Fluid Tolerance in the Septic Patient–Outstanding 2012 Vimeo Video

Fluid Resuscitation in Severe Sepsis is an outstanding 2012 Vimeo video from Dr. Chad Meyers.

The whole video is worth watching several times and the summary from 16:05 to 17:39 (the end) brilliantly sums up his whole talk.

Resources:

A-lines and B-lines: lung ultrasound as a bedside tool for predicting pulmonary artery occlusion pressure in the critically ill [PubMed Abstract], [Full Text HTML], [Full Text PDF]. Chest. 2009 Oct;136(4):1014-20. doi: 10.1378/chest.09-0001.

Lung ultrasound predicts well extravascular lung water but is of limited usefulness in the prediction of wedge pressure [PubMed Abstract]. Anesthesiology. 2014 Aug;121(2):320-7. doi: 10.1097/ALN.0000000000000300.

Lactate Clearance vs Central Venous Oxygen Saturation as Goals of Early Sepsis Therapy:
A Randomized Clinical Trial [PubMed Abstract], [Full Text HTML], [DownloadPDF]. JAMA. 2010 Feb 24;303(8):739-46. doi: 10.1001/jama.2010.158.

To: NQF’s Patient Safety Standing Committee
        NQF Consensus Standards Approval Committee (CSAC)
Re: Severe Sepsis and Septic Shock: Management Bundle (NQF measure #0500)
FM: Henry Ford Health Systems, The Measure Steward
Date: 6-26-2014 [Download PDF] : “The original NQF Sepsis Measure 0500 was submitted in 2007 and was approved in 2013 some 6 years after submission. Within a few months after this approval, a NQF Ad Hoc Committee’s responded to a request to review the Protocolized Care for Early Septic Shock (ProCESS) trialwhich was published on March, 2014.1 Less than 3 months after the ProCESS trial was published, the Ad Hoc Committee, by the most narrow margin voted to remove from it item ‘F’ or the central venous catheter (CVC) to measure central venous pressure (CVP) and oxygen saturation (ScvO2) as measure goals.” This memo then goes on to describe the writers objections to this change.

Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock [PubMed Abstract], [Full Text HTML], [Full Text PDF]. Rivers E et al, N Engl J Med. 2001 Nov 8;345(19):1368-77. 

Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares [PubMed Abstract], [Full Text HTML], [Full Text PDF].

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