Podcast 544: C is for Sepsis
Emergency Medical Minute25 Feb 2020

Podcast 544: C is for Sepsis

Author: Aaron Lessen, MD

Educational Pearls:

  • Previously, trials had shown promising evidence that vitamin C may improve mortality rates in patients with sepsis or septic shock.
  • A 2017 retrospective before-after study gave a "cocktail" of hydrocortisone, vitamin C, and thiamine to patients with severe sepsis or in septic shock and reported a decrease in mortality from 40% to 8%.
  • A 2020 randomized controlled trial demonstrated that giving patients hydrocortisone, vitamin C, and thiamine showed no benefits in improving sepsis outcomes.
  • Currently use of Vitamin C in sepsis and septic shock remains controversial due to lack of sufficient data

References

1) Marik PE, Khangoora V, Rivera R, Hooper MH, Catravas J. Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest. 2017;151(6):1229. Epub 2016 Dec 6.

2) Fujii T, Luethi N, Young PJ, et al. Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock: The VITAMINS Randomized Clinical Trial. JAMA. 2020;323(5):423–431. doi:10.1001/jama.2019.22176

Summarized by Jackson Roos, MS3 | Edited by Erik Verzemnieks, MD



Episoder(1146)

Podcast #249: Detecting Pulses

Podcast #249: Detecting Pulses

Author: Jared Scott, M.D. Educational Pearls Overall, medical providers are bad at detecting pulses. However, only 2% of patients do not have a detectable DP pulse. In one study, for patients with l...

10 Sep 20173min

Podcast #248: Family Presence During Resuscitation

Podcast #248: Family Presence During Resuscitation

Author: Aaron Lessen, M.D. Educational Pearls Traditionally the family is removed from the room during procedures and codes, but recent research shows that family presence may be beneficial. 50% pati...

8 Sep 20173min

Podcast #249: D-Dimer

Podcast #249: D-Dimer

Author: Michael Hunt, M.D. Educational Pearls In the recent YEARS study, investigators checked every patient with suspicion for PE with a D-dimer, using a modified Wells score for risk stratification...

6 Sep 20173min

Podcast #248: Patent Foramen Ovale

Podcast #248: Patent Foramen Ovale

Author: Jared Scott, M.D. Educational Pearls The foramen ovale (FO) connects the left and right atria to allow oxygenated blood to bypass the developing lungs, it usually closes at birth but for some...

4 Sep 20173min

Podcast #247: Are You Listening? - 3 Ear Emergencies You Can't Miss!

Podcast #247: Are You Listening? - 3 Ear Emergencies You Can't Miss!

Author: Don Stader, M.D. Educational Pearls Ear pain is a common complaint in adults and kids. A red, hot, painful ear with involvement of the pinna could indicate perichondritis - an infection of th...

2 Sep 20176min

Podcast #246: Fever in Sepsis

Podcast #246: Fever in Sepsis

Author: Nick Hatch, M.D. Educational Pearls A recent observational cohort study found that the biggest predictor for sepsis survival was fever. Those with higher fevers had better outcomes. Some poss...

31 Aug 20172min

Podcast #245: Hypoglycemia

Podcast #245: Hypoglycemia

Author: Dylan Luyten, M.D. Educational Pearls Hypoglycemia is very common in type 2 diabetics, and is often caused by insulin overdose or missed meals. Knowing the peak time of action for common diab...

29 Aug 20174min

Podcast #244: Clavicle Fracture Review

Podcast #244: Clavicle Fracture Review

Author: Nick Hatch, M.D. Educational Pearls The force required to break a clavicle is significant, so clavicle fracture may be associated with other injury (pneumothorax, vascular injury). Most fract...

27 Aug 20172min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
villmarksliv
forskningno
sinnsyn
fjellsportpodden
rss-paradigmepodden
nevropodden
rss-nysgjerrige-norge
tidlose-historier
vett-og-vitenskap-med-gaute-einevoll
diagnose
smart-forklart
pod-britannia
dekodet-2
hva-er-greia-med