Infectious Disease

What changed when Sepsis-3 was introduced in 2016? This overview explains the shift towards organ dysfunction, the roles proposed for SOFA and qSOFA, and revised septic-shock definitions, while noting early concerns about applicability and performance across different clinical settings.

What happens to circulation when we give intravenous fluid, and how can we tell whether it has helped? This 2015 physiology review connects Frank–Starling and Guyton models with fluid responsiveness, examining the limitations of routine observations and the role of cardiac output assessment.

What does a raised lactate actually tell us? This 2015 physiology discussion revisits lactate production and clearance, then explores hypoxia, the stress response and interpretation in sepsis and trauma. It questions the leap from a marker of illness severity to a treatment endpoint.

How did sepsis guidance respond to ProMISe, ProCESS and ARISE? This 2015 commentary examines changes to the Surviving Sepsis Campaign care bundles, particularly the shift away from mandatory central venous targets, and considers the resulting choices around assessing circulation and response to treatment.

The 2015 ProMISe trial compared early goal-directed therapy with usual care for patients with septic shock in UK hospitals. This appraisal examines mortality, treatment overlap and patient selection, asking what the findings added to ARISE and ProCESS and which questions about individualised care remained unresolved.

An initial response to the 2014 ProCESS trial of protocolised sepsis care. The post asks how changing background care, differences between patient populations and widespread adoption of resuscitation principles might affect the interpretation of a trial that challenged early goal-directed therapy.