Archive

Tag: Sepsis

The CLASSIC Trial: IV Fluid Restriction in Septic Shock

Background: The Surviving Sepsis Campaign guidelines recommend an initial fixed volume of 30mL/kg of IDEAL body weight within the first 3 hours of resuscitation (weak recommendation, low-quality evidence). [2].  Additionally, the Surviving Sepsis Campaign Guidelines state there is insufficient evidence …

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Endocrine, Metabolic, Fluid, and ElectrolytesInfectious DiseaseResuscitation

The VICTAS Trial: How Many More RCTs do we Need on the Metabolic Cocktail in Sepsis?

Background: Since the publication of the before and after Marik trial [1] published in 2016, there have been six randomized clinical trials trying to answer the question of the utility of the metabolic cocktail (Vitamin C, thiamine, and hydrocortisone) in …

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Infectious Disease

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

The ORANGES Trial: Why You Can’t Just Read the Abstract

Background: The cornerstones of sepsis management continues to include early identification, early appropriate empiric antibiotics, definitive source control, and vasopressors to support end organ perfusion. There have been multiple studies looking at the co-administration of hydrocortisone, ascorbic acid, and thiamine …

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Infectious Disease

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