Sepsis archivos - Perfusfind Intensive Care

Fluid resuscitation management in patients with sepsis and septic shock: a network meta-analysis

Summary This network meta-analysis of 28 randomized controlled trials (8,770 patients) compares fluid resuscitation strategies in sepsis/septic shock. Balanced crystalloids (BC) demonstrated significant advantages, reducing 90-day mortality compared to saline (RR 0.89) and low-molecular-weight hydroxyethyl starch (L-HES; RR 0.84). Hyperoncotic albumin showed promise for renal protection but BC ranked highest overall, with superior outcomes for […]

fluid resuscitation, sepsis, septic shock

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Sepsis

Efficacy of targeting high mean arterial pressure for older patients with septic shock (OPTPRESS): a multicentre, pragmatic, open-label, randomised…

Abstract: Endo et al. conducted the OPTPRESS trial, a multicenter randomized controlled trial in Japan, evaluating whether a higher mean arterial pressure (MAP) target (80–85 mmHg) reduces mortality in older patients (≥65 years) with septic shock compared to standard targets (65–70 mmHg). The trial was terminated early due to increased mortality and adverse events in

Critical Care, mean arterial pressure, septic shock

Efficacy of targeting high mean arterial pressure for older patients with septic shock (OPTPRESS): a multicentre, pragmatic, open-label, randomised… Read Post »

Sepsis

Biomarkers to guide sepsis management

🧬 Biomarkers to Guide Sepsis Management: The Next Frontier Abstract: Sepsis remains a leading global cause of mortality and morbidity. This review highlights how biomarkers—from inflammatory mediators to endothelial and immune markers—are increasingly being used to guide key elements of sepsis management: early diagnosis, antibiotic stewardship, fluid therapy, vasopressor initiation, and immunotherapy. Precision therapeutics anchored

biomarkers, sepsis

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Sepsis

Sepsis-Associated Acute Kidney Injury

Summary Acute kidney injury (AKI) is a common complication of sepsis and significantly increases patient morbidity and mortality. Nearly two-thirds of patients with septic shock develop AKI, resulting in a six- to eightfold increase in mortality. Despite progress in understanding its pathophysiology and biomarkers, there are still limited effective therapies. This review outlines the epidemiology,

acute kidney injury, AKI, sepsis, Sepsis-associated acute lung injury

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Sepsis

Sepsis and post-sepsis syndrome: a multisystem challenge requiring comprehensive care and management—a review

Summary: This comprehensive review discusses the multifaceted nature of sepsis, emphasizing its high mortality and complex management, spanning early recognition, acute intervention, and long-term rehabilitation. Post-sepsis syndrome (PSS) represents a critical challenge with sustained immune dysregulation, chronic inflammation, and metabolic dysfunction leading to recurrent infections, cardiovascular disease, and neurocognitive impairment. The review underscores mitochondrial dysfunction,

sepsis

Sepsis and post-sepsis syndrome: a multisystem challenge requiring comprehensive care and management—a review Read Post »

Sepsis

Sepsis-induced cardiac dysfunction: mitochondria and energy metabolism

Summary of Sepsis-induced cardiac dysfunction: mitochondria and energy metabolism (Yu et al.) Abstract Summary: Yu et al. systematically reviewed the pathophysiological mechanisms underlying sepsis-induced myocardial dysfunction (SIMD), emphasizing mitochondrial dysfunction and disruptions in myocardial energy metabolism. The review highlights critical aspects, including alterations in myocardial substrates, mitochondrial damage, oxidative stress, calcium imbalance, mitochondrial DNA (mtDNA)

cardiac dysfunction, energy metabolism, sepsis

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Sepsis

Metabolic septic shock sub-phenotypes, stability over time and association with clinical outcome

Summary of Metabolic Septic Shock Sub-Phenotypes, Stability Over Time and Association with Clinical Outcome Abstract Summary: Antcliffe et al. examined metabolic sub-phenotypes in septic shock using metabolomic data from two clinical trials (LeoPARDS and VANISH). They identified three distinct metabolic clusters, primarily characterized by lipid metabolite levels, especially lysophospholipids. Persistence in low lysophospholipid clusters correlated

phenotypes, sepsis, septic shock

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Sepsis

Temperature control in sepsis

Summary of Temperature Control in Sepsis Abstract: This mini-review explores the complex role of temperature control in sepsis. While fever can serve as an adaptive immune response, extreme temperatures—either hyperthermia or hypothermia—may lead to harmful outcomes. Evidence on managing temperature in septic patients remains inconclusive, with limited support for the use of antipyretics or cooling

sepsis, temperature

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Miscellaneous, Sepsis

How I personalize fluid therapy in septic shock?

Abstract During septic shock, fluid therapy is aimed at increasing cardiac output and improving tissue oxygenation, but it poses two problems: it has inconsistent and transient efficacy, and it has many well-documented deleterious effects. We suggest that there is a place for its personalization according to the patient characteristics and the clinical situation, at all

Cardiac output, Fluid balance, fluid challenge, fluid therapy, septic shock, Tidal volume, Volume expansion

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Sepsis

“The NET effect”: Neutrophil extracellular traps—a potential key component of the dysregulated host immune response in sepsis

Abstract Neutrophils release neutrophil extracellular traps (NETs) as part of a healthy host immune response. NETs physically trap and kill pathogens as well as activating and facilitating crosstalk between immune cells and complement. Excessive or inadequately resolved NETs are implicated in the underlying pathophysiology of sepsis and other inflammatory diseases, including amplification of the inflammatory

Coagulation, DAMPs (damage-associated molecular patterns), Immunothrombosis, Neutrophil extracellular traps (NETs), sepsis, Thromboinflammation, Thrombosis

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