Empiric dual antipseudomonal coverage:
When do you use it, and why is it only in neutropenic septic shock?
#neutropenia #sepsis #pseudomonas #antibiotics #antimicrobialstewardship #IDTwitter @ABsteward @ABStewardess @IDstewardship @IDdocAdi @DrToddLee @BradSpellberg @IdVilchez
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@IDiots_pod & @DrToddLee
#aminoglycoside on top of beta lactam backbone FTW..? 2/2 Post antibiotic effect while cx cooking from 1 dose?
@InYourFAECIUM @IDstewardship #TwitteRx @ABsteward
(FQ mono tx is NEVER the answer in shock, & in combo tx the BL is doing the heavy lifting)
May 2 • 14 tweets • 5 min read
#sepsis
Is sparing even one more day of multi #vasopressor support worthwhile in #septicshock? #sscguidelines @SCCM #CriticalCare #idcrit #pulmtwitter #MedTwitter #FOAMcc #TwitteRx @CritCareIDN @IM_Crit_ @PulmCrit @IDCritMD @raj_karnatak @MBrigmon @NephRodby @medrants
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How do you “get there?”
@SCCM @SurvivingSepsis #sscguidelines & available lit suggests #albumin may allow ~1 more pressor-free day (poss #ICU LOS as well, debated)
2/14 🧵
Nov 25, 2023 • 13 tweets • 3 min read
Where did the #sepsis 30mL/kg IVF rec come from?
After Rivers’ EGDT in 2001 until 2015, the literature was combed to find how much reasonable physicians gave to septic patients and their outcomes. That #? ~2-3L. Which is ABOUT 30mL/kg for the average sized adult.
Thought 🧵 1/6
I say “reasonable physicians” as the SSC guidelines admit this was decided upon from the average amount given in the pre randomization of PROCESS, ARISE, PROMISE trials. That amount being 2-3L.
#MedTwitter #pulmtwitter #FOAMed #MedEd #critcare #emergencymedicine
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