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Septic shock is a frequent condition in emergency departments, requiring rapid hemodynamic assessment. Noninvasive cardiac output monitoring (NICOM) offers a convenient method for evaluating these patients. In this study, we retrospectively analyzed 50 septic shock patients (34 males, 16 females) from a cohort of 627 NICOM cases in northern Taiwan emergency department between January 2020 and December 2021. Patients were classified into normal and high stroke volume variation percentage groups, and survivors versus non-survivors. The high stroke volume variation percentage group had an older average age (72.1 vs 59.5, P = .004) and required more fluid resuscitation before inotropic agents (1322 mL vs 864 mL, P = .043). Non-survivors were older (77.6 vs 64.7 years, P = .013), had higher NT-proBNP levels (655 vs 307, P = .029), and longer ICU stays (3.7 vs 1.2 days, P = .007). The overall mortality rate was 22%. NICOM is a valuable tool for guiding fluid resuscitation in septic shock patients. Further studies are recommended to refine its application.
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http://dx.doi.org/10.1097/MD.0000000000043990 | DOI Listing |
Extracorporeal blood purification (EBP) is an emerging technique for reducing elevated levels of inflammatory mediators and/or endotoxins in critically ill patients with sepsis or other hyperinflammatory conditions. The oXiris filter combines endotoxin adsorption, cytokine adsorption, hemofiltration and anti-thrombosis, and an emerging body of evidence demonstrates its use in critical care patients with hyperinflammatory conditions and acute kidney injury (AKI). A group of Asia-Pacific experts convened to formulate consensus statements for the use of the oXiris filter based on a comprehensive review of publications.
View Article and Find Full Text PDFPediatr Crit Care Med
September 2025
Paediatric Intensive Care Unit, Great Ormond Street Hospital for Children NHS Foundation Trust and NIHR Biomedical Research Centre, London, United Kingdom.
Objective: To review the timing of death in children with sepsis referred for intensive care, 2018-2023, and compare with our previous 2005-2011 practice. We hypothesized that most deaths occur within 24 hours of referral to the PICU, with many before PICU admission.
Design, Setting, And Patients: We reviewed referrals to the Children's Acute Transport Service (CATS), North Thames regional pediatric intensive care transport service in the United Kingdom, between January 2018 and March 2023.
Cardiol Rev
September 2025
Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Sepsis remains a leading cause of critical illness and mortality worldwide, driven by a dysregulated host response to infection and often complicated by persistent tachycardia and cardiovascular dysfunction. Increasing evidence implicates excessive sympathetic activation as a contributor to sepsis-related hemodynamic instability and myocardial injury, prompting growing interest in the use of β-adrenergic blockade as a therapeutic adjunct. This review synthesizes current data on the safety and efficacy of short-acting, cardioselective β-blockers (BBs), particularly esmolol and landiolol, in septic shock.
View Article and Find Full Text PDFCrit Care Explor
September 2025
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Objective: Vitamin C has been linked to alterations in platelet count and aggregation behavior. Given recent findings suggesting an association between vitamin C and adverse outcomes in patients with septic shock, we aimed to investigate whether vitamin C influences mortality in septic patients through its impact on platelets.
Design: Post hoc analysis of the Lessening Organ Dysfunction With Vitamin C (LOVIT) randomized trial (clinicaltrials.
South Afr J Crit Care
May 2025
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background: Shock, characterised by circulatory hypoperfusion and cellular hypoxia, represents a critical medical condition requiring immediate attention. Despite its significance, there are limited data on shock incidence and outcomes, particularly within the context of Thailand.
Objectives: This retrospective observational study aimed to investigate the incidence, management and outcomes of shock patients admitted to the internal medicine department of Siriraj Hospital, a referral university hospital in Bangkok, Thailand.