Archive

Tag: Sepsis

Adjunctive Methylene Blue in Septic Shock?

Background: Sepsis can induce numerous physiologic derangements.  At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e. septic shock).  Judicious fluid resuscitation is indicated in patients with signs of ...

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Infectious DiseaseResuscitation

REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. These patients can have a vasodilated vascular bed and the initial use of fluids is hypothesized to ...

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Infectious DiseaseResuscitation

The LOVIT Trial: Orange Crushed

Background: Vitamin C dissociates to ascorbate at physiological pH and is not organically synthesized by the human body. Vitamin C can function as an antioxidant and may mitigate endothelial oxidative stress in sepsis. (Amrein 2018) A small, single-center, before-and-after study ...

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Resuscitation

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). .  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 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

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