iSepsis Project (EMCrit)

Vitamin C, Hydrocortisone and Thiamine: Q/A. We have received hundreds of e-mails (and a few letters to the Editor) in response to the publication of our paper. Below is a compilation of the most common questions together with our best answers.  Q. Why was the mortality rate in your control group so high relative to world averages? A.  When we began using this “cocktail” we … [Read more...]

Vitamin C, Hydrocortisone and Thiamine for the treatment of Severe Sepsis and Septic Shock: “The Metabolic Resuscitation Protocol".  A large body of experimental data has demonstrated that both corticosteroids and intravenous vitamin C reduce activation of nuclear factor kB (NF-kB) attenuating the release of pro-inflammatory mediators, reduce the endothelial injury … [Read more...]

Vena Caval Ultrasonography. Why? It has been well established that only about 50% of hemodynamically unstable patients are fluid responsive; i.e that they will increase their stroke volume by greater than 10% following a fluid challenge (usually 500 cc crystalloid). Consequently many static and dynamic “hemodynamic” parameters have been investigated (and adopted) as indices of … [Read more...]

The Treatment Approach to Sepsis. We believe that sepsis is a treatable and “curable” disease and that if the disease is diagnosed early and treated according the evidence-based approach outlined below patients will not develop progressive organ failure or die from sepsis.  It is however important to emphasize that patients with a rapidly fatal and/or incurable underlying … [Read more...]