Discover and read the best of Twitter Threads about #Sepsis

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Sepsis - warum ist das knifflig?

Obwohl moderne Medizin mit ausgeklügelten Verfahren vieles erreicht, ist Sepsis - oft missverständlich als „Blutvergiftung“ bezeichnet - bis heute eine der Haupttodesursachen auf Intensivstationen. Wo liegt eigentlich das Problem?
Infektionen - ob mit Bakterien, Viren, Pilzen oder Parasiten - sind für den menschlichen Körper ein alltägliches Phänomen. Die Immunabwehr ist so ausgebildet, dass sie die meisten Krankheitserreger zügig erkennen, lokalisieren und abtöten kann.
Hierbei handelt es sich um einen lokalen Prozess - eine Infektion der Lunge oder in der Haut wird direkt dort bekämpft. Dazu nutzen die Abwehrzellen unseres Immunsystems eine ausgeklügelte Kommunikation, die eine genaue Navigation an den Ort des Geschehens ermöglicht.
Read 11 tweets
Pediatric Sepsis Research on LMIC countries: Overcoming challenges. Another oustanding conferences by Daniela @danicds72 #PedsICU #Sepsis@ILASepse⁩ ⁦@WFPICCS⁩ ⁦@LA_Rednetwork⁩ ⁦@slepe8
The Agenda #PedsICU
The 80/20 Rule. We know 80% from those places where the 20% happens #PedsICU @WFPICCS @SLACIP17 @slepe8 @LA_Rednetwork @atip_latam
Read 28 tweets
Thrilling to see so much focus on #sepsis endotyping and reducing heterogeneity at #ISICEM19 @ISICEM! For the non-expert, perhaps a brief review is helpful: /1
Lots of prognostic tools for #sepsis exist, and many are well-validated. Although endotypes often show outcomes differences at baseline, they are NOT for outcomes prediction! Purpose-built tools and biomarkers are better for this. /2
Instead, the goal of #sepsis endotyping is PREDICTIVE enrichment, by which we mean, predicting which patients will respond favorably to a given drug (classically an immunotherapy). Since no drug has ever been shown to work in the broad sepsis population, the idea is that /3
Read 10 tweets
#twitterjournalclub
The ANDROMEDA- SHOCK Randomised Clinical Trial
Thoughts by @z_cepillo
jamanetwork.com/journals/jama/…
Multicentre (28) open label RCT to determine if peripheral perfusion targeted resuscitation during early septic shock in adults is more effective than a lactate-targeted resuscitation for reducing mortality.
Inclusion criteria: adult patients with septic shock (infection, lactate >2, vasopressors to maintain MAP >65mmHg after IV fluid of 20ml/kg over 60 mins.
Read 26 tweets
This week's Tweetorial is by @doctorsinfuga & is on the #CENSER study published by @ATSBlueEditor last week showing early noradrenaline is associated with increased shock control by 6 hours:
atsjournals.org/doi/pdf/10.116…
#atsjournals #sepsis #vasopressors
CENSER was a phase II, randomized, double-blind, placebo-controlled clinical single center trial conducted in Bangkok during the October 2013 to March 2017
Adults aged ≥18 years who presented to the emergency room with MAP<65mmHg and suspected infection were eligible for inclusion
Read 18 tweets
🗣️Hilo

Los mejores artículos #PedsICU (UCIP) del 2018 📖
La suma de lo más relevante publicado y un #Tweetorial acompañante

Selección colaborativa con entre @PICJournalWatch & @sgdambrauskas
Publicado en simultáneo Inglés/Español

Favor comparte. ¡Nos vemos en 2019!
1/
Estudio PARIS en @nejm
Gran estudio que gatilló discusión en el ámbito del #CNAF. Incluso diferentes interpretaciones de resultados de sus coautores

¿Cambió mi práctica? NO
¿Mi investigación? SI

ncbi.nlm.nih.gov/pubmed/29562151

Lean correspondencia:
nejm.org/doi/full/10.10…
2/
ECA en @PedCritCareMed
@pus27 y cols encontraron que #CPAP precoz en niños inmunocomprometidos admitidos en #PedsICU no es mejor (incluso peor) que O2 estándar en 🇬🇧
¿Cambió mi práctica? Quizás
¿Mi investigación? NO

ncbi.nlm.nih.gov/pubmed/30095746
Read 21 tweets
1/ 🗣️
Aquí va un hilo en vivo sobre mis frases preferidas de las III Jornadas Internacionales de @LA_Rednetwork

Here a live-thread about 🔝phrases/ideas from today's III @LA_Rednetwork anual meeting

#sepsis #PICSyndrome
#PedsICU #MeetingLARed18 @juancajara78 @rjabornisky

👇
2/
Arriving at @PeluffoGiguens and we look at the board the invitation
Llegamos Fundación y vemos la cartelera

#MeetingLARed18
3/
With @Nmtvd preparing connections

#MeetingLARed18
Read 52 tweets
Starting "Voices without Frontiers" #VoicesIWS
A program by @IWS_Network to promote awareness about the challenges & lessons learned by #Immigrant and #International #WomenInScience

I was born & raised in Chicoral, Colombia. A tiny town in the middle of the Andes Cordillera.
I attended Nuestra Señora del Rosario school, located in Espinal, 15Km away from Chicoral. Due to the high heat by noon, all schools start really early back home. This meant, I had to wake up at 5am to attend school every morning since I was 4 years old. #VoicesIWS
I did well in math and science in elementary and high school, so I chose to study clinical microbiology. Although coming from a low-middle income family, I was able to attend university, thanks to my parents’ effort to prioritize education over other commodities. #VoicesIWS
Read 40 tweets
#BigData #ICU #sepsis research I wish some1 would do

Optimal Duration of Time-Limited Trials in Critically Ill Patients

"If they are going to respond to this, we should see a response by ..."

What are median + 95th percentile for responses to common life-saving therapies?
I feel like we "know" this for lots of small things
- Lasix should make 'em pee within 20 minutes
- PEEP improves oxygenation in 20 minutes
- uroseptic shock should break within 24 hour
There are some scattered superb research projects:
- optimal durations of SBTs
- optimal time to neuroprognostication s/p anoxic injury
- Blood cultures will turn positive for MRSA w/i 48 hours if they are going to
Read 6 tweets

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