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REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

RebelEM

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4 Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4

Sepsis 105
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Episode 7: Sepsis

PHEM Cast

[link] We hope you enjoyed our sepsis podcast. St Emlyns Induction podcast on Sepsis. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. March 2016.

Sepsis 52
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REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

RebelEM

Click here for Direct Download of the Podcast Paper: Knack SKS et al. It is possible that the induction agent used could play an important role on hemodynamic effects in critically ill adults. REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED? Range 5 to 9) Etomidate: 7.0 Range 5 to 9) Diff -0.2; 95% CI -1.4

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Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS

PulmCCM

Further, the treating clinician must have deemed either normal saline or balanced crystalloid as appropriate resuscitation options; the patient’s expected-admission to the ICU must have been at least 3 days. saline crystalloid resuscitation, the inter-trial evaluations become murkier, though seemingly less tendentious.

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REBEL Core Cast 94.0 – SBO

RebelEM

Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5

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Back to the BaSICS: does the infusion rate of a fluid bolus affect mortality?

PulmCCM

Sylvia Plath Background Implicit in resuscitation is speed. Septic sheep randomized to early, rapid volume resuscitation had greater vasopressor requirements 12 hours after initial fluid bolus. sepsis – defined as suspected or confirmed infection plus acute organ dysfunction; d.] Jon-Emile S. older than 65 years; b.]

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What Minimal Volume of Intravenous Fluid Challenges the Heart?

PulmCCM

.’ What they found 45 critically-ill patients were included with a 28-day mortality rate of 29%; distributive shock was the most common cause of circulatory failure with sepsis being the most common cause of distributive physiology. Download his free textbook here. mL/kg and 4.2 mL/kg, respectively.