51. Sepsis

In this episode of Critical Care Time, Drs. Cyrus Askin and Nick Mark delve into the extensive history of sepsis, tracing its understanding and treatment from ancient times to the present day. They explore the contributions of historical figures like Hippocrates, Ignaz Semmelweis, and Florence Nightingale, and discuss the evolution of sepsis definitions, diagnostic tools, and treatment strategies, including the impact of the Rivers Protocol and the Surviving Sepsis Campaign. The hosts also discuss current controversies and future directions in sepsis management, such as the use of vitamin C, beta blockers, and precision medicine approaches, and share their pragmatic approaches to managing septic patients in the ICU, emphasizing early action, source control, and individualized care.

Outlines

Part 1: Historical Context and Early Discoveries

Part 2: Development of Sepsis Treatment Protocols

Part 3: Current Controversies and Future Directions

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Critical Care Time

Part 1: Historical Context and Early Discoveries

Introduction to Sepsis: Historical Perspectives

Key Figures in Early Sepsis Understanding: Semmelweis and Osler

Advancements in Microbiology, Antibiotics, and the Birth of the ICU

Part 2: Development of Sepsis Treatment Protocols

The Development of Central Lines, Swan-Ganz Catheters, and Early Goal-Directed Therapy

Criticisms of Early Goal-Directed Therapy and the Rise of the Surviving Sepsis Campaign

Questioning Early Goal-Directed Therapy and the Seminal Studies: ARISE, PROCESS, and PROMISE

Vasopressors, Steroids, and the Sepsis-3 Definition

The 2021 Surviving Sepsis Campaign Guidelines and Pathophysiology of Sepsis

Part 3: Current Controversies and Future Directions

Antimicrobial Stewardship, Long-Term Morbidity, and the Vitamin C Controversy

Cognitive Fallacies, Eminence-Based Medicine, and Beta Blockers in Sepsis

Chemoperfusion Strategies, Point-of-Care Renal Testing, and Precision Medicine

Pragmatic Approaches to Sepsis Management and Farewell

51. Sepsis

Critical Care Time

Part 1: Historical Context and Early Discoveries

00:02Introduction to Sepsis: Historical Perspectives

Introduction to Sepsis: Historical Perspectives

07:11Key Figures in Early Sepsis Understanding: Semmelweis and Osler

Key Figures in Early Sepsis Understanding: Semmelweis and Osler

13:44Advancements in Microbiology, Antibiotics, and the Birth of the ICU

Advancements in Microbiology, Antibiotics, and the Birth of the ICU

Part 2: Development of Sepsis Treatment Protocols

20:03The Development of Central Lines, Swan-Ganz Catheters, and Early Goal-Directed Therapy

The Development of Central Lines, Swan-Ganz Catheters, and Early Goal-Directed Therapy

27:39Criticisms of Early Goal-Directed Therapy and the Rise of the Surviving Sepsis Campaign

Criticisms of Early Goal-Directed Therapy and the Rise of the Surviving Sepsis Campaign

35:04Questioning Early Goal-Directed Therapy and the Seminal Studies: ARISE, PROCESS, and PROMISE

Questioning Early Goal-Directed Therapy and the Seminal Studies: ARISE, PROCESS, and PROMISE

44:47Vasopressors, Steroids, and the Sepsis-3 Definition

Vasopressors, Steroids, and the Sepsis-3 Definition

53:08The 2021 Surviving Sepsis Campaign Guidelines and Pathophysiology of Sepsis

The 2021 Surviving Sepsis Campaign Guidelines and Pathophysiology of Sepsis

Part 3: Current Controversies and Future Directions

1:02:04Antimicrobial Stewardship, Long-Term Morbidity, and the Vitamin C Controversy

Antimicrobial Stewardship, Long-Term Morbidity, and the Vitamin C Controversy

1:14:01Cognitive Fallacies, Eminence-Based Medicine, and Beta Blockers in Sepsis

Cognitive Fallacies, Eminence-Based Medicine, and Beta Blockers in Sepsis

1:25:24Chemoperfusion Strategies, Point-of-Care Renal Testing, and Precision Medicine

Chemoperfusion Strategies, Point-of-Care Renal Testing, and Precision Medicine

1:35:33Pragmatic Approaches to Sepsis Management and Farewell

Pragmatic Approaches to Sepsis Management and Farewell