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SCCM president-elect Clifford S. Deutschman, MD, FCCM, professor of anesthesiology and critical care at the University of Pennsylvania School of Medicine in Philadelphia, shares how his involvement within SCCM helped shape aspects of his career. Deutschman goes on to discuss an article published in a supplement to Critical Care Medicine, “Cytochrome C Oxidase Dysfunction in Sepsis.”
Craig Coopersmith, MD, FCCM, is a professor of surgery at Emory University School of Medicine in Atlanta, Georgia, as well as associate director of the surgical intensive care unit at Emory University Hospital. He shares how early involvement within the Society, his receiving the Vision Grant, and his participation in Specialty Sections helped shape his career, while stressing the importance of mentorship. Coopersmith goes on to discuss his sepsis research, including two papers published in Critical Care Medicine, “Cancer Causes Increased Mortality and Is Associated with Altered Apoptosis in Murine Sepsis” and “Streptococcus Pneumoniae and Pseudomonas Aeruginosa Pneumonia Induce Distinct Host Responses.”
Jerry J. Zimmerman, MD, PhD, FCCM, discusses his article published in the January Pediatric Critical Care Medicine, titled “Adjunctive Corticosteroid Therapy in Pediatric Severe Sepsis: Observations From the RESOLVE.” Zimmerman is a professor of pediatrics, chief of the Division of Critical Care Medicine and director of Continuous Quality Improvement at Seattle Children’s Hospital in Washington.
Djillali Annane, MD, discusses a study on epinephrine versus norepinephrine for septic shock he presented during the 36th Critical Care Congress. Dr. Annane is professor of critical care Raymond Poincare Hospital in Garches, France.
Derek Angus, MD, MPH, discusses a new, multicenter research consortium, called Protocolized Care for Early Septic Shock (ProCESS). The consortium is beginning a large-scale study to determine whether specific interventions can halt the progression to severe sepsis and septic shock. Dr. Angus along with SCCM members Mitchell Fink, MD, and Donald Yealy, MD, will lead a team of intensive care unit and emergency department personnel. The study is likely to offer valuable insight on the best ways to treat sepsis and the value of early goal-directed therapy. Dr. Angus is vice chairman of research for the University of Pittsburgh School of Medicine's critical care department.
Children being treated for sepsis stayed in the hospital longer if they lived in low-income ZIP codes compared to those who were from high-income ZIP codes, suggests a large national study being presented at the Society of Critical Care Medicine’s 50th Critical Care Congress.
Catecholamine is used in patients with septic shock to augment hemodynamics and achieve goal mean arterial pressure. Ludwig H. Lin, MD, is joined by Gretchen L. Sacha BCCCP, PharmD, to discuss this retrospective observational study to evaluate the associations of catecholamine dose, lactate concentration, and timing from shock onset at vasopressin initiation with in-hospital mortality. (Sacha G, et al. Crit Care Med. 2022;50:614-623). Dr. Sacha is a critical care clinical specialist at Cleveland Clinic in Cleveland, Ohio. This podcast is sponsored by Sound Physicians.
Sepsis continues to affect Americans and hospital patients across the United States. The Centers for Disease Control and Prevention (CDC) estimates that approximately 1.7 million adult Americans develop sepsis each year1; this is more than the entire population of Phoenix, the fifth-largest city in the country.2 Approximately 270,000 of these patients die from sepsis.
This Concise Critical Appraisal delves into the impact of blood culture positivity on community-acquired sepsis and evaluates the epidemiology, resistance profiles, and clinical outcomes of culture-positive and culture-negative sepsis. In a recent study, 14% of patients with community-acquired sepsis had positive blood cultures, in-hospital mortality was lower in patients with culture-positive sepsis, and 55% involved gram-negative bacilli.
Is there an association between balanced versus unbalanced fluids and endothelial glycocalyx integrity in children with sepsis? This Concise Critical Appraisal offers insight into the vascular dysfunction that occurs in pediatric patients with sepsis or septic shock after receiving either balanced or unbalanced fluids.
The Society of Critical Care Medicine (SCCM) is committed to reducing mortality and morbidity from sepsis and septic shock worldwide. The Surviving Sepsis Campaign (SSC) released its first evidence-based guidelines for the pediatric patient population. “Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children” was published in the February 2020 issue of Pediatric Critical Care Medicine (Weiss S, et al. Pediatr Crit Care Med. 2020;21(2);e52-e106).
Determine the safest, most effective approach to sepsis intervention.
Should critically injured children receive balanced crystalloid (BC) solutions or normal saline (NS) during fluid resuscitation? This Concise Critical Appraisal explores a recent study examining whether the use of BC solutions versus NS is associated with the development of new or progressive acute kidney injury in children with septic shock.
When should antibiotics be administered in septic patients with septic arthritis? This Concise Critical Appraisal reviews a recent study that sought to determine whether patients with septic arthritis should receive antibiotics prior to synovial fluid aspiration analysis or wait until synovial fluid analysis has been completed.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.
From Critical Care Medicine. In this foreword, the authors contend that there should be no debate that SARS-CoV-2 is an important cause of sepsis and that labeling it as such is beneficial and appropriate.
From Critical Care Medicine. The authors present some common features shared by severe coronavirus disease 2019 patients and sepsis and describe proposed anti-inflammatory therapies for coronavirus disease 2019 which have been previously evaluated in sepsis.
From Critical Care Medicine The authors invesitated the safety and efficacy of megadose sodium ascorbate in sepsis.
From Critical Care Medicine The authors tested and found that a previously defined bacterial sepsis endotype classifier recapitulates the same clinical and immunological endotypes in viral sepsis (coronavirus disease 2019).
From Critical Care Medicine The authors found that procalcitonin exerts a moderate but harmful effect on disease progression in experimental septic shock, and suggests a potential therapeutic application for calcitonin gene-related peptide receptor inhibitors in sepsis.