Delayed lactate measurement is associated with delayed antibiotic administration and increased mortality in patients with increased lactate levels.
Although the Systemic Inflammatory Response Syndrome criteria have been used for decades to identify sepsis in patients with suspected infection, they have been re-evaluated in the Third International Consensus Definitions for Sepsis and Septic Shock.
Early antibiotic administration in treating infection has evident biological plausibility, however, time-sensitivity to outcomes appears to be most relevant in septic shock.
Study demonstrated a new approach to incorporate time ("delay") when analyzing the effect on outcomes and provided new evidence for clinical practice and research of severe sepsis or septic shock.
Researchers evaluated the prognostic significance of the cutoff value for lactate via comparison of clinical presentation and outcome between patients with septic shock with high and low lactate levels.
In patients with insulin-treated diabetes and sepsis, increased highest glucose levels and glycemic variability have a significant illness severity-adjusted association with decreasing in-hospital mortality.
In this study involving patients with septic shock, 90-day all-cause mortality was lower in patients who received hydrocortisone plus fludrocortisone than in patients who received placebo.
Patients with septic shock in the intensive care unit undergoing mechanical ventilation receiving hydrocortisone plus fludrocortisone had a lower 90-day all-cause mortality compared to placebo treated patients.
Patients with septic shock in the intensive care unit (ICU) undergoing mechanical ventilation and managed with adjunctive continuous hydrocortisone infusion, did not have a lower 90-day mortality compared to placebo.
Induced hypothermia (target temperature 32°C-34°C) proved harmful with regards to respiratory function and it also prolonged septic shock.
Adjunctive glucocorticoid therapy in patients with septic shock may reduce the duration of shock.
Stanford T. Shulman, MD, editorial advisory board member for Infectious Disease Advisor, outlines reasons why IDSA elected not to endorse the 2016 Surviving Sepsis Campaign Guidelines.
Asthma patients with infections have a reduced risk of developing sepsis.
A patient who recently acquired a new tattoo developed Vibrio vulnificus septic shock after swimming in seawater, leading to death.
Three multicenter trials (ProCESS, ARISE, and ProMISe) showed that EGDT did not reduce mortality in patients presenting to the emergency department with septic shock when compared to usual care.
Hospitals see higher rate of in-hospital mortality from septic shock after norepinephrine shortage.
Researchers did not observe a significant improvement with hydrocortisone over placebo for time until septic shock or mortality.
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