collection
https://read.qxmd.com/read/29490185/hydrocortisone-plus-fludrocortisone-for-adults-with-septic-shock
#1
RANDOMIZED CONTROLLED TRIAL
Djillali Annane, Alain Renault, Christian Brun-Buisson, Bruno Megarbane, Jean-Pierre Quenot, Shidasp Siami, Alain Cariou, Xavier Forceville, Carole Schwebel, Claude Martin, Jean-François Timsit, Benoît Misset, Mohamed Ali Benali, Gwenhael Colin, Bertrand Souweine, Karim Asehnoune, Emmanuelle Mercier, Loïc Chimot, Claire Charpentier, Bruno François, Thierry Boulain, Franck Petitpas, Jean-Michel Constantin, Gilles Dhonneur, François Baudin, Alain Combes, Julien Bohé, Jean-François Loriferne, Roland Amathieu, Fabrice Cook, Michel Slama, Olivier Leroy, Gilles Capellier, Auguste Dargent, Tarik Hissem, Virginie Maxime, Eric Bellissant
BACKGROUND: Septic shock is characterized by dysregulation of the host response to infection, with circulatory, cellular, and metabolic abnormalities. We hypothesized that therapy with hydrocortisone plus fludrocortisone or with drotrecogin alfa (activated), which can modulate the host response, would improve the clinical outcomes of patients with septic shock. METHODS: In this multicenter, double-blind, randomized trial with a 2-by-2 factorial design, we evaluated the effect of hydrocortisone-plus-fludrocortisone therapy, drotrecogin alfa (activated), the combination of the three drugs, or their respective placebos...
March 1, 2018: New England Journal of Medicine
https://read.qxmd.com/read/31348056/reversal-of-vasodilatory-shock-current-perspectives-on-conventional-rescue-and-emerging-vasoactive-agents-for-the-treatment-of-shock
#2
REVIEW
Jonathan H Chow, Ezeldeen Abuelkasem, Susan Sankova, Reney A Henderson, Michael A Mazzeffi, Kenichi A Tanaka
Understanding the different mechanisms of vasoconstrictors is crucial to their optimal application to clinically diverse shock states. We present a comprehensive review of conventional, rescue, and novel vasoactive agents including their pharmacology and evidence supporting their use in vasodilatory shock. The role of each drug in relation to the Surviving Sepsis Guidelines is discussed to provide a context of how each one fits into the algorithm for treating vasodilatory shock. Rescue agents can be utilized when conventional medications fail, although there are varying levels of evidence on their clinical effectiveness...
January 2020: Anesthesia and Analgesia
https://read.qxmd.com/read/31166204/inotropes-and-vasopressors-use-in-cardiogenic-shock-when-which-and-how-much
#3
REVIEW
Bruno Levy, Julie Buzon, Antoine Kimmoun
PURPOSE OF REVIEW: Data and interventional trials regarding vasopressor and inotrope use during cardiogenic shock are scarce. Their use is limited by their side-effects and the lack of solid evidence regarding their effectiveness in improving outcomes. In this article, we review the current use of vasopressor and inotrope agents during cardiogenic shock. RECENT FINDINGS: Two recent Cochrane analyses concluded that there was not sufficient evidence to prove that any one vasopressor or inotrope was superior to another in terms of mortality...
August 2019: Current Opinion in Critical Care
https://read.qxmd.com/read/30935893/reconsidering-vasopressors-for-cardiogenic-shock-everything-should-be-made-as-simple-as-possible-but-not-simpler
#4
REVIEW
Pierre Squara, Steven Hollenberg, Didier Payen
Scientific statements and publications have recommended the use of vasoconstrictors as the first-line pharmacologic choice for most cases of cardiogenic shock (CS), without the abundance of strong clinical evidence. One challenge of guidelines is that the way recommendations are stated can potentially lead to oversimplification of complex situations. Except for acute coronary syndrome with CS, in which maintenance of coronary perfusion pressure seems logical prior to revascularization, physiologic consequences of increasing afterload by use of vasoconstrictors should be analyzed...
August 2019: Chest
https://read.qxmd.com/read/24635770/high-versus-low-blood-pressure-target-in-patients-with-septic-shock
#5
RANDOMIZED CONTROLLED TRIAL
Pierre Asfar, Ferhat Meziani, Jean-François Hamel, Fabien Grelon, Bruno Megarbane, Nadia Anguel, Jean-Paul Mira, Pierre-François Dequin, Soizic Gergaud, Nicolas Weiss, François Legay, Yves Le Tulzo, Marie Conrad, René Robert, Frédéric Gonzalez, Christophe Guitton, Fabienne Tamion, Jean-Marie Tonnelier, Pierre Guezennec, Thierry Van Der Linden, Antoine Vieillard-Baron, Eric Mariotte, Gaël Pradel, Olivier Lesieur, Jean-Damien Ricard, Fabien Hervé, Damien du Cheyron, Claude Guerin, Alain Mercat, Jean-Louis Teboul, Peter Radermacher
BACKGROUND: The Surviving Sepsis Campaign recommends targeting a mean arterial pressure of at least 65 mm Hg during initial resuscitation of patients with septic shock. However, whether this blood-pressure target is more or less effective than a higher target is unknown. METHODS: In a multicenter, open-label trial, we randomly assigned 776 patients with septic shock to undergo resuscitation with a mean arterial pressure target of either 80 to 85 mm Hg (high-target group) or 65 to 70 mm Hg (low-target group)...
April 24, 2014: New England Journal of Medicine
https://read.qxmd.com/read/25277635/early-versus-delayed-administration-of-norepinephrine-in-patients-with-septic-shock
#6
JOURNAL ARTICLE
Xiaowu Bai, Wenkui Yu, Wu Ji, Zhiliang Lin, Shanjun Tan, Kaipeng Duan, Yi Dong, Lin Xu, Ning Li
INTRODUCTION: This study investigated the incidence of delayed norepinephrine administration following the onset of septic shock and its effect on hospital mortality. METHODS: We conducted a retrospective cohort study using data from 213 adult septic shock patients treated at two general surgical intensive care units of a tertiary care hospital over a two year period. The primary outcome was 28-day mortality. RESULTS: The 28-day mortality was 37...
October 3, 2014: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/29110979/complications-from-administration-of-vasopressors-through-peripheral-venous-catheters-an-observational-study
#7
JOURNAL ARTICLE
Kamal Medlej, Amin Antoine Kazzi, Ahel El Hajj Chehade, Mothana Saad Eldine, Ali Chami, Rana Bachir, Dina Zebian, Gilbert Abou Dagher
BACKGROUND: The placement of a central venous catheter for the administration of vasopressors is still recommended and required by many institutions because of concern about complications associated with peripheral administration of vasopressors. OBJECTIVE: Our aim was to determine the incidence of complications from the administration of vasopressors through peripheral venous catheters (PVC) in patients with circulatory shock, and to identify the factors associated with these complications...
January 2018: Journal of Emergency Medicine
https://read.qxmd.com/read/30585692/corticosteroids-for-treating-pneumonia
#8
JOURNAL ARTICLE
Peter Tepler, Shahriar Zehtabchi
No abstract text is available yet for this article.
April 2019: Academic Emergency Medicine
https://read.qxmd.com/read/30343957/intravenous-sodium-bicarbonate-in-treating-patients-with-severe-metabolic-acidemia
#9
EDITORIAL
Jeffrey A Kraut, Nicolaos E Madias
No abstract text is available yet for this article.
April 2019: American Journal of Kidney Diseases
https://read.qxmd.com/read/30267448/venous-thrombosis-in-unusual-sites-a-practical-review-for-the-hematologist
#10
REVIEW
Joseph J Shatzel, Matthew O'Donnell, Sven R Olson, Matthew R Kearney, Molly M Daughety, Justine Hum, Khanh P Nguyen, Thomas G DeLoughery
Thrombosis of unusual venous sites encompasses a large part of consultative hematology and is encountered routinely by practicing hematologists. Contrary to the more commonly encountered lower extremity venous thrombosis and common cardiovascular disorders, the various thromboses outlined in this review have unique presentations, pathophysiology, workup, and treatments that all hematologists should be aware of. This review attempts to outline the most up to date literature on cerebral, retinal, upper extremity, hepatic, portal, splenic, mesenteric, and renal vein thrombosis, focusing on the incidence, pathophysiology, provoking factors, and current recommended treatments for each type of unusual thrombosis to provide a useful and practical review for the hematologist...
January 2019: European Journal of Haematology
https://read.qxmd.com/read/19318384/intensive-versus-conventional-glucose-control-in-critically-ill-patients
#11
RANDOMIZED CONTROLLED TRIAL
Simon Finfer, Dean R Chittock, Steve Yu-Shuo Su, Deborah Blair, Denise Foster, Vinay Dhingra, Rinaldo Bellomo, Deborah Cook, Peter Dodek, William R Henderson, Paul C Hébert, Stephane Heritier, Daren K Heyland, Colin McArthur, Ellen McDonald, Imogen Mitchell, John A Myburgh, Robyn Norton, Julie Potter, Bruce G Robinson, Juan J Ronco
BACKGROUND: The optimal target range for blood glucose in critically ill patients remains unclear. METHODS: Within 24 hours after admission to an intensive care unit (ICU), adults who were expected to require treatment in the ICU on 3 or more consecutive days were randomly assigned to undergo either intensive glucose control, with a target blood glucose range of 81 to 108 mg per deciliter (4.5 to 6.0 mmol per liter), or conventional glucose control, with a target of 180 mg or less per deciliter (10...
March 26, 2009: New England Journal of Medicine
https://read.qxmd.com/read/30111341/effect-of-procalcitonin-guided-antibiotic-treatment-on-clinical-outcomes-in-intensive-care-unit-patients-with-infection-and-sepsis-patients-a-patient-level-meta-analysis-of-randomized-trials
#12
JOURNAL ARTICLE
Yannick Wirz, Marc A Meier, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Stefan Schroeder, Vandack Nobre, Djillali Annane, Konrad Reinhart, Pierre Damas, Maarten Nijsten, Arezoo Shajiei, Dylan W deLange, Rodrigo O Deliberato, Carolina F Oliveira, Yahya Shehabi, Jos A H van Oers, Albertus Beishuizen, Armand R J Girbes, Evelien de Jong, Beat Mueller, Philipp Schuetz
BACKGROUND: The clinical utility of serum procalcitonin levels in guiding antibiotic treatment decisions in patients with sepsis remains unclear. This patient-level meta-analysis based on 11 randomized trials investigates the impact of procalcitonin-guided antibiotic therapy on mortality in intensive care unit (ICU) patients with infection, both overall and stratified according to sepsis definition, severity, and type of infection. METHODS: For this meta-analysis focusing on procalcitonin-guided antibiotic management in critically ill patients with sepsis of any type, in February 2018 we updated the database of a previous individual patient data meta-analysis which was limited to patients with respiratory infections only...
August 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/26129881/direct-comparison-of-the-diagnostic-accuracy-between-blood-and-cerebrospinal-fluid-procalcitonin-levels-in-patients-with-meningitis
#13
COMPARATIVE STUDY
Hong-Yuan Shen, Wei Gao, Juan-Juan Cheng, Shi-Di Zhao, Yi Sun, Zhi-Jun Han, Jun Hua
OBJECTIVE: To compare the clinical utility of serum and cerebrospinal fluid (CSF) procalcitonin (PCT) for the diagnosis of bacterial meningitis (BM) among patients with suspected meningitis. METHODS: Patients with meningitis-like symptoms (n=120), admitted to the Second People's Hospital of Wuxi or the Changhai Hospital of Shanghai between January 2011 and December 2013, were prospectively and consecutively enrolled in this study. BM was finally diagnosed by CSF culture, Gram staining, quantitative polymerase chain reaction (qPCR), and treatment response...
November 2015: Clinical Biochemistry
https://read.qxmd.com/read/30113379/clinical-practice-guidelines-for-the-prevention-and-management-of-pain-agitation-sedation-delirium-immobility-and-sleep-disruption-in-adult-patients-in-the-icu
#14
JOURNAL ARTICLE
John W Devlin, Yoanna Skrobik, Céline Gélinas, Dale M Needham, Arjen J C Slooter, Pratik P Pandharipande, Paula L Watson, Gerald L Weinhouse, Mark E Nunnally, Bram Rochwerg, Michele C Balas, Mark van den Boogaard, Karen J Bosma, Nathaniel E Brummel, Gerald Chanques, Linda Denehy, Xavier Drouot, Gilles L Fraser, Jocelyn E Harris, Aaron M Joffe, Michelle E Kho, John P Kress, Julie A Lanphere, Sharon McKinley, Karin J Neufeld, Margaret A Pisani, Jean-Francois Payen, Brenda T Pun, Kathleen A Puntillo, Richard R Riker, Bryce R H Robinson, Yahya Shehabi, Paul M Szumita, Chris Winkelman, John E Centofanti, Carrie Price, Sina Nikayin, Cheryl J Misak, Pamela D Flood, Ken Kiedrowski, Waleed Alhazzani
OBJECTIVE: To update and expand the 2013 Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the ICU. DESIGN: Thirty-two international experts, four methodologists, and four critical illness survivors met virtually at least monthly. All section groups gathered face-to-face at annual Society of Critical Care Medicine congresses; virtual connections included those unable to attend. A formal conflict of interest policy was developed a priori and enforced throughout the process...
September 2018: Critical Care Medicine
https://read.qxmd.com/read/29910040/sodium-bicarbonate-therapy-for-patients-with-severe-metabolic-acidaemia-in-the-intensive-care-unit-bicar-icu-a-multicentre-open-label-randomised-controlled-phase-3-trial
#15
MULTICENTER STUDY
Samir Jaber, Catherine Paugam, Emmanuel Futier, Jean-Yves Lefrant, Sigismond Lasocki, Thomas Lescot, Julien Pottecher, Alexandre Demoule, Martine Ferrandière, Karim Asehnoune, Jean Dellamonica, Lionel Velly, Paër-Sélim Abback, Audrey de Jong, Vincent Brunot, Fouad Belafia, Antoine Roquilly, Gérald Chanques, Laurent Muller, Jean-Michel Constantin, Helena Bertet, Kada Klouche, Nicolas Molinari, Boris Jung
BACKGROUND: Acute acidaemia is frequently observed during critical illness. Sodium bicarbonate infusion for the treatment of severe metabolic acidaemia is a possible treatment option but remains controversial, as no studies to date have examined its effect on clinical outcomes. Therefore, we aimed to evaluate whether sodium bicarbonate infusion would improve these outcomes in critically ill patients. METHODS: We did a multicentre, open-label, randomised controlled, phase 3 trial...
July 7, 2018: Lancet
https://read.qxmd.com/read/30060896/are-patients-receiving-the-combination-of-vancomycin-and-piperacillin-tazobactam-at-higher-risk-for-acute-renal-injury
#16
EDITORIAL
Brit Long, Michael D April
No abstract text is available yet for this article.
October 2018: Annals of Emergency Medicine
https://read.qxmd.com/read/29271844/efficacy-and-safety-of-procalcitonin-guidance-in-patients-with-suspected-or-confirmed-sepsis-a-systematic-review-and-meta-analysis
#17
JOURNAL ARTICLE
Irena Iankova, Philippe Thompson-Leduc, Noam Y Kirson, Bernie Rice, Juliane Hey, Alexander Krause, Sophie A Schonfeld, Christopher R DeBrase, Samuel Bozzette, Philipp Schuetz
OBJECTIVE: Sepsis is a leading cause of mortality in noncoronary ICUs. Although immediate start of antibiotics reduces sepsis-related mortality, antibiotics are often administered for too long, leading to suboptimal treatment and, importantly, contributes to antimicrobial resistance. Prior literature suggests that procalcitonin correlates with infection and thus may help to guide the decision on when to stop antibiotic treatment. This study was conducted as part of a regulatory submission to the U...
May 2018: Critical Care Medicine
https://read.qxmd.com/read/28114931/procalcitonin-guided-diagnosis-and-antibiotic-stewardship-revisited
#18
REVIEW
Ramon Sager, Alexander Kutz, Beat Mueller, Philipp Schuetz
Several controlled clinical studies have evaluated the potential of the infection biomarker procalcitonin (PCT) to improve the diagnostic work-up of patients with bacterial infections and its influence on decisions regarding antibiotic therapy. Most research has focused on lower respiratory tract infections and critically ill sepsis patients. A clinical utility for PCT has also been found for patients with urinary tract infections, postoperative infections, meningitis, and patients with acute heart failure with possible superinfection (i...
January 24, 2017: BMC Medicine
https://read.qxmd.com/read/30025177/low-dose-magnesium-sulfate-versus-high-dose-in-the-early-management-of-rapid-atrial-fibrillation-randomized-controlled-double-blind-study-lomaghi-study
#19
RANDOMIZED CONTROLLED TRIAL
Wahid Bouida, Kaouthar Beltaief, Mohamed Amine Msolli, Noussaiba Azaiez, Houda Ben Soltane, Adel Sekma, Imen Trabelsi, Hamdi Boubaker, Mohamed Habib Grissa, Mehdi Methemem, Riadh Boukef, Zohra Dridi, Asma Belguith, Semir Nouira
OBJECTIVES: We aim to determine the benefit of two different doses magnesium sulfate (MgSO4 ) compared to placebo in rate control of rapid atrial fibrillation (AF) managed in the emergency department (ED). METHODS: We undertook a randomized, controlled, double-blind clinical trial in three university hospital EDs between August 2009 and December 2014. Patients > 18 years with rapid AF (>120 beats/min) were enrolled and randomized to 9 g of intravenous MgSO4 (high-dose group, n = 153), 4...
February 2019: Academic Emergency Medicine
https://read.qxmd.com/read/28779830/role-of-procalcitonin-in-the-management-of-infected-patients-in-the-intensive-care-unit
#20
REVIEW
David N Gilbert
The combination of molecular pathogen diagnostics and the biomarker procalcitonin (PCT) are changing the use of antimicrobials in patients admitted to critical care units with severe community-acquired pneumonia, possible septic shock, or other clinical syndromes. An elevated serum PCT level is good supportive evidence of a bacterial pneumonia, whereas a low serum PCT level virtually eliminates an etiologic role for bacteria even if the culture for a potential bacterial pathogen is positive. Serum PCT levels can be increased in any shocklike state; a low PCT level eliminates invasive bacterial infection as an etiology in more than 90% of patients...
September 2017: Infectious Disease Clinics of North America
label_collection
label_collection
5277
1
2
2018-07-13 19:03:10
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.