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Objectives: This study aims to investigate the association between the 30-day mortality in patients with septic shock (SS) and a prehospital bundle of care completion, antibiotic therapy administration, and hemodynamic optimization defined as a fluid expansion of at least 10 mL.kg -1 .hr -1 .Design: To assess the association between prehospital BUndle of Care (BUC) completion and 30-day mortality, the inverse probability treatment weighting (IPTW) propensity method was performed.Setting: International guidelines recommend early treatment implementation in order to reduce SS mortality. More than one single treatment, a bundle of care, including antibiotic therapy and hemodynamic optimization, is more efficient.Patients: From May 2016 to March 2021, patients with SS requiring prehospital mobile ICU (mICU) intervention were retrospectively analyzed.Interventions: None.Measurements and Main Results: Among the 529 patients with SS requiring action by the mICU enrolled in this study, 354 (67%) were analyzed. Presumed pulmonary, digestive, and urinary infections were the cause of the SS in 49%, 25%, and 13% of the cases, respectively. The overall 30-day mortality was 32%. Seventy-one patients (20%) received prehospital antibiotic therapy and fluid expansion. Log binomial regression weighted with IPTW resulted in a significant association between 30-day mortality and prehospital BUC completion (respiratory rate [RR] of 0.56 [0.33-0.89]; p = 0.02 and adjusted RR 0.52 [0.27-0.93]; p = 0.03).Conclusions: A prehospital bundle of care, based on antibiotic therapy and hemodynamic optimization, is associated with a 30-day mortality decrease among patients suffering from SS cared for by an mICU. [ABSTRACT FROM AUTHOR]

The article focuses on the efforts of the physicians and researchers in trying to improve the medical care given to survivors of cardiac arrest. It talks about the importance of improving the postcardiac arrest management inorder to improve the neurological injury of the survivors using novel therapies. It tells about cardiac arrest injuring the brain with dysregulated cerebrovascular autoregulation.

The article focuses on the role of microcirculation as a treatment for circulatory shock. It mentions that circulatory shock can be addressed properly through taking into account several systemic hemodynamic variables including arterial blood pressure. It mentions the study of van Genderen and colleagues on the of microcirculation in pigs where the authors claim that the success of the therapy lies on the time management of the sepsis therapy.