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A bunch of fun new ideas re: sepsis for 2019

Fluids

30 ml/kg may be based on IBW if you write in the chart that that was what you were using

Andromeda-Shock Trial

A fascinating study by Hernandez et al.1

* See Rory's take on it

* The Bottom Line

Censer Trial

Early fixed-dose norepi use was examined in this trial.2

https://www.thebottomline.org.uk/summaries/icm/censer/

Procalcitonin

HiTemp Study3

Procalcitonin was poor for differentiating bacterial infections and other causes of fever in the ED.

Now on to the Podcast...

1.

Hernández G, Ospina-Tascón G, Damiani L, et al. Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA. 2019;321(7):654-664. [PubMed]

2.

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. February 2019. [PubMed]

3.

van der, Limper M, Jie K, et al. Procalcitonin-guided antibiotic therapy in patients with fever in a general emergency department population: a multicentre non-inferiority randomized clinical trial (HiTEMP study). Clin Microbiol Infect. 2018;24(12):1282-1289. [PubMed]