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Hydrocortisone plus fludrocortisone for community acquired pneumonia-related septic shock: a subgroup analysis of the APROCCHSS phase 3 randomised trial.
Lancet Respir Med
May 2024
Department of Intensive Care, Raymond Poincaré Hospital, APHP University Versailles Saint Quentin-University Paris Saclay, Garches, France; Institut Hospitalo Universitaire PROMETHEUS, Garches, France; Laboratory of Infection & Inflammation-U1173, School of Medicine, INSERM, University Versailles Saint Quentin-University Paris Saclay, Garches, France; FHU SEPSIS, Garches, France. Electronic address:
Article Synopsis
- The study explores the effectiveness of hydrocortisone and fludrocortisone treatments in patients with septic shock caused by community-acquired pneumonia (CAP) compared to non-CAP cases.
- It includes data from the phase 3 APROCCHSS trial, which initially tested these treatments across multiple centers in France, focusing specifically on how they impact mortality outcomes.
- Results indicate that patients with CAP may respond differently to these treatments, and various mortality rates and recovery metrics were analyzed to determine the overall benefit of the steroid regimen.
Health economic evaluations of sepsis interventions in critically ill adult patients: a systematic review.
J Intensive Care
January 2020
3Centre for Health Economics, Monash University, Melbourne, Victoria Australia.
Background: Sepsis is a global health priority. Interventions to reduce the burden of sepsis need to be both effective and cost-effective. We performed a systematic review of the literature on health economic evaluations of sepsis treatments in critically ill adult patients and summarised the evidence for cost-effectiveness.
View Article and Find Full Text PDFDisseminated Intravascular Coagulation: An Update on Pathogenesis, Diagnosis, and Therapeutic Strategies.
Clin Appl Thromb Hemost
December 2018
Service d'Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique Hoôpitaux de Paris, Paris, France.
Disseminated intravascular coagulation (DIC) is an acquired clinicobiological syndrome characterized by widespread activation of coagulation leading to fibrin deposition in the vasculature, organ dysfunction, consumption of clotting factors and platelets, and life-threatening hemorrhage. Disseminated intravascular coagulation is provoked by several underlying disorders (sepsis, cancer, trauma, and pregnancy complicated with eclampsia or other calamities). Treatment of the underlying disease and elimination of the trigger mechanism are the cornerstone therapeutic approaches.
View Article and Find Full Text PDFMicrovascular monitoring - Do 'global' markers help?
Best Pract Res Clin Anaesthesiol
December 2016
Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium.
The microcirculation is altered in sepsis, and the degree and persistence of these alterations are associated with outcome. When there are significant alterations of the systemic circulation, as in shock, the microcirculation is always altered. However, sometimes global variables can be restored to normal while the microcirculation remains altered.
View Article and Find Full Text PDFTwenty-four hour infusion of human recombinant activated protein C (Xigris) early in severe acute pancreatitis: The XIG-AP 1 trial.
Pancreatology
September 2016
Hepatobiliary Surgical Unit, Manchester Royal Infirmary, Manchester, UK. Electronic address:
Objective: Patients with severe acute pancreatitis were excluded from major trials of human recombinant activated protein C (Xigris) because of concern about pancreatic haemorrhage although these individuals have an intense systemic inflammatory response that may benefit from treatment. The object of this study was to provide initial safety data evaluating Xigris in severe acute pancreatitis.
Design: Prospective clinical trial recruiting between November 2009 and October 2011.
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