Articles Tagged With: Shock
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Differentiating and Managing Pediatric Shock
Early recognition and management of pediatric shock is critical for acute care providers. The authors review the subtle presentations, different approaches, and management strategies to effectively manage the different types of pediatric shock.
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Optimal Blood Pressure Targets in Different Shock States
This review will discuss the different shock states and the suggested BP targets for the different subsets of patients.
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Management of Pediatric Shock
Pediatric shock carries a high morbidity and mortality, making early recognition key. Recently, pediatric critical care and resuscitation has been the focus of emergency department care improvement.
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Patients with Higher Renin Levels May Derive More Benefit from Angiotensin II Treatment
Serum renin concentration in patients with catecholamine-resistant vasodilatory shock may identify those for whom treatment with angiotensin II has improved intensive care unit outcomes.
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Vitamin C, Thiamine, and Steroids for Septic Shock — Still Unproven
Combination treatment with ascorbic acid (vitamin C), thiamine (vitamin B1), and corticosteroids does not improve clinical outcomes in adults with septic shock.
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ORANGES and ACTS Trials: No Mortality Benefit with Ascorbic Acid, Thiamine, and Hydrocortisone in Septic Shock Patients
Two double-blinded, placebo-controlled, randomized trials involving 337 patients (ORANGES, n = 137; ACTS, n = 200) with sepsis and septic shock have shown that administration of ascorbic acid, thiamine, and hydrocortisone did not reduce organ dysfunction or improve overall mortality. However, both trials showed that this combination therapy was effective in reducing the time to achieve shock resolution or shock-free days.
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Improving Sepsis Outcomes: Raising the Bar
In addition to compliance with the sepsis bundles, how can critical care providers revolutionize and individualize sepsis care for optimal results?
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IDSA Sepsis Committee and SEP-1 Quality Measures
The IDSA Sepsis Committee proposes that The Centers for Medicare & Medicaid Services’ Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) should be applied only to septic shock, not sepsis without shock.
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Vitamin C, Thiamine, and Hydrocortisone for Septic Shock
The combination of vitamin C, thiamine, and hydrocortisone did not improve outcomes compared with hydrocortisone alone in patients with septic shock.
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Balanced Crystalloids Reduce Mortality in Critically Ill Adults With Sepsis or Septic Shock
Compared to saline, balanced crystalloids reduced in-hospital mortality and major adverse kidney events within 30 days in critically ill patients with sepsis or septic shock.