Posts Tagged ‘sepsis’

The Final Nail in Early Goal Directed Therapy’s Coffin?

Posted by • March 24th, 2015

You are called to evaluate Ms. Smith urgently.  She reports several days of progressive malaise, weakness and a new cough. On your exam she is tachycardic, tachypneic and febrile.  You diagnose Ms. Smith with sepsis and explain the importance of quickly treating this life-threatening condition.  In the United States, situations like this—presentations leading to the… Read More…

ICU-Acquired Weakness

Posted by • April 25th, 2014

Stays in intensive care units are commonly accompanied by muscle weakness. The latest article in the Critical Care series reviews the basis for this condition and provides guidance on how to prevent, diagnose, and treat it. Weakness acquired in the intensive care unit (ICU) is caused by many different pathophysiological mechanisms that are not mutually exclusive…. Read More…

Sepsis, Albumin, and the Therapeutic Potential of Improving Oncotic Pressure

Posted by • April 9th, 2014

In physiology, as in all other sciences, no discovery is useless … we may be certain that every advance achieved in the quest of pure knowledge will sooner or later play its part in the service of man. —    Dr Ernest Henry Starling, The Linacre Lecture on the Law of the Heart (1915) Modern sepsis treatment owes a… Read More…

45-Year-Old Man with a Rash

Posted by • March 28th, 2014

In the latest Case Record of the Massachusetts General Hospital, a 45-year-old man was admitted to the hospital because of diffuse, purple, blanching livedo over his arms and legs and signs of severe sepsis. Three days before presentation, the patient was bitten on his hands and forearms while bathing his dog. A diagnostic test result… Read More…

Severe Sepsis and Septic Shock

Posted by • August 30th, 2013

Sepsis, a complex physiological and metabolic response to infection, is a common reason for admission to an intensive care unit. The first article in our Critical Care Medicine review series examines the basis, diagnosis, and current treatment of this disorder. In 1992, an international consensus panel defined sepsis as a systemic inflammatory response to infection, noting… Read More…

New NEJM Review Series: Critical Care

Posted by • August 29th, 2013

The first article in a new series on Critical Care, Severe Sepsis and Septic Shock, is now available on NEJM.org. Sepsis, a complex physiological and metabolic response to infection, is a common reason for admission to an ICU. This review, from University of Pittsburgh’s Derek Angus and University of Amsterdam’s Tom van der Poll, examines the… Read More…

Infective Endocarditis

Posted by • April 13th, 2013

Diagnosis of endocarditis is usually based on clinical, microbiologic, and echocardiographic findings. Treatment involves antimicrobial therapy targeted to the identified organism. Surgical indications include heart failure, uncontrolled infection, and prevention of embolic events. The latest article in our Clinical Practice series reviews diagnosis and treatment options for infective endocarditis. Infective endocarditis has an estimated annual incidence… Read More…

Starch or Ringer’s Acetate in Severe Sepsis

Posted by • July 11th, 2012

When a skydiver is falling through the air at 50 m/s, he needs to make a snap decision: pull out the parachute now, or later? The choice needs to be made quickly and he needs to be sure about it—it’s the difference between life and death. Treating a patient with sepsis can feel like skydiving… Read More…