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Management and Diagnosis of Sepsis and Septic Shock

Duration: 1:41:46

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ivette.r.davis@*.com

Mar 08 2023, 5:43 pm

Great lecture. Sepsis is so intimidating to me and this tool gives me mor insight about management in the ICU.

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ejhang@*.com

Jan 16 2023, 1:04 pm

Nice lecture! I kind of disagree with not giving more IV fluids. I've been hospitalized recently with septic shock with a lactic acid of 4.9. The IV saline helps the shooting pains and lowers my LA and after 1 bag 1000ml of LR I was still at 2.8. Also there seems to be some debate over Lactated Ringers and Normal Saline and kidney damage. A nurse at NYU told me that LR could damage my kidneys it does contain potassium. I kind of like lots of saline for the pain when I have high lactic acid and acidosis. Sometimes during severe infection LR causes pain in the upper back. I also wonder about pressors with decent blood pressure like 100/70 105/70, does this reduce oxygen and blood flow to the heart and kidneys and brain and lungs and all organs?

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luisverduzco1981@*.com

Jan 15 2023, 7:46 pm

Hi, thank you for your thoughts! I think 1-2 liters of IVF is reasonable but recall that the majority of fluid given will go into the extracellular space in only a few hours (recall you had a normal amount of fluid in your vessels prior to vasodilatation from sepsis). The treatment is the underlying condition leading to shock. Inflammation worsens capillary leakage and hypotension increases inflammation; starting pressors early normalizes the BP and therefore would be expected to lower inflammation. Re LR vs NS, the potassium in LR is 4 mEq/L so even if I gave you an infinity amount of LR, your body's potassium would then reach 4. In fact, in patients undergoing renal transplants who are randomized to LR vs NS during the procedure, none of the patients in the LR group required treatment for high K but the NS group did--this is due to K shift from non-anion gap acidosis.

Dr. Luis A. Verduzco Intensivist, Anaesthesiologist Dr. Verduzco presents the diagnosis, labs, pathophysiology, and management of sepsis and septic shock.

Learning objectives of this video are the following:

1. Systemic Inflammatory Response Syndrome (SIRS)

2. Sepsis definition 

3. Lactate and Procalcitonin

4. Practical approach to septic shock 

5. Clinical scenarios 

Presented by Dr. Luis A Verduzco

Following answers are created by ChatGPT. Occasionally the answer may be harmful, incorrect, false, misleading, incomplete, or limited in knowledge of world. Please contact your doctor for all healthcare decisions. Also, double check the answer provided by the AI below.

Faculty

In addition to the presenter, following authors may have helped with the content writing, review, or approval:

  • Luis A Verduzco M.D.

CME, CE, CEU and Other Credit Types:

ACCME Accreditation Statement
The DrBeen Corp is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement
The DrBeen Corp designates this enduring material for a maximum of 1.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Disclosure Information

In accordance with the disclosure policies of DrBeen Corp and the ACCME (Accreditation Council for Continuing Medical Education), we are committed to upholding principles of balance, independence, objectivity, and scientific rigor in all of our Continuing Medical Education (CME) and Continuing Education (CE) activities. These policies include the careful management and mitigation of any relevant financial relationships with organizations that are not eligible.
All members of the Activity Planning Committee and presenters have disclosed their relevant financial relationships. The DrBeen Corp CE Committee has thoroughly reviewed these disclosures and determined that these relationships are not deemed inappropriate in the context of their respective presentations. Additionally, they are found to be consistent with the educational objectives and the integrity of the activity.

Faculty Disclosures
Luis A Verduzco M.D. Author declares no conflict of interest.

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Instructors

Luis A Verduzco M.D.

Luis A Verduzco M.D.

Anesthesiology and Perioperative Medicine

Dr. Luis Verduzco, MD is a Critical Care Medicine Specialist in Denver, CO. He is affiliated with Denver Health Medical Center. Luis A. Verduzco M.D., is certified by the American Board of Anesthesiology in anesthesiology and critical care medicine. He completed his undergraduate degree with distinction from Yale University and then went on to medical school at Harvard, having graduated as an Arthur Lehman and LInnane Scholar. Dr. Verduzco received his residency training at Stanford and was elected chief resident during his final year. He stayed at Stanford for critical care fellowship training. He is a former Academy of Achievement Student Delegate and Howard Hughes Medical Institute Research Training Fellow. Dr. Verduzco has authored multiple book chapters and peer-reviewed manuscripts, with primary authorships in prestigious journals such as Stroke and Blood. He is an avid learner who practices evidence-based medicine and enjoys teaching.

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