In this randomized, double-blinded, placebo-controlled trial, intravenous vitamin C infusion did not influence a change in the modified Sequential Organ Failure Assessment score from the time of infusion to four days compared to placebo.
While taking blood cultures should not significantly delay needed treatment, investigators noted their data prove that cultures taken post-treatment lose nearly half the clinical information needed to make subsequent treatment decisions.
The authors of this study used development and validation cohorts to retrospectively identify temperature trajectories over the first 72 hours from presentation in the setting of sepsis. Patients presenting with hyperthermia that resolved quickly (within the first 24 hours) had lower mortality compared to those with slow resolution or those presenting with hypothermia.
Sepsis is not always diagnosable, or even present, at the time of an ED visit. All testing performed in the ED may provide negative results. Despite these facts, plaintiffs still may prevail in a missed sepsis lawsuit.
Adult patients experiencing sepsis with hypotension but who did not meet the definition of septic shock received a median of 800 mL of intravenous fluid prior to initiation of norepinephrine 0.05 mcg/kg/min as a non-titratable infusion. Patients in this early vasopressor group had much lower odds of failing to achieve their primary outcome of adequate mean arterial pressure and tissue perfusion when early norepinephrine was provided.
In this systematic review and meta-analysis of randomized, controlled trials comparing administration of corticosteroids with placebo or standard supportive care in sepsis, corticosteroids were associated with reduced 28-day mortality.
This article addresses the pathophysiology, discusses various clinical presentations, and reviews current evidence-based practices for managing adrenal insufficiency and crisis in the emergency department.