Intensive Care Medicine

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The Surviving Sepsis Campaign (SSC) has released a new updated Hour-1 Bundle to reflect the latest evidence from the International Guidelines for Management of Sepsis and Septic Shock 2016.

In this revision of the SSC bundles, the 3-hour and 6-hour bundles have been combined into a single “Hour-1 Bundle” with the explicit intention of beginning resuscitation and management immediately. This new sepsis “Hour-1 Bundle” should be introduced to staff in the emergency department (ED), wards, and intensive care unit as the next iteration of ever-improving tools in the care of patients with sepsis and septic shock as we all work to lessen the global burden of sepsis.

ESICM is releasing the The Surviving Sepsis Campaign Bundle: 2018 update (Free Access) in our official journal Intensive Care Medicine. Additionally, we have prepared a short animation video to highlight the five steps of the Hour-1 Bundle that healthcare providers should begin as soon as sepsis is recognised:

Featured Article

from Critical Care

Ultrasound-assessed diaphragmatic impairment is a predictor of outcomes in patients with acute exacerbation of COPD undergoing noninvasive ventilation

In this single-center prospective study, Alessandro Marchioni et al. conclude that early and noninvasive ultrasound assessment of diaphragmatic dysfunction during severe acute exacerbations of COPD is reliable and accurate in identifying patients at major risk for noninvasive ventilation failure and worse prognosis.

Indicators of ICU capacity strain

Strained ICU capacity represents a fundamental supply-demand mismatch in ICU resources. In this systematic review, Oleksa G. Rewa et al. identify and characterize 16 indicators of strained ICU capacity across the spectrum of healthcare quality domains.

Early versus standard initiation of renal replacement therapy (RRT) in furosemide stress test (FST) non-responsive AKI patients (the FST trial)

The timing of initiation of RRT in severe AKI remains controversial, with early initiation resulting in unnecessary therapy for some patients, while expectant therapy may delay RRT for other patients. In this multicenter pilot study, Nuttha Lumlertgul et al. conclude that FST appears to be feasible and effective in identifying patients for randomization to different RRT initiation times.