Category: Infectious disease

Hydrocortisone plus Fludrocortisone in Septic Shock

D. Annane, A. Renault, C. Brun‑Buisson et el published results of APROCCHSS trial by CRICS-TRIGGERSEP Network  which was originally designed to test drotrecogin alfa (activated) in septic shock.   A human recombinant activated protein C, drotrecogin alpha (activated), initially showed a survival benefit in sepsis; this benefit was not confirmed in subsequent trials, resulting in the withdrawal of its commercial form (Xigris) …

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ESICM/ESCMID/ALAT guidelines for the management of HAP and VAP

European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT) Recently published guidelines for management of hospital acquired pneumonia(HAP), and ventilator associated pneumonia. These guidelines are sligtly different then presented by IDSA and ATS published in July 2016. Some of the differences in …

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Bundle to reduce ventilator associated events

Nishi Rawat, Ting Yang,  Kisha J. Ali et el  published a two state multifaceted intervention study showing benefits of improved compliance with evidence based practices can reduce ventilator-associated event, infection-related ventilator- associated complication, and probable ventilator-associated pneumonia. It was a longitudinal quasi-experimental study involving 56 ICUs at 38 hospitals in Maryland and Pennsylvania from October 2012 to March 2015. PROBLEM …

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Another retrospective study proving early antibiotics in sepsis improves mortality

Christopher W. Seymour, Foster Gesten et el published a retrospective study in NEJM looking at impact of implementation of bundle treatment in sepsis. WHAT THEY DID Looked at the data(On patients with sepsis and septic shock, community acquired only) reported to New York Health Department from April 1, 2014, to June 30, 2016. More than 98% of …

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Vit C, Thiamine and Hydrocortisone in Sepsis : New trial needed

Paul Marik et el published a “retrospective before after ” study in Chest, Dec, 2016 about use of combination of parenteral Vit C, Thiamine and Hydrocortisone in sepsis and reported a mortality of 8.5% in treatment group compared with 40.4% in control group(p =<0.001). Results are astonishing if you believe in the study. There are several …

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Poor adherence to CLABSI prevention guidelines worldwide

Cristina Valencia, Naïma Hammami et el published a worldwide survey of healthcare professionals in this month’s Antimicrobial Resistance & Infection Control journal. Overall, only 23% of the ICUs strictly adhere to the guidelines to prevent CLABSI. Just for review, here are the components of CLABSI prevention bundle by the Joint Commission  Hand hygiene Hands are …

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