Topic Review - Newest First (only newest 5 are displayed)

icumicuccu

Re: septic shock

The patient is doing well and has no disability

memon

Re: septic shock

How is the Patient now. Please update us. Have you learnt any thing from this case? Would you manage it any different next time?

Aamir

amujtaba

Re: Re: septic shock

quote:

---

yasir wrote:
Excellent Management, but unfortunate patient. It is glad to know that you have tried all possible means to save the patient.

Cardian depression can also be due to Pneumococcal induced Myocarditis. And use of dobutamine in this case is recommended.

I wanted to know details about PROWESS trial as it is not available in NEJM.

What to do if you dont have all these facilities available? We see such paitents daily in our emergencies, and start treatment empirically most of the time, our patients and hospitals both are poor.

What is the recommendation of starting Steroids in sepsis?

---

Regarding the steroid question,
I think this paper by Marik and Zagola is an interesting read; although keep in mind that Dr Marik's views are a little extreme about the issue
Adrenal Insufficiency in the Critically Ill*
A New Look at an Old Problem
Paul E. Marik, MD, FCCP and Gary P. Zaloga, MD, FCCP Chest. 2002;122:1784-1796.)

icumicuccu

Re: septic shock

No she is white
now hemodynamically stable
off the ventilator
neurologically intact
undergoing daily but regular hemodialysis as apposed to CRRT. We will attempt to space out dialysis timing to see if her electrolytes stay stable and she makes any urine
she has developed extensive excoriation and bullous skin lesions in her extremities requiring burn type care they are presumably a result of hypoperfusion
has pulses in her extremities but a few cyanotic digits not gangrenous yet we are closely observing those
so there is hope
thanks for asking

chameed

Re: septic shock

Is this a black woman? and is she still alive?