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An Herbal Hope: Is XBJ A Game-Changer in Sepsis Management?

RebelEM

Background: Could Xuebijing (XBJ) catalyze a paradigm shift in sepsis management? XBJ is an herbal compound used in China to manage various inflammatory and infectious processes in recent years, including sepsis. This post evaluates the recent “Efficacy of Xuebijing Injection in Patients With Sepsis (EXIT-SEP)” trial.

Sepsis 98
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Adjunctive Methylene Blue in Septic Shock?

RebelEM

Background: Sepsis can induce numerous physiologic derangements. It also reduced length of stay in ICU and hospital without adverse effects. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e. septic shock). 95% CI 15.4

Shock 145
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REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below). PMID: 21422387 Wan S et al. Thrombolysis Compared with Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials. PMID: 15262836 Sharifi M et al.

Stroke 136
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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

The patient was extubated on Day-3 of the hospital stay. The stay in the cardiac intensive care unit (CICU) was further complicated by sepsis, delirium, GI bleeding, and anuric renal failure with need for renal replacement therapy. However, he suddenly developed a series of malignant ventricular arrhythmias.

EKG/ECG 131
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Diagnostics: Inflammatory Markers

Taming the SRU

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear. Cleland DA, Eranki AP.

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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Taming the SRU

2018) Epidemiology of lumbar punctures in hospitalized patients in the United States. The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. Journal of the history of the neurosciences, 6(2), 147–153. PLOS ONE 13(12): e0208622. van de Beek, D.,

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The Pediatric Surgical Abdomen

Pediatric Emergency Playbook

2004; 199(4):628-635. Management of the child after enema-reduced intussusception: hospital or home? 2004 Aug;44(2):131-7. Acute Intestinal Obstruction in children: Experience in a Tertiary Care Hospital. Intestinal Malrotation in Children: A Problem-Solving Approach to the Upper Gastrointestinal Series. Radiographics.