Background: The Severe Sepsis and Septic Shock Early Management Bundle (SEP-1), the sepsis performance measure introduced by the Centers for Medicare & Medicaid Services (CMS), requires up to 5 hemodynamic interventions, as many as 141 tasks, and 3 hours to document for a single patient. Purpose: To evaluate whether moderate- or high-level evidence shows that use of SEP-1 … [Read more...]
iSepsis – Sepsis 3.0- Flogging a dead horse!
Background: The quick Sequential Organ Failure Assessment (qSOFA) has been proposed for prediction of mortality in patients with suspected infection. Purpose: To summarize and compare the prognostic accuracy of qSOFA and the systemic inflammatory response syndrome (SIRS) criteria for prediction of mortality in adult patients with suspected infection. Data Sources: Four … [Read more...]
iSepsis – Patients with sepsis have SCURVY
Background: Vitamin C is an essential water-soluble nutrient which cannot be synthesised or stored by humans. It is a potent antioxidant with anti-inflammatory and immune-supportive roles. Previous research has indicated that vitamin C levels are depleted in critically ill patients. In this study we have assessed plasma vitamin C concentrations in critically ill patients … [Read more...]
iSepsis – Sepsis 3.0: Much to do about Nothing
Background: Several studies were published to validate quick-SOFA (qSOFA), namely in comparison with Systemic Inflammatory Response Syndrome (SIRS) criteria. We performed a systematic review and a metaanalysis with the aim of comparing qSOFA and SIRS in patients outside the ICU. Method: We searched the MEDLINE, CINAHL, and Web of Science database, from February 23rd, … [Read more...]
iSepsis – The Lactate Myths
Lactate is GOOD for the patient and not BADIt would appear that despite intense scientific inquiry most clinicians still believe that the Earth is flat and that an increased serum lactate is the result of impaired tissue oxygen delivery and anaerobic metabolism. This concept is perpetuated by The Surviving Sepsis Campaign who state “we suggest targeting resuscitation to … [Read more...]