Procalcitonin

How and when should we be using PCT (e.g. initiation, monitoring, cessation of antibiotics)? How is it more useful than CRP? What are it’s limitations? What type of values e.g whole numbers, double digits give us a ‘almost certainty’ as to the presence of infection? Does anyone who has worked with PCT have any advice/experience or … More Procalcitonin

Early enteral nutrition

Are there any contraindications or disadvantages in instituting early enteral nutrition (EN)? How soon after failure to provide EN should TPN be considered? A – From what I can gather from the literature, critical care patients who are not expected to be on a full oral diet within 3 days should be stared on EN. The best available evidence, although … More Early enteral nutrition

Beta blockers in sepsis

The next Sira debate: In patients with a diagnosis of sepsis is there a cohort who benefit from the administration of beta blockers? If so, what is the purported physiological benefit? A – There is a nice summary from Life in the fast lane https://lifeinthefastlane.com/ccc/catecholamine-excess-beta-blockade-and-critical-illness/ My pragmatic take on it is that I get tempted when patients are … More Beta blockers in sepsis