analgesia for Renal Colic, Inhaled Steroids for Asthma, Hypocalcemia in Bleeding Trauma Patients appeared first on Emergency Medicine Cases.