There is now very convincing evidence to support a restrictive transfusion threshold — hemoglobin, <7 g/dL — for most critically ill patients that is supported by guidelines from the American Association of Blood Banks and the TRICC and FOCUS trials. …
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Fever is universally treated in the setting of infection in virtually all hospitals, but does treatment of fever improve outcomes in patients with sepsis? This meta-analysis of eight randomized trials (1507 patients) and six observational studies (2058 patients) that compared…
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The bactericidal activity of antibiotics depends on the class of antibiotic used. Some antibiotics like vancomycin, aminoglycosides and fluoroquinolones are dose-dependent for their bactericidal activity. Other antibiotics like beta-lactam antibiotics are time-dependent antibiotics.  Time-dependent antibiotics have increased bactericidal activity the…
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Definitions Presumed source with SIRS criteria = infection Infection with life-threatening organ dysfunction = sepsis Sepsis refractory to intravenous fluid challenge = septic shock Treatment of sepsis or septic shock Draw blood cultures x 2 Analyze any fluid that may…
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The bactericidal activity of antibiotics depends on the class of antibiotic used. Some antibiotics like vancomycin, aminoglycosides and fluoroquinolones are dose-dependent for their bactericidal activity. Other antibiotics like beta-lactam antibiotics are time-dependent antibiotics which depend on maintaining drug concentrations above…
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In an open-label trial involving adults with complicated intra-abdominal infections at 23 centers in the U.S. and Canada, researchers have investigated whether fixed-duration antimicrobial therapy (4 days) after source control is as effective as the traditional strategy (antibiotic administration until 2 days…
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Preface: Nice summary of the changing pathogenic organisms causing severe sepsis.  This summary also displays how improved sepsis recognition and management has decreased mortality from 40% to 28% over the last decade. Mortality decreased from 40% to 28% overall. Although…
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In 2001, the Rivers trial showed that Early Goal Directed Therapy for septic shock resulted in a 16% absolute mortality risk reduction1. In the treatment arm of this trial, septic patients with a lactate above 4 mmol/L or systolic blood…
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