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Rebel Category: REBEL Crit

The ATESS Trial: Time to Let Go of the Metabolic Cocktail

Background: The only well-established treatments for sepsis and septic shock are antibiotic therapy and source control.  Septic shock, the most severe form of sepsis, is characterized by circulatory and cellular metabolism abnormalities.  There have been a host of randomized controlled ...

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Infectious Disease

Let’s Get Our ACTS Together: The Metabolic Cocktail and Septic Shock Again

Background: Though it’s been stated numerous times on this blog, it bears repeating: the pillars of sepsis care remain early identification of sepsis, early appropriate empiric antibiotics, source control, and supportive care. The focus should be on getting the basics ...

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Infectious Disease

STARRT-AKI Trial: Timing of Renal Replacement Therapy Initiation in Acute Kidney Injury

Background Information: It is well documented throughout the literature that critically ill patients admitted to the intensive care unit (ICU) with acute kidney injury have a higher morbidity and mortality.1–4 Acute kidney injury may be complicated by acidosis, hyperkalemia and ...

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Endocrine, Metabolic, Fluid, and ElectrolytesRenal and Genitourinary

Therapy Options in Acute Respiratory Distress Syndrome

 Background Information: The care and management of patients with acute respiratory distress syndrome (ARDS) is complex and follows an inciting injury to the lungs. This constellation of symptoms is characterized by hypoxemia, diffuse lung inflammation, decreased lung compliance and noncardiogenic ...

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Thoracic and Respiratory

Hemophagocytic Lymphohistiocytosis (HLH): A Zebra Diagnosis We Should All Know

What is it HLH? Hemophagocytic Lymphohistiocytosis (HLH) is a rare and often fatal syndrome of uncontrolled and ineffective inflammatory response to a certain trigger. It is characterized by excessive proliferation of lymphocytes and macrophages (histiocytes), hence the name “lymphohistiocytosis”. This ...

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Hematology and Oncology

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