We are in the initial stages of reviewing pro-calcitonin use for abx 
de-escalation. I am in need of more information. Is anyone else currently do 
this?

 
Jessica Wonderly, RN
DSRIP Front Line Facilitator
Hospital Staff Nurse II
Kern Medical Center
Phone: (661) 326-5637
Pager: (661) 307-1098 
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Today's Topics:

   1. Re: Initial Fluid Bolus (Dellinger, Phil)
   2. procalcitonin (Edwards, Jody L)


----------------------------------------------------------------------

Message: 1
Date: Mon, 28 Oct 2013 11:54:48 -0400
From: "Dellinger, Phil" <[email protected]>
To: Hesham Hassaballa <[email protected]>,
"[email protected]"
<[email protected]>
Subject: Re: [Sepsis Groups] Initial Fluid Bolus
Message-ID:
<c342909a34ff664b9d135fda934ed6f215de88b...@mail-ccr02.chsmail.root.cooperhealth.edu>

Content-Type: text/plain; charset="utf-8"

Probably the best thing to do. And definitely simpler than trying to figure out 
a more precise fluid load estimate. I addressed this issue with the primary 
investigators and research coordinators for the EUPHRATES trial(for which I am 
the PI for the international trial). We are looking at endotoxin removal with 
hemoperfusion in patients with septic shock identified to have high endotoxin 
activity.  One of the entry criteria, which also includes a certain level of 
vasopressor support, is 30 ml/kg actual body weight of crystalloid(or colloid 
equivalent) fluid resuscitation.

?From a purist standpoint, fluid bolus in obese septic shock patients should be 
somewhat less per kg than in someone who is normal body habitus since the 
intravascular volume expands at a somewhat lower  % as body weight increases in 
the obese patient. However no one has ever used, in septic shock research 
trials, formulas that are available but not well validated to adjust for blood 
volume in the obese patient..?


From: [email protected] 
[mailto:[email protected]] On Behalf Of Hesham 
Hassaballa
Sent: Friday, October 25, 2013 9:33 AM
To: [email protected]
Subject: [Sepsis Groups] Initial Fluid Bolus

I'm using actual body weight, and it works out very well. I think if we use 
ideal body weight, it will under resuscitate the patient.

Hesham A. Hassaballa, MD
Program Medical Director
Critical Care
Rush-Copley Medical Center
2000 Ogden Avenue
Aurora, IL 60504
Phone: (331) 454-6572

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Message: 2
Date: Tue, 29 Oct 2013 13:07:02 +0000
From: "Edwards, Jody L" <[email protected]>
To: "[email protected]"
<[email protected]>
Subject: [Sepsis Groups] procalcitonin
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Our physician group is looking at procalcitonin levels vs lactic acid levels as 
which one is a more accurate biomarker for severe sepsis and septic shock. Has 
anyone completed a study regarding this issue. Any comments would be greatly 
appreciated.

Thank you,
Jody

Jody Edwards MSN, RN
Sepsis PI Coordinator
Springfield Regional Medical Center
100 Medical Dr. 45504
937-523-5268
[email protected]

"Education will never be as expensive as ignorance"-Anonymous




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