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martes, 30 de enero de 2018

Metabolic Sepsis Resuscitation

PulmCrit (EM Crit)

PulmCrit (EM Crit) - January 29, 2018 - By Josh Farkas
  • "The ADRENAL trial showed that stress-dose steroids are fairly safe, have no mortality benefit, and accelerate clinical improvement.
  • ADRENAL shows that steroid offers meaningful patient-centered benefit to patients on anydose of vasopressor (not solely patients on high-dose vasopressor).
  • Treatment for septic shock involves immediate initiation of numerous therapies to stabilize the patient as rapidly as possible. It makes sense to initiate steroid promptly, rather than withholding it until the patient is failing to respond to high doses of vasopressor.
  • Metabolic sepsis resuscitation with hydrocortisone, ascorbic acid, and thiamine remains controversial. By demonstrating the safety and efficacy of hydrocortisone, the ADRENAL study provides indirect support for this combination."