In this episode, I’ll discuss the risk factors for invasive candida infection in critically ill patients. Subscribe on iTunes, Android, or Stitcher The sepsis guidelines recommend using empiric antifungal therapy for adults with sepsis or septic shock at high risk of fungal infection. However, the risk assessment is not well defined in the guidelines beyond a […]
Episode 657: What is the current recommendation on using PCC in bleeding critically ill adults?
In this episode, I’ll discuss the European Society of Intensive Care Medicine’s recommendations on using PCC in bleeding critically ill adults. Subscribe on iTunes, Android, or Stitcher The journal Intensive Care Medicine has recently published a clinical practice guideline from the European Society of Intensive Care Medicine on transfusion strategies in bleeding critically ill adults. […]
Episode 656: The mark of a high-quality journal
In this episode, I’ll discuss why I think the journal Intensive Care Medicine is of high quality. Subscribe on iTunes, Android, or Stitcher In episode 654 I discussed a study recently published in the journal Intensive Care Medicine about the effects of oral chlorhexidine vs an oral care bundle on mortality for mechanically ventilated patients […]
Episode 655: Four changes to vasopressor recommendations in the 2021 Sepsis Guidelines
In this episode, I’ll discuss 4 changes to vasopressor recommendations in the 2021 Sepsis Guidelines. Subscribe on iTunes, Android, or Stitcher The 2021 Sepsis Guidelines are out and there are some changes to vasopressor-related recommendations. First, the wording for the MAP goal was slightly changed. It now reads: For adults with septic shock on vasopressors, […]
Episode 654: Does oral chlorhexidine do anything (good or bad)?
In this episode, I’ll discuss the effects of oral chlorhexidine vs an oral care bundle on mortality for mechanically ventilated patients in the ICU. Subscribe on iTunes, Android, or Stitcher In recent years, the journal Intensive Care Medicine has published a cohort study and editorial that call into question the safety and efficacy of oral […]
Episode 653: How well does 5 units of insulin work for hyperkalemia instead of 10?
In this episode, I’ll discuss how 5 units of insulin works for hyperkalemia instead of 10. Subscribe on iTunes, Android, or Stitcher While insulin is an effective way to lower potassium during hyperkalemia treatment, hypoglycemia may result even if dextrose is given along with insulin treatment. This is especially likely in patients with renal dysfunction […]
Episode 652: Which should be given first – the beta-lactam or the vancomycin?
In this episode, I’ll discuss which antibiotic should be given first in sepsis – the beta-lactam or the vancomycin? Subscribe on iTunes, Android, or Stitcher Quickly administering appropriate empiric antibiotic therapy is essential in the treatment of severe infections. If multiple antibiotics are required for empiric therapy to treat a severe infection (such as for […]
Episode 651: What is the Sepsis-Induced Coagulopathy (SIC) Score?
In this episode, I’ll discuss the Sepsis-Induced Coagulopathy (SIC) Score. Subscribe on iTunes, Android, or Stitcher The Sepsis-Induced Coagulopathy (SIC) Score predicts likelihood of sepsis-induced coagulopathy. This scoring system is specifically designed for predicting coagulation disturbances in sepsis using the Sepsis-3 definition. The SIC score addresses 3 domains for a possible 0 to 6 points […]
Episode 650: Should vasopressin be started sooner rather than later in septic shock?
In this episode, I’ll discuss whether vasopressin should be started sooner rather than later in septic shock. Subscribe on iTunes, Android, or Stitcher Sepsis guidelines recommend starting vasopressin once the norepinephrine dose reaches 0.25 to 0.5 mcg/kg/min if the patient’s MAP is not adequate. However the best timing for the addition of vasopressin is still […]
Episode 649: Do albumin infusions improve outcomes in hospitalized patients with decompensated cirrhosis?
In this episode, I’ll discuss whether albumin infusions improve outcomes in hospitalized patients with decompensated cirrhosis. Subscribe on iTunes, Android, or Stitcher Albumin is frequently used for various indications in hospitalized patients, but in some use cases the evidence of benefit is unclear. Albumin may fall under the laboratory or pharmacy budget depending on how […]
Episode 648: Prehospital antibiotics for severe sepsis
In this episode, I’ll discuss prehospital antibiotics for severe sepsis. Subscribe on iTunes, Android, or Stitcher Back in episode 185, I discussed a study that looked at Delays From First Medical Contact to Antibiotic Administration for Sepsis. The authors found that the median time from first medical contact to antibiotic administration was 4.2 hours with a […]
Episode 647: Do Patients Taking Beta-Blockers Require Increased Doses of Epinephrine for Anaphylaxis?
In this episode, I’ll discuss whether patients taking beta-blockers require increased doses of epinephrine for anaphylaxis. Subscribe on iTunes, Android, or Stitcher Animal data suggests that patients taking beta-blockers have more severe anaphylaxis, possibly by decreasing the threshold for mast cell activation. With beta-blockers interfering with the same receptors epinephrine needs to activate in order […]
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