Clinicians have greatly improved care for septic shock. Urgent resuscitation using intravenous fluids and vasopressors as well as rapid administration of broad spectrum antibiotics are probably the most basic and universally accepted interventions. Various trials have compared different types of vasopressors, associations of vasopressors and inotropes, and pressure targets. End goal-directed therapy algorithms are designed to optimize oxygen delivery by use of fluids, vasopressors, inotropes, and blood products. Patients who have a poor response to resuscitation and patients with known severe ventricular dysfunction might merit advanced hemodynamic monitoring. This review examines important vasopressor and septic shock trials.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ccm.2016.01.008 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Translating PK-PD principles into improved methodology for clinical trials which compare intermittent with prolonged infusion of beta-lactam antibiotics.
Clin Infect Dis
January 2025
Professor of Medicine, Director, Institute for Therapeutic Innovation at University of Florida, Orlando, FL, USA.
Based on the fact that beta-lactam antibiotics demonstrate time-dependent killing, different dosing strategies have been implemented to increase the time that free (f) (unbound) antibiotic concentrations remain above the Minimal Inhibitory Concentration (MIC), including prolonged and continuous infusion. Multiple studies have been performed that compared continuous with traditional intermittent infusion to improve outcomes in patients with severe sepsis and/or septic shock. These studies have yielded inconsistent results for patients as measured by clinical response to treatment and mortality due to heterogeneity of included patients, pathogens, dosing strategies and the absence of Therapeutic Drug Monitoring (TDM).
View Article and Find Full Text PDFBacteremia is a serious clinical condition in which pathogenic bacteria enter the bloodstream, putting patients at risk of septic shock and necessitating antibiotic treatment. Choosing the most effective antibiotic is crucial not only for resolving the infection but also for minimizing side effects, such as dysbiosis in the healthy microbiome and reducing the selection pressure for antibiotic resistance. This requires prompt identification of the pathogen and antibiotic susceptibility testing, yet these processes are inherently slow in standard clinical microbiology labs due to reliance on growth-based assays.
View Article and Find Full Text PDFDeveloping and validating a machine learning model to predict multidrug-resistant -related septic shock.
Front Immunol
January 2025
Department of Medical Laboratory, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China.
Background: Multidrug-resistant Klebsiella pneumoniae (MDR-KP) infections pose a significant global healthcare challenge, particularly due to the high mortality risk associated with septic shock. This study aimed to develop and validate a machine learning-based model to predict the risk of MDR-KP-associated septic shock, enabling early risk stratification and targeted interventions.
Methods: A retrospective analysis was conducted on 1,385 patients with MDR-KP infections admitted between January 2019 and June 2024.
Effect of taurine supplementation on preventing ventilator-associated pneumonia in pediatrics under mechanical ventilation, a randomized controlled double-blind clinical trial.
Front Pediatr
January 2025
Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
Introduction: One of the most prevalent healthcare-associated infections in the pediatric intensive care unit is ventilator-associated pneumonia (VAP). VAP not only results in prolonged hospital and intensive care unit (ICU) stays but also imposes higher costs on patients and the healthcare system. Therefore, it is essential to implement preventive measures.
View Article and Find Full Text PDFAtypical presentation and response to treatment in scrub typhus: a series of 2 cases.
Sudan J Paediatr
January 2024
Department of Pediatrics, Manipal Tata Medical College and Tata Main Hospital, Jamshedpur, India.
Scrub typhus is an acute febrile illness caused by . It usually presents with high fever, lymphadenopathy, rash, organomegaly and an eschar formation at the site of the bite. Doxycycline is the drug of choice usually showing rapid defervescence, but rarely some cases does not respond.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!