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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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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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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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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This post is a multi-physician, multi-specialty petition detailing significant concerns with the surviving sepsis campaign guidelines.
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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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This post explores the diagnosis and critical steps in the management of pancreatitis.
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