Podcast 598: Sepsis, Round One

Podcast 598: Sepsis, Round One

Contributor: Aaron Lessen, MD

Educational Pearls:

  • Early antibiotics have been shown to improve outcomes in septic patients time after time
  • Emerging evidence challenges the concept of one-size-fits-all large fluid boluses for septic shock patients and fluid may worsen patients who have underlying sepsis-induced pulmonary capillary leak
  • Starting peripheral vasopressors early, and relaxing if fluid resuscitation is successful, is appearing to be a more appropriate strategy than fluids first, then vasopressors

References

CLASSIC Trial Group; Scandinavian Critical Care Trials Group. Restricting volumes of resuscitation fluid in adults with septic shock after initial management: the CLASSIC randomised, parallel-group, multicentre feasibility trial. Intensive Care Med. 2016 Nov;42(11):1695-1705. doi: 10.1007/s00134-016-4500-7. Epub 2016 Sep 30. PMID: 27686349.

Permpikul C, Tongyoo S, Viarasilpa T, Trainarongsakul T, Chakorn T, Udompanturak S. Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER). A Randomized Trial. Am J Respir Crit Care Med. 2019 May 1;199(9):1097-1105. doi: 10.1164/rccm.201806-1034OC. PMID: 30704260.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD



Episoder(1147)

Podcast #295: UTI

Podcast #295: UTI

Author: Sam Killian, M.D. Educational Pearls Traditionally, UTI diagnosis has been dependent on urine culture, urinalysis and clinical symptoms. But a recent study casts some doubt on the utility of ...

26 Jan 20184min

Podcast #294: Rhabdomyolysis

Podcast #294: Rhabdomyolysis

Author: Michael Hunt, M.D. Educational Pearls Rhabdomyolysis is caused by the destruction of skeletal muscle that leads to the release of myoglobin, which causes renal failure. It presents with pain ...

22 Jan 20183min

Podcast #293: Transient Global Amnesia

Podcast #293: Transient Global Amnesia

Author: Sam Killian, M.D. Educational Pearls Transient global amnesia is a paroxysmal, transient memory issue. Remote and immediate memory is preserved, but new memories cannot be made. Patients will...

19 Jan 20184min

Podcast #292: Hypercalcemia

Podcast #292: Hypercalcemia

Author: John Winkler, M.D. Educational Pearls Normally, the parathyroid is the master regulator of serum Ca levels. It secretes PTH, which stimulates calcium uptake from the bone and gut. Causes of ...

17 Jan 20182min

Podcast #291: Cincinnati Stroke Scale

Podcast #291: Cincinnati Stroke Scale

Author: Nick Hatch, M.D. Educational Pearls The Cincinnati Stroke Scale uses 3 measures to screen for ischemic stroke. The measures are: facial asymmetry, speech quality and arm drift. This scale is ...

15 Jan 20182min

Podcast #290: The Biochemistry of DKA

Podcast #290: The Biochemistry of DKA

Author: Dave Rosenberg, M.D. Educational Pearls DKA commonly causes hyperkalemia, leading to peaked T-waves on ECG. However, DKA causes hypokalemia at the same time. In DKA, glucose cannot be taken i...

12 Jan 20186min

Podcast #289: Cannabinoid Hyperemesis

Podcast #289: Cannabinoid Hyperemesis

Author: Dylan Luyten, M.D. Educational Pearls Cannabinoid Hyperemesis syndrome is a relatively new diagnosis that presents with vomiting and abdominal pain without a clear etiology in the setting of ...

10 Jan 20183min

Podcast #288: Diarrhea

Podcast #288: Diarrhea

Author: Peter Bakes, M.D. Educational Pearls Chronic diarrhea is defined as 3 or more loose, watery stools lasting more than 2-3 weeks. Look for clues in the history, including travel (could suggest...

8 Jan 20187min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
rss-paradigmepodden
sinnsyn
forskningno
villmarksliv
pod-britannia
fjellsportpodden
dekodet-2
rss-lundqvist-podden
rss-nysgjerrige-norge
hva-er-greia-med
tidlose-historier
rss-overskuddsliv
diagnose
tomprat-med-gunnar-tjomlid