Sepsis, causes,vitamin c?????

[loriaz]

I am curious what other hospitals are seeing. I am a resource nurse and float to many different ICU in our hospitals. We are seeing more and more sepsis. What are you guys seeing as the cause of Sepsis???? We have seen pneumonia, post C-sections, surgical site infections and post op surgery as some of the causes. What is everyone seeing. I also seen an article about giving vitamin c for sepsis and patients recovering from sepsis quicker. Our doctors aren't using this yet are your docs using this???? I have been doing my own research to enquire about sepsis. This is kind of a personal mission I lost someone close to me due to sepsis. Just wanting to see what is happening around other hospitals today.

[Greenclip]

In our older patients we see UTI and pneumonia as the most common factors behind sepsis. Other causes are much less common. Regardless of cause, older patients and immune compromised patients are much more likely to present with sepsis. Our docs started using the vitamin C/thiamine/steroid protocol pretty much the week the news broke.

[loriaz]

Have you seen a difference with the use of vitamin C/thiamine/steroid protocol? Are patients getting out of ICU quicker?

[addieshaf]

Urosepsis is the number one cause in our ICU. Our docs are using vitamin C and steroids for certain sepsis patients, though I'm not sure of inclusion/exclusion criteria.

[ILUVERNSG, MSN, RN]

CAUTI and central lines. Still need to get onboard with the vitamin C protocol.

[ghillbert, MSN, NP]

We use Vit c/Thiamine/Steroids for patients in septic shock with hypotension refractory to multiple vasopressor agents. Unclear if it helps - not enough evidence and the patients are at death's door when it's added. It's more of a "shouldn't hurt them and may help so let's do it"

[ghillbert, MSN, NP]

Follow up - Vanderbilt and Johns Hopkins are about to start a multi center RCT into VitC/Thiamine/Steroids for septic shock.

[Susie2310]

Prostatitis leading to a complicated UTI/pyelonephritis and sepsis.

GI tract as a source of sepsis.

[offlabel]

Look at/ listen to this. You'll understand.

EMCrit Wee - Edited Version of Paul Marik on the Metabolic Resuscitation of Sepsis

[marienm, RN, CCRN]

We sometime use it in burn shock (right after the injury, not when they are septic). The theory as I understand it is that it 'fortifies' capillary membranes and reduces third-spacing. By keeping more fluid in the circulatory system, less fluid and/or pessors are needed. However, the limited studies of this in burn shock don't definitively show that it reduces ventilator days. A few studies from burn patients also had concerns about oxalate crystals that were found on autopsy of patients who had received this...but it was unclear whether the ascorbic acid had definitively caused the crystals or whether the crystals had contributed to the death. Sepsis and shock (especially when you can't remove the source by immediate antibiotic treatment, or pulling out a bad line, or doing a bowel resection) are still sometimes too much for the body to handle.