Review
Medicine, General & Internal
Matteo Guarino, Benedetta Perna, Alice Eleonora Cesaro, Martina Maritati, Michele Domenico Spampinato, Carlo Contini, Roberto De Giorgio
Summary: This review aims to update physicians on the main pillars of treatment for sepsis/septic shock, which include empirical antimicrobial treatment, fluid replacement, and the use of vasoactive agents. Other treatments such as mechanical ventilation, anticoagulation, and glycemic control are also recommended but their efficacy is debated.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Cell Biology
Federico Carbone, Luca Liberale, Alberto Preda, Thomas Hellmut Schindler, Fabrizio Montecucco
Summary: The onset of cardiomyopathy in sepsis is a common feature that affects its pathophysiology and clinical care. However, there is a lack of consensus in the definition of sepsis-induced cardiomyopathy, and the wide range of ultrasonographic findings may not fully reflect the understanding of the condition. This review explores the current state of research on sepsis-related cardiomyopathy, highlighting the shortcomings in its definition and discussing the dynamic changes in cardiac performance in response to different hemodynamic clusters. The review also addresses the molecular mechanisms leading to myocardial dysfunction and their similarities to myocardial hibernation.
Article
Critical Care Medicine
Ari Moskowitz, Katherine M. Berg, Anne V. Grossestreuer, Lakshman Balaji, Xiaowen Liu, Michael N. Cocchi, Maureen Chase, Michelle Ng Gong, Jonathan Gong, Samir M. Parikh, Long Ngo, Noa Berlin, Michael W. Donnino
Summary: Thiamine supplementation does not significantly attenuate kidney injury in patients with septic shock, but it does increase ICU-free days.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Article
Emergency Medicine
Joseph D. Lykins, Hani I. Kuttab, Erron M. Rourke, Michelle D. Hughes, Eric P. Keast, Jason A. Kopec, Brooke L. Ward, Natasha N. Pettit, Michael A. Ward
Summary: Factors associated with delayed administration of the second dose of antibiotics include ED boarding, antibiotics requiring more frequent dosing, receiving 30 mL/kg of fluids within three hours, and renal failure. Delays in second-dose administration were not found to be associated with increased mortality or other outcomes.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Immunology
Marcela Hortova-Kohoutkova, Monika Skotakova, Isaac G. Onyango, Miriam Slezakova, Roman Panovsky, Lukas Opatril, Peter Slanina, Marco De Zuani, Ondrej Mrkva, Ivana Andrejcinova, Petra Laznickova, Martina Dvoncova, Alexandra Mytnikova, Vaughn Ostland, Michal Sitina, Gorazd B. Stokin, Vladimir Sramek, Marcela Vlkova, Martin Helan, Jan Fric
Summary: This study investigated the dynamics of iron regulation in different clinical settings and determined the suitability of hepcidin and/or ferritin levels as biomarkers of inflammatory disease severity. The results showed that hepcidin levels reflect overall immune cell activation driven by intrinsic stimuli, while ferritin levels are more strongly influenced by pathogen-induced inflammation. Furthermore, the hepcidin-to-ferritin ratio has the ability to predict mortality in septic shock.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Immunology
Chanu Rhee, Kathleen Chiotos, Sara E. Cosgrove, Emily L. Heil, Sameer S. Kadri, Andre C. Kalil, David N. Gilbert, Henry Masur, Edward J. Septimus, Daniel A. Sweeney, Jeffrey R. Strich, Dean L. Winslow, Michael Klompas
Summary: The Infectious Diseases Society of America (IDSA) is concerned about the potential for antibiotic overuse due to the SEP-1 measure and has outlined recommendations to limit its application to patients with septic shock. The IDSA believes that managing possible sepsis without shock should be guided by more appropriate guidelines that allow for individualized patient care.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Critical Care Medicine
Laura Piccolo Serafim, Douglas A. Simonetto, Alexandra L. Anderson, Dae Hee Choi, Timothy J. Weister, Andrew C. Hanson, Patrick S. Kamath, Ognjen Gajic, Alice Gallo de Moraes
Summary: The study found that the use of systemic steroids in patients with cirrhosis and septic shock did not significantly affect mortality, length of ICU admission, or length of hospital stay, and also did not increase adverse effects. The prevalence of steroid use was higher in cirrhotic patients with higher vasopressor requirements.
Article
Nutrition & Dietetics
Jun-Kwon Cha, Hyung-Sook Kim, Eun-Ji Kim, Eun-Sook Lee, Jae-Ho Lee, In-Ae Song
Summary: The initial nutritional delivery policy and route of nutrition delivery may have an impact on the clinical outcomes of patients with sepsis. Higher protein intake during the first week of sepsis onset is associated with lower in-hospital mortality, while higher energy intake is associated with lower 30-day mortality. Additionally, in patients with a high modified nutrition risk in the critically ill score, enteral feeding with supplemental parenteral nutrition is superior to other routes of nutrition delivery and is associated with lower mortality.
Article
Pediatrics
Fan Yin, Yue-Ling Xi, Ying Wang, Bi-Ru Li, Juan Qian, Hong Ren, Jian Zhang, Hong-Zhi Tang, Bo-Tao Ning
Summary: In patients with severe sepsis/septic shock, the presence of severe neutropenia is associated with a higher proportion of using vasoactive drugs, and these patients tend to have higher levels of inflammatory biomarkers.
TRANSLATIONAL PEDIATRICS
(2021)
Article
Medicine, General & Internal
Veronika Tomaskova, Alexandra Mytnikova, Marcela Hortova Kohoutkova, Ondrej Mrkva, Monika Skotakova, Michal Sitina, Katerina Helanova, Jan Fric, Jiri Parenica, Vladimir Sramek, Martin Helan
Summary: This study examined the ability of sEng to predict mortality and its correlation with other clinical characteristics in septic shock patients and severe COVID-19 patients. The results showed that sEng was not predictive of mortality or correlated with organ dysfunction markers in COVID-19 patients. However, in septic shock patients, sEng levels were significantly higher in patients with early mortality and correlated with signs of circulatory failure.
FRONTIERS IN MEDICINE
(2022)
Review
Critical Care Medicine
Jing Yue, Ronghao Zheng, Huiping Wei, Jie Li, Jiannan Wu, Ping Wang, Hui Zhao
Summary: The study found that in pediatric patients with septic or severe infection shock, the no bolus group showed significantly lower mortality rates at 48 hours, especially in cases of malaria. Similar results were observed with colloids and crystalloids solution treatment in malaria shock patients.
Article
Medicine, General & Internal
Jae Ha Lee, Seong-Ho Kim, Ji Hoon Jang, Jin Han Park, Kyung Min Jo, Tae-Hoon No, Hang-Jea Jang, Hyun-Kyung Lee
Summary: This study evaluated the role of biomarkers in the diagnosis of sepsis and septic shock in the emergency department. The results showed that procalcitonin was a useful biomarker for predicting sepsis and septic shock. Higher levels of lactic acid, predisposing chronic pulmonary diseases, and high SAPS III scores were associated with a greater mortality risk in patients with sepsis.
Article
Pharmacology & Pharmacy
Sai Huang, Bo Yang, Yaojun Peng, Qinrui Xing, Lili Wang, Jing Wang, Xuan Zhou, Yuan Yao, Li Chen, Cong Feng
Summary: This study aimed to explore the effectiveness of sodium bicarbonate (SB) administration on mortality in septic patients with acute moderate lactic acidosis (MLA). Retrospective analysis of a large ICU database (MIMIC-IV) showed that SB administration was associated with reduced ICU and hospital mortality in septic patients with acute MLA.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Critical Care Medicine
Jeremy Cohen, Antje Blumenthal, Gabriel Cuellar-Partida, David M. Evans, Simon Finfer, Qiang Li, Johanna Ljungberg, John Myburgh, Elizabeth Peach, Joseph Powell, Dorrilyn Rajbhandari, Andrew Rhodes, Anne Senabouth, Balasubramanian Venkatesh
Summary: In patients with septic shock, there is no association between adrenocortical candidate gene expression and mortality. Patients with higher expression of GLCCI1 who received hydrocortisone achieved shock resolution faster than those receiving placebo; conversely, patients who had higher expression of BHSD1 who received hydrocortisone achieved shock resolution slower than those who received placebo. Variation in gene expression may be a mechanism for heterogeneity of treatment response to corticosteroids in septic shock.
INTENSIVE CARE MEDICINE
(2021)
Article
Critical Care Medicine
John A. Kellum, Claudio Ronco
Summary: Septic shock, caused by bacterial toxins like endotoxin, is a severe disease that can lead to organ failure. It is important to note that endotoxin may play a role in all types of septic shock, including non-bacterial causes such as COVID-19. Diagnosis relies on measuring endotoxin activity in addition to clinical assessment. Treatment options are limited, with immune modulating therapies and extracorporeal blood purification still being investigated.
