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Sepsis

Endothelial glycocalyx: http://lifeinthefastlane.com/education/ccc/glycocalyx-in-critical-illness/

From Weingart:

Evidence for Non-Invasive Protocol

1. Jones AE, Shapiro NI, et al.; Emergency Medicine Shock Research Network (EMShockNet) Investigators. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010 Feb;303(8):739-46.
Evidence for the Invasive Protocol
2. Jones AE, Brown MD, et al.; Emergency Medicine Shock Research Network investigators. The effect of a quantitative resuscitation strategy on mortality in patients with sepsis: a meta-analysis. Crit Care Med. 2008 Oct;36(10):2734-9. Review.
3. Rivers, E, Nguyen, B, et al. (for the Early Goal-Directed Therapy Collaborative Group). Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock. N Engl J Med. 2001 Nov; 345(19):1368?77.
4. Rivers EP. Point: adherence to early goal?directed therapy: does it really matter? Yes. After a decade, the scientific proof speaks for itself. Chest. 2010 Sep;138(3):476-80; discussion 484-5.

Sonography of the IVC for Prediction of Fluid Responsiveness

1. Brennan JM, Blair JE, et al. A comparison by medicine residents of physical examination versus hand?carried ultrasound for estimation of right atrial pressure. Am J Cardiol. 2007 Jun;99(11):1614-6. Epub 2007 Apr 18.

2. Brennan JM, Ronan A, et al. Handcarried ultrasound measurement of the inferior vena cava for assessment of intravascular volume status in the outpatient hemodialysis clinic. Clin J Am Soc Nephrol. 2006 Jul;1(4):749-53. Epub 2006 May 24.
3. Carr, Brendan G., Dean, Anthony J., et al.; Intensivist Bedside Ultrasound (INBU) for Volume Assessment in the Intensive Care Unit: A Pilot Study. Journal of Trauma-Injury Infection & Critical Care. 2007 Sept: 63(3): 495-502.
4. Kircher BJ, Himelman RB, Schiller NB. Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol. 1990
Aug;66(4):493-6.
5. Moretti R, Pizzi B. Inferior vena cava distensibility as a predictor of fluid responsiveness in patients with subarachnoid hemorrhage. Neurocrit Care. 2010 Aug;13(1):3-9.

6. Nagdev AD, Merchant RC, et al. Emergency department bedside ultrasonographic measurement of the caval index for noninvasive determination of low central venous pressure. Ann Emerg Med. 2010 Mar;55(3):290-5. Epub 2009 Jun 25.

7. Weekes A., Tassone H., Tayal V.S. et al. 233: The Sonodynamic Study: Comparison of Qualitative Versus Quantitative Assessment and Inter-Rater Reliability In Serial Ultrasonography Evaluations of Inferior Vena Cava Dynamics and Left Ventricular Systolic Function In Fluid Resuscitation of Emergency Department Patients With Symptomatic Hypotension. Annals of Emergency Medicine. 2010 Sept: 56(3), Supplement , Page S77.

8. Yanagawa, Youichi; Sakamoto, Toshihisa; Okada, Yoshiaki. Hypovolemic Shock Evaluated by Sonographic Measurement of the Inferior Vena Cava During Resuscitation in Trauma Patients. Journal of Trauma-Injury Infection & Critical Care. 2007 Dec. 63(6):1245?1248.

Lactate as a Marker for Adequate Resuscitation

1. Jansen TC, van Bommel J, et al for the LACTATE study group. Early lactate-guided therapy in Intensive Care Unit patients: A multicenter, open-label, randomized controlled trial. Am J Respir Crit Care Med. 2010 Sept;182(6): 752-761
2. Levy MM, Dellinger RP, et al.; Surviving Sepsis Campaign. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med. 2010 Feb;38(2):367-74.

Early Antibiotics

1. Kumar A, Roberts D, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006 Jun;34(6):1589-96.
2. Kumar A, Ellis P, et al.; Cooperative Antimicrobial Therapy of Septic Shock Database Research Group. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest. 2009 Nov;136(5):1237-48. Epub 2009 Aug 20.

Barriers to Implementation

1. Carlbom DJ, Rubenfeld GD. Barriers to implementing protocol-based sepsis resuscitation in the emergency department: results of a national survey. Crit Care Med. 2007 Nov; 35(11):2525-32.

2. Mikkelsen ME, Gaieski DF, et al. Factors associated with nonadherence to early goaldirected therapy in the ED. Chest. 2010 Sep;138(3):551-8. Epub 2010 Feb 19. 

Surviving Sepsis Campaign Guidelines
1. Dellinger RP, Levy MM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med. 2008 Jan; 36(1):296-327. Erratum in: Crit Care Med. 2008 Apr;36(4):1394-6.
Normal Vital Signs do not predict adequate resuscitation 

1. Rady MY, Rivers EP, Nowak RM. Resuscitation of the critically ill in the ED: responses of blood pressure, heart rate, shock index, central venous oxygen saturation, and lactate. Am J Emerg Med. 1996 Mar; 14(2):218-25.
Intubation will improve organ perfusion
1. Hernandez G, Peña H, et al. Impact of emergency intubation on central venous oxygen saturation in critically ill patients: a multicenter observational study. Crit Care. 2009; 13(3):R63. Epub 2009 May 4.

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