New Guidelines: Neutropenic Sepsis, Cardiogenic Shock & More +++ +++ +++

Neutropenic Sepsis (NICE) Neutropenic Sepsis: Prevention and Management in People with Cancer Source: National Institute for Health and Care Excellence January 2020: updated to reflect the Medicines and Healthcare products Regulatory Agency (MHRA) restrictions and precautions for the use of fluoroquinolone antibiotics following rare reports of disabling and potentially long-lasting or irreversible side effects (see the guideline for full details of the update). •Empiric treatment: first steps https://reference.medscape.com/cc2/p10/neutropenic-sepsis-prevention-and-management-people-cancer-2022a10024nz?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 •Managing unresponsive fever https://reference.medscape.com/cc2/p10/neutropenic-sepsis-prevention-and-management-people-cancer-2022a10024nz?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 •IV or oral therapy https://reference.medscape.com/cc2/p10/neutropenic-sepsis-prevention-and-management-people-cancer-2022a10024nz?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 Cardiogenic Shock in Women (SCAI/EAPCI) Cardiogenic Shock in Women Source: Multiple Guideline Bodies In 2025, the Society for Cardiovascular Angiography and Interventions (SCAI), European Association of Percutaneous Cardiovascular Interventions (EAPCI), and Association for Acute Cardiovascular Care (ACVC) published a joint expert consensus statement on the diagnosis and treatment of women with cardiogenic shock (CS). The SCAI/EAPCI/ACVC consensus statement aims to provide a comprehensive summary of available evidence on CS in women, identify knowledge gaps, and suggest directions for future clinical investigation. •Early diagnosis and risk assessment https://reference.medscape.com/cc2/p10/expert-consensus-statement-cardiogenic-shock-women-2025a1000eui?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 •Revascularization in AMI–CS https://reference.medscape.com/cc2/p10/expert-consensus-statement-cardiogenic-shock-women-2025a1000eui?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 •Anticoagulation in pregnancy https://reference.medscape.com/cc2/p10/expert-consensus-statement-cardiogenic-shock-women-2025a1000eui?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 Acute Coronary Syndromes (ESC) Acute Coronary Syndromes Source: European Society of Cardiology; Medically Reviewed by Dr Shouvik Haldar In 2023, the European Society of Cardiology (ESC) published a guideline on acute coronary syndromes (ACS). This guideline summary covers key recommendations, including initial diagnosis and management, risk assessment, therapeutic strategies, and long-term management. Please refer to the full guideline for all recommendations, rationale, and background information. •5 key diagnosis tools https://reference.medscape.com/cc2/p10/guideline-essentials-european-society-cardiology-2024a1000i2t?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 •Antithrombotic essentials https://reference.medscape.com/cc2/p10/guideline-essentials-european-society-cardiology-2024a1000i2t?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 •UA, NSTEMI, or STEMI? https://reference.medscape.com/cc2/p10/guideline-essentials-european-society-cardiology-2024a1000i2t?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 Acute Heart Failure (AHA/ESC) Acute Heart Failure: Comparison of UK, European, and US Guidance Source: Multiple Guideline Bodies; Medically Reviewed by Dr Shouvik Haldar This Medscape guideline overview for cardiologists provides a tabular comparison of the most up-to-date recommendations from UK, European, and US guidance on acute heart failure. Collated by the Medscape editorial team and reviewed by Dr Shouvik Haldar, this comparison summary covers recommendations from: The National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of acute heart failure (published 2014, updated 2021) The NICE guideline on the diagnosis and management of chronic heart failure (published 2018) The European Society of Cardiology guideline for the diagnosis and treatment of acute and chronic heart failure (published 2021), and a focused update (published 2023) The American Heart Association, American College of Cardiology, and Heart Failure Society of America guideline for the management of heart failure (published 2022). •Comparison of major global guidance https://reference.medscape.com/cc2/p10/guideline-essentials-acute-heart-failure-comparison-uk-2024a1000cvm?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 •Recommended laboratory investigations https://reference.medscape.com/cc2/p10/guideline-essentials-acute-heart-failure-comparison-uk-2024a1000cvm?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 •Initial pharmacological treatment https://reference.medscape.com/cc2/p10/guideline-essentials-acute-heart-failure-comparison-uk-2024a1000cvm?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 Acquired Brain Injury (EI) Diagnosing and Managing Acquired Brain Injury, Including Encephalitis, in Adults and Children Source: Encephalitis International This Medscape summary of Encephalitis International guidance outlines recommendations for recognising the signs of, and managing, acute brain injury (ABI) in adults and children, and recognition and management of encephalitis in general practice. For the complete set of recommendations, refer to the full guideline. •Suspecting acute CNS events https://reference.medscape.com/cc2/p10/diagnosing-and-managing-acquired-brain-injury-including-2022a1001bl3?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 •Recognizing encephalitis https://reference.medscape.com/cc2/p10/diagnosing-and-managing-acquired-brain-injury-including-2022a1001bl3?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 •Long-term management https://reference.medscape.com/cc2/p10/diagnosing-and-managing-acquired-brain-injury-including-2022a1001bl3?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963#1 COPD (GOLD) Diagnosis and Management of COPD Source: Global Initiative for Chronic Obstructive Lung Disease; Medically Reviewed by Dr Kevin Gruffydd-Jones The following outlines key new and updated information in the 2025 Global Initiative for Chronic Obstructive Lung Disease (GOLD) chronic obstructive pulmonary disease (COPD) strategy: coverage of pulmonary hypertension increased coverage of cardiovascular risk, stressing the necessity of addressing cardiovascular issues in individuals with COPD provision of personalised treatment approaches for those with COPD and pulmonary hypertension information on the influence of climate change on COPD, noting the effects of extreme weather and air pollution (not covered in this Medscape summary) information on lung function trajectories a section on dysbiosis (not covered in this Medscape summary) updated spirometry information updated computed tomography information on emphysema, lung nodules, airways, and COPD-related morbidities updated vaccination recommendations for people with COPD information on the delivery of pulmonary rehabilitation, education, and self-management, including remote patient follow up a revised section on inhaled corticosteroid withdrawal updated sections on phosphodiesterase 3 and 4 inhibitors and other drugs for reducing exacerbations​. The section on COVID-19 and COPD, which appeared in previous versions of the GOLD COPD strategy, has been removed for 2025. •New guidance on lung function https://reference.medscape.com/cc2/p10/2025-gold-copd-2025a10000qu?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 •2025 vaccine recommendations https://reference.medscape.com/cc2/p10/2025-gold-copd-2025a10000qu?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 •Addressing cardiovascular risk https://reference.medscape.com/cc2/p10/2025-gold-copd-2025a10000qu?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 Pediatric Pneumonia & Diarrhea (WHO) Management of Pneumonia and Diarrhoea in Children Up to 10 Years of Age Source: World Health Organization https://reference.medscape.com/cc2/p10/guideline-management-pneumonia-and-diarrhoea-children-10-2025a10005u2?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 •Enhanced care knowledge gap https://reference.medscape.com/cc2/p10/guideline-management-pneumonia-and-diarrhoea-children-10-2025a10005u2?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 This Medscape guideline summary covers the World Health Organization's (WHO) recommendations on the management and treatment of pneumonia and diarrhoea in children up to 10 years of age. For information on changes from previous WHO recommendations, a summary of the evidence, and evidence-to-decision judgements, please refer to the full guideline. In addition, refer to the full guideline for information on care in hospital settings, research priorities, and implementation. •When to use antibiotics https://reference.medscape.com/cc2/p10/guideline-management-pneumonia-and-diarrhoea-children-10-2025a10005u2?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 •Outpatient vs inpatient care https://reference.medscape.com/cc2/p10/guideline-management-pneumonia-and-diarrhoea-children-10-2025a10005u2?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 ARTICLES OF INTEREST •A Clinician's Guide to Recognition and Referral Suspected Sepsis: A Clinician's Guide to Recognition and Referral Dr Greg Edwards reviews guidance on suspected sepsis, emphasising the pivotal role of general practice in recognising and referring possible cases https://reference.medscape.com/cc1/p10/suspected-sepsis-gps-guide-recognition-and-referral-2025a100092h?ecd=WNL_drugguide_260206_MSCPREF_ccu_etid8081963&uac=148436CN&impID=8081963 •ACC 2025 ACS Update That Could Change Practice ACC 2025: ACC/AHA Guideline on the Management of Acute Coronary Syndromes This Expert Insight assesses the key recommendations from an updated guideline on acute coronary syndromes presented at the ACC annual meeting in March 2025 https://reference.medscape.com/cc1/p10/acc-2025-acc-aha-guideline-management-acute-coronary-2025a1000b4i#1