Shock index and early recognition of sepsis in the emergency department: pilot study.

Introduction: Screening for severe sepsis in adult emergency department (ED) patients may involve potential delays while waiting for laboratory testing, leading to postponed identification or over-utilization of resources. The systemic inflammatory response syndrome (SIRS) criteria are inaccurate at predicting clinical outcomes in sepsis. Shock index (SI), defined as heart rate / systolic blood pressure, has previously been shown to identify high risk septic patients.

Hyperlactatemia affects the association of hyperglycemia with mortality in nondiabetic adults with sepsis.

Background: Admission hyperglycemia has been reported as a mortality risk factor for septic nondiabetic patients; however, hyperglycemia's known association with hyperlactatemia was not addressed in these analyses.

Objectives: The objective was to determine whether the association of hyperglycemia with mortality remains significant when adjusted for concurrent hyperlactatemia.

Methods: This was a post hoc, nested analysis of a retrospective cohort study performed at a single center.

Acute superior vena cava syndrome after rupture of Kommerell's diverticulum: a case report.

Kommerell's diverticulum, a rare congenital aortic anomaly, is dilatation at the region in which an aberrant subclavian artery branches from either a left-sided or right-sided thoracic aorta. We report a rare case of acute superior vena cava syndrome that developed in a young healthy male patient who presented to the emergency department in imminent respiratory arrest after rupture of this diverticulum.

Impact of metformin use on the prognostic value of lactate in sepsis.

Objective: The objective of this study is to determine if metformin use affects the prevalence and prognostic value of hyperlactatemia to predict mortality in septic adult emergency department (ED) patients.

Methods: This is a single-center retrospective cohort study. Emergency department providers identified study subjects; data were collected from the medical record.