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Effect of methylprednisolone vs hydrocortisone on 30-day mortality in critically ill adults with septic shock: an analysis of the MIMIC-IV database.
BMC Infect Dis
March 2025
Department of Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Background: Methylprednisolone is still used to treat adults with septic shock in real-world clinical settings, despite current international guidelines recommending hydrocortisone. The aim of this study was to assess the effect of methylprednisolone vs hydrocortisone on 30-day mortality among critically ill patients with septic shock.
Methods: We conducted a retrospective cohort study on adults with septic shock using the MIMIC-IV v3.
Copeptin Levels During Cardiac Surgery.
J Cardiothorac Vasc Anesth
February 2025
Department of Cardiothoracic and Vascular Surgery, Linköping University Hospital and Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Medicine, Linköping University, Linköping, Sweden.
Objectives: To investigate copeptin levels during the full perioperative course in open, adult cardiac surgery with cardiopulmonary bypass (CPB).
Design: Prospective cohort study.
Setting: A single-center study conducted in a tertiary care hospital.
Application of causal forests to randomised controlled trial data to identify heterogeneous treatment effects: a case study.
BMC Med Res Methodol
February 2025
Imperial College London, London, UK.
Background: Classical approaches to subgroup analysis in randomised controlled trials (RCTs) to identify heterogeneous treatment effects (HTEs) involve testing the interaction between each pre-specified possible treatment effect modifier and the treatment effect. However, individual significant interactions may not always yield clinically actionable subgroups, particularly for continuous covariates. Non-parametric causal machine learning approaches are flexible alternatives for estimating HTEs across many possible treatment effect modifiers in a single analysis.
View Article and Find Full Text PDFLow apolipoprotein A-II levels causally contribute to increased mortality in septic shock.
J Intensive Care
February 2025
Centre for Heart Lung Innovation, St. Paul's Hospital, The University of British Columbia, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Background: Lipoproteins and their component apolipoproteins play an important role in sepsis. However, little is known with regard to the association and causal contribution of these proteins to mortality in patients of different ancestries following septic shock. The objective of this study was to determine whether lipoprotein and apolipoprotein levels, and related genetic variants, are associated with clinical outcomes in septic shock.
View Article and Find Full Text PDFAdjunctive Vasopressors and Short-Term Mortality in Adults with Septic Shock: A Systematic Review and Meta-Analysis.
Shock
February 2025
The Cleveland Clinic Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland, Ohio, United States.
Background: Adjunctive vasopressors are added to norepinephrine in one-third of adults with septic shock in the United States. However, effectiveness of this approach is unclear, and treatment recommendations are based on indirect evidence. We sought to synthesize the direct evidence for adjunctive vasopressor administration in adults with septic shock.
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