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Is hydrocortisone for septic shock best used alone or in combination with fludrocortisone? This Concise Critical Appraisal explores a retrospective cohort study that found that treatment with hydrocortisone plus fludrocortisone led to lower rates of mortality or discharge to hospice, hospital deaths, and fewer days on vasopressors than treatment with hydrocortisone alone.
From the earliest days of critical care medicine, the importance of measuring cardiac output and hemodynamic monitoring were recognized in understanding the physiology of critically ill patients. However, methods for measuring cardiac output were cumbersome or not widely available. Ashish K. Khanna, MD, FCCP, FCCM, is joined by Margaret M. Parker, MD, MCCM, to discuss the evolution of the pulmonary artery catheter in critically ill patients, as discussed in “The Story of the Pulmonary Artery Catheter: Five Decades in Critical Care Medicine,” published in Critical Care Medicine.
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. This podcast is sponsored by Sound Physicians.
Todd Fraser, MD, speaks with Allan Garland, MD, about the article, “Interaction Between Fluids and Vasoactive Agents on Mortality in Septic Shock: A Multicenter, Observational Study,” published in Critical Care Medicine.
Margaret Parker, MD, MCCM, speaks with Mark C. Dugan, MD, about the article, “Does Simulation Improve Recognition and Management of Pediatric Septic Shock, and If One Simulation Is Good, Is More Simulation Better?” published in the July 2016 issue of Pediatric Critical Care Medicine.
Ranjit Deshpande, MD, speaks with James A. Russell, MD, about the article, “The Septic Shock 3.0 Definition and Trials: A Vasopressin and Septic Shock Trial Experience,” published in the June 2017 issue of Critical Care Medicine.
Ludwig Lin, MD, speaks with Daniel E. Leisman, BS, about the article, “Patterns and Outcomes Associated With Timeliness of Initial Crystalloid Resuscitation in a Prospective Sepsis and Septic Shock Cohort,” published in Critical Care Medicine.
Margaret Parker, MD, MCCM, speaks with Joseph A. Carcillo, MD, about the article, "American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock," published in the June 2017 issue of Critical Care Medicine.
Margaret M. Parker, MD, MCCM, and Jerry J. Zimmerman, MD, PhD, FCCM, talk about the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock.
This resource details how angiotensin II can used for COVID-19 patients with shock.
This is SCCM curated COVID-19 microlearning content.
From Critical Care Explorations. In this study, the authors found that angiotensin-II treatment for coronavirus disease 2019–induced distributive shock was associated with rapid improvement in multiple physiologic indices and that angiotensin-II in coronavirus disease 2019–induced shock warrants further study.
Can the biomarkers identified in the Pediatric Sepsis Biomarker Risk Model (PERSEVERE II) be used to predict acute kidney injury and renal recovery in pediatric septic shock? This Concise Critical Appraisal explores a study in which Stanski et al (Am J Respir Crit Care Med. 2020;201:848-855) sought to answer this question.
Point of Care (PoC) Refresher Training
Ped Crit Care Med. 2020 Feb;21(2)e52-e106
Levy et al (J Am Coll Cardiol. 2018;72:173-182) conducted a prospective, double-blind, multicenter RCT comparing epinephrine to norepinephrine in the setting of CS in patients who underwent AMI treated with percutaneous coronary intervention.