NephMadness 2015: Critical Care • Second Round Results


Conventional RRT in Sepsis vs Furosemide Stress Test
Winner: Furosemide Stress Test in AKI

4-3 split

The Furosemide stress test is a win for the practical over the possible. It takes readily available resources, furosemide, balanced IV fluids, and the ability to measure urine output, and turns it into a credible prognostic tool. Nephrology could use more of this type of thinking. The FST rolls on!

Comment from the blue-ribbon panel (BRP): “Furosemide stress test beat AKI indices, The more I use AKI indices the less I find them useful so I was glad to see something new in the AKI world, and the furosemide stress test may have some practical value. It gets my vote.“

Vasopressin in Sepsis vs EGDT
Winner: Vasopressin in Sepsis

5-2 split

Early goal directed therapy has taken more bumps in the last year than most concepts will in their entire lifetime. No surprise that it went down, but I still can’t figure out how vasopressin beat norepinephrine. Comment from the BRP: “Early Goal Directed Therapy beat MAP in sepsis? I guess, but I’ve seen EGDT get carried away too many times, just like I have seen pressor use get carried away. Unnecessary fluid overload or unequally dead toes? I liked MAP in sepsis. but it lost. So between Vasopressin and EGDT, I like vasopressin, I think there is more promise there. However, I’ve seen way too much fluid given over the years for sepsis from Goal Directed Therapy.”

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