The sepsis 3 guidelines recommended the use of the Sepsis Related Organ Failure Assessment (SOFA) score for early identification of sepsis in adults (Singer 2016, PMID: 26903338). An abbreviated version of SOFA (Quick SOFA or qSOFA) includes variables available at the bedside in the ED (systolic BP,
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Tagged ‘Critical Care’
Journal Review
Accuracy of the Age-Adjusted Quick SOFA Score in Children
Journal Review
Delayed Fluid Resuscitation for Hypotensive Patients with Penetrating Torso Injuries
Prior to this study, the preoperative approach to hypotensive patients with trauma included prompt intravenous infusion of isotonic fluids – the rationale being to sustain tissue perfusion and vital organ function while diagnostic and therapeutic procedures were underway.
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Journal Review
Balanced Solutions vs 0.9% Saline in Critical Care (SMART)
Although 0.9% sodium chloride (“normal” saline) is traditionally the most commonly used intravenous fluid, it is unclear if “normal” saline is the best fluid. Data from prior studies suggests 0.9% saline use may result in hyperchloremic acidosis.
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Journal Review
ADRENAL – Corticosteroids in Septic Shock
During physiological stress, hypotension, or severe infection, the hypothalamic-pituitary-adrenal (HPA) axis is activated. The hypothalamus secretes corticotrophin-releasing hormone (CRH) stimulating the release of adrenocorticotrophin hormone (ACTH) from the anterior pituitary.
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Core
Petition to Retire the Surviving Sepsis Campaign Guidelines
This post is a multi-physician, multi-specialty petition detailing significant concerns with the surviving sepsis campaign guidelines.
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Journal Review
Apneic Oxygenation in the ICU
Hypoxemia is the most common complication of endotracheal intubation in the critically ill and the strongest risk factor for periprocedural cardiac arrest and death. The traditional approach to avoiding desaturation during intubation is preoxygenation.
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Core
Acute Pancreatitis
This post explores the diagnosis and critical steps in the management of pancreatitis.
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