: In 2015, the Surviving Sepsis Campaign six-hour bundle was updated. The revised version now recommends documenting the reassessment of volume status and tissue perfusion after initial fluid resuscitation through a repeated focused examination. This article addresses the practice and interpretation of two components of this examination in adults: capillary refill time and skin mottling score. It further discusses how to best integrate these noninvasive parameters into the care of patients undergoing resuscitation for septic shock.
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http://dx.doi.org/10.1097/01.NAJ.0000525851.44945.70 | DOI Listing |
Ann Intensive Care
January 2025
Faculté de Médecine, Service de Médecine Intensive-Réanimation, Université de Strasbourg (UNISTRA), Hôpitaux universitaires de Strasbourg, Nouvel Hôpital Civil, 1, place de l'Hôpital, Strasbourg, F-67091, cedex, France.
Diagnosing coagulopathy in septic patients remains challenging in intensive care. Disseminated intravascular coagulation (DIC) indeed presents with complex pathophysiology, complicating timely diagnosis. Epidemiological data indicate a significant prevalence of DIC in septic patients, with mortality rates up to 60%.
View Article and Find Full Text PDFIntroduction: Simulation has become an integral part of healthcare education. Studies demonstrate rapid knowledge and skill acquisition with the use of simulation and rapid knowledge degradation if it is not further reinforced. Effect of simulation on metacognitive processes, or the ability to understand one's own knowledge, is not well-investigated yet.
View Article and Find Full Text PDFJ Vasc Access
January 2025
Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Background: Extracorporeal membrane oxygenation (ECMO) is a critical treatment for severe cardiopulmonary failure. However, traditional ECMO decannulation methods, such as manual compression and surgical repair, are associated with significant complications. This study evaluates suture-mediated closure devices, specifically Perclose ProGlide, as a potentially favorable decannulation strategy.
View Article and Find Full Text PDFCureus
December 2024
Gastroenterology II, Mohammed V Military Teaching Hospital, Rabat, MAR.
Acute esophageal necrosis (AEN) is an uncommon endoscopic finding characterized by a patchy or diffuse circumferential black pigmentation of the esophageal mucosa, corresponding to ischemic necrosis. It usually presents with upper gastrointestinal bleeding and is thought to be caused by a systemic low blood flow in patients with predisposing risk factors, like advanced age and cardiovascular comorbidities. After initial hemodynamic stabilization, diagnosis is established by esophagogastroduodenoscopy (EGD) with careful biopsies and histological evaluation.
View Article and Find Full Text PDFInfect Drug Resist
January 2025
Department of Clinical Laboratory Science, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People's Republic of China.
Objective: This study investigated the distribution and changes in pancreatic infections among patients with acute pancreatitis (AP) from 2019 to 2023, while exploring the impact of multidrug-resistant bacterial infections on the prognosis of patients with poor outcomes.
Methods: This study included patients diagnosed with SAP between 2019 and 2023 and collected the demographic and clinical characteristics of all participants. Based on routine clinical microbiological culture results, the distribution and drug resistance of pathogens associated with pancreatic infections were analyzed.
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