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Intensive insulin therapy in critically ill patients. Arabi YM, Dabbagh OC, Tamim HM, Al-Shimemeri AA, Memish ZA, Haddad SH, et al. Intensive versus conventional insulin therapy: cock inch randomized controlled trial in medical and surgical critically ill patients. A prospective surgery annals of multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study.

Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V, et al. Intensive versus conventional glucose control in critically ill patients. Roche posay creme S, Liu B, Chittock DR, Norton R, Myburgh JA, McArthur C, et al. Hypoglycemia and risk of death in critically ill patients. Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, et al.

Intensive insulin therapy and pentastarch resuscitation in severe sepsis. Kalfon Roche posay creme, Giraudeau B, Ichai C, Guerrini A, Brechot N, Cinotti R, et al. Tight computerized versus conventional roche posay creme control in the ICU: a randomized controlled trial.

Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. Meduri GU, Headley AS, Golden E, et al. Effect of prolonged methylprednisolone therapy roche posay creme unresolving acute respiratory distress syndrome: a randomized controlled trial.

Nathens AB, Rotstein OD. Selective decontamination of the digestive tract in acute severe pancreatitis--an indication the best way of learning key factor in learning time has come. Kristina L Bailey, MD Assistant Professor, Department of Medicine, Section of Pulmonary, Critical Care, Sleep and Allergy, University of Nebraska Medical Center Kristina L Bailey, MD is a member of the following medical societies: American College of Chest Physicians, American Thoracic Society, Research Society on AlcoholismDisclosure: Nothing to disclose.

Reproduced with permission from Drage, LE. Life-threatening rashes: dermatologic signs of four infectious diseases. This photomicrograph shows early stage (exudative stage) DAD. This is a high-powered photomicrograph of early stage (exudative stage) DAD. Fibrin stain depicts collagenous tissue, which may develop into fibrotic stage of DAD. View Media Gallery Etiology of Septic Shock Regarding the causes of septic shock, most patients who develop sepsis and septic shock have underlying circumstances that interfere roche posay creme local or systemic host defense mechanisms.

Fungal infections are rare causes of septic shock. Media Gallery Strawberry tongue in a child with staphylococcal toxic shock syndrome. A 26-year-old woman developed rapidly progressive shock roche posay creme with purpura and signs of meningitis. Her blood culture results confirmed the presence of Neisseria meningitidis.

The skin manifestation seen in this image is characteristic of severe meningococcal infection and is called purpura fulminans. Gram stain of blood showing the presence of Neisseria meningitidis. Acute respiratory distress syndrome (ARDS), commonly observed in septic shock as a part of multiorgan failure syndrome, results in pathologically diffuse alveolar damage (DAD). Photomicrograph showing delayed stage roche posay creme or organizing stage) of diffuse alveolar damage (DAD).

Acute respiratory distress syndrome (ARDS) in a patient who developed septic shock secondary to toxic shock syndrome. Bilateral airspace disease and acute respiratory failure in a patient with gram-negative septic roche posay creme. The source of the roche posay creme was urosepsis. A 45-year-old woman was admitted to the intensive care unit with septic shock secondary roche posay creme spontaneous biliary peritonitis.

She subsequently developed acute respiratory distress syndrome (ARDS) and multiorgan failure. An 8-year-old boy developed septic shock secondary to Blastomycosis pneumonia.

Diagram depicting the pathogenesis of sepsis and multiorgan failure. Soft-tissue infection secondary to group A streptococci, leading to toxic shock syndrome.

Necrosis of the little toe of the right foot and cellulitis of the foot secondary to group A streptococcal infection. Gram stain of blood showing group A streptococci that was isolated from a patient who developed toxic shock syndrome. Image courtesy of T.

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