Management of Septic Shock

Rebecca E Berger, Emanuel Rivers, Mitchell M Levy
New England Journal of Medicine 2017 June 8, 376 (23): 2282-2285
New England Journal of Medicine, Volume 376, Issue 23, Page 2282-2285, June 2017.


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Tracy Land

What about the use of point of care ultrasound to guide therapy based on real time physiology?


Jon Murphy

So called "elephant in the room" in septic shock is toxin associated vasodilation. Also contributing to reduced oxygen delivery is reduced contractility. Low O2 delivery to reduced O2 utilization to increased lactate levels is how I see it. Best generic antitoxin I know is calcium ascorbate ala the clinical guide and publications of Fred Klenner MD so 250-350mg/kg/day to remove toxins more rapidly restore vasotone and contractility. And cortisol(hydrocortisone) to support adrenal functions during the extreme stress of reduced oxygen utilization.


gao gan

I prefer the EGDT


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