Optimizing Hemodynamic Support in Severe Sepsis and Septic Shock, An Issue of Critical Care Clinics

Optimizing Hemodynamic Support in Severe Sepsis and Septic Shock, An Issue of Critical Care Clinics
Author: Dane Nichols
Publisher: Elsevier Health Sciences
Total Pages: 207
Release: 2010-05-10
Genre: Medical
ISBN: 1455700215

Guest Editor Dane Nichols, MD, has assembled a panel of experts focusing on Hemodynamic Support in Septic Shock. Topics include: Oxygen Delivery and Consumption: A Macro-Circulatory Perspective; Mean Arterial Pressure: Therapeutic Goals and Pharmacologic Support,Mechanisms; Detection and Potential Management of Microcirculatory Disturbances; Detection of Hypoxia at the Cellular Level; Type A & B Lactic Acidosis: Recognition, Kinetics, and Associated Prognosis; Venous blood gases: What Can They Tell Us About the State of the Circulation; Noninvasive Assessment of Cardiac Preload and Performance through CO2 Rebreathing/ETCO2 Monitoring.

Septic Shock

Septic Shock
Author: George H. Sakorafas
Publisher: Nova Publishers
Total Pages: 128
Release: 2005
Genre: Medical
ISBN: 9781594541681

Sepsis is one of the most frequent complications in the surgical patient and one of the leading causes of mortality in intensive care units. During the past two decades, a great deal has been learned about surgical bacteriology, antibiotic prophylaxis, supportive management, and the host response to microbial invasion. Sepsis can be caused by infection with gram-negative bacteria, gram-positive bacteria, fungi (and particularly Candida), or viruses. Sepsis may also occur in the absence of detectable bacterial invasion, and in these cases, microbial toxins, particularly gram-negative bacterial endotoxin (lipopolysaccharide, LPS), and endogenous cytokine production have been implicated as initiators and mediators. Although activation of the immune system during microbial invasion is generally protective, septic shock develops in a significant number of patients as a consequence of a poorly regulated immune response to the offending organism. Sepsis can be presented with a spectrum of severity. Septic shock represents the most severe form of host response to infection. The aim of this monograph is to summarise the currently available data regarding epidemiology, pathogenesis, and optimal management of septic shock, with a particular emphasis on the role of source control in sepsis. Emerging therapies for septic shock are also discussed.

Sepsis Management in Resource-limited Settings

Sepsis Management in Resource-limited Settings
Author: Arjen M. Dondorp
Publisher: Springer
Total Pages: 216
Release: 2019-02-08
Genre: Medical
ISBN: 3030031438

This book is open access under a CC BY 4.0 license. It constitutes a unique source of knowledge and guidance for all healthcare workers who care for patients with sepsis and septic shock in resource-limited settings. More than eighty percent of the worldwide deaths related to sepsis occur in resource-limited settings in low and middle-income countries. Current international sepsis guidelines cannot be implemented without adaptations towards these settings, mainly because of the difference in local resources and a different spectrum of infectious diseases causing sepsis. This prompted members of the Global Intensive Care working group of the European Society of Intensive Care Medicine (ESICM) and the Mahidol-Oxford Tropical Medicine Research Unit (MORU, Bangkok, Thailand) - among which the Editors – to develop with an international group of experts a comprehensive set of recommendations for the management of sepsis in resource-limited settings. Recommendations are based on both current scientific evidence and clinical experience of clinicians working in resource-limited settings. The book includes an overview chapter outlining the current challenges and future directions of sepsis management as well as general recommendations on the structure and organization of intensive care services in resource-limited settings. Specific recommendations on the recognition and management of patients with sepsis and septic shock in these settings are grouped into seven chapters. The book provides evidence-based practical guidance for doctors in low and middle income countries treating patients with sepsis, and highlights areas for further research and discussion.

Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine

Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine
Author: Cheston B. Cunha
Publisher: CRC Press
Total Pages: 495
Release: 2020-07-12
Genre: Medical
ISBN: 1351583395

Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine 4E has been fully updated and revised. The clinical diagnostic approach to common infectious disease problems in the CCU is the underlying theme in the book. Emphasized throughout is the importance of formulating an accurate early presumptive clinical syndromic diagnosis which is the basis for selecting optimal initial antimicrobial therapy in the CCU. Without an accurate presumptive clinical diagnosis, effective therapy is unlikely at best. Based on the most probable clinical diagnosis, optimal antibiotic empiric therapy, based on antimicrobial stewardship principles, minimizes resistance and antibiotic complications in the CCU. This new edition features chapters that explain the tenets of differential diagnostic reasoning, differential diagnostic characteristics of fever patterns in the CCU. The proper interpretation of rapid diagnostic tests, in the appropriate clinical context, is included. The diagnostic importance of cardinal clinical findings, particularly when combined, in the appropriate clinical context is emphasized and remains the basis for clinical problem solving in the CCU. Uniquely, critical diagnostic physical findings in the CCU, including color atlas of diagnostic eye findings, are included as important diagnostic determinants in the CCU. Written by infectious disease clinicians for CCU consultants, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine 4E remains a useful evidence based and experience tempered key clinical resource for infectious disease problems in the CCU. Key Features Essentials of the tenets of clinical diagnostic reasoning is explained as it relates to formulating a rapid and accurate clinical syndromic diagnosis in the CCU The diagnostic significance of fever patterns and their relationship to the pulse rate in the proper clinical context is explained in depth as related to the CCU setting Formulating an accurate early clinical syndromic diagnosis is presented as essential since it is the basis of effective empiric antibiotic therapy in the CCU How to combine key non-specific laboratory and imaging findings to increase diagnostic specificity and diagnostic probability in the CCU is presented Clinical perspective on the proper interpretation of the clinical significance of rapid diagnostic test results in the CCU is included A clinical approach to apparent "antibiotic failure" in the CCU is presented either due to actual antibiotic failure or seeming but unrelated non-antibiotic failure Section focuses on the practical aspects of antimicrobial stewardship particularly as related to optimizing dosing effectiveness while minimizing resistance and adverse effects in the CCU

Empiric Antimicrobial Therapy in Critically Ill Septic Patients

Empiric Antimicrobial Therapy in Critically Ill Septic Patients
Author: Ahlem Trifi
Publisher:
Total Pages: 0
Release: 2018
Genre: Electronic books
ISBN:

Sepsis is a medical emergency and life-threatening condition due to a dysregulated host response to infection, which is time-dependent and associated with unacceptably high mortality. At the bedside of a patient with sepsis or septic shock, clinician must make immediate life-saving decisions including empirical initiation of broad-spectrum antimicrobials; the most likely to be appropriate. The empiric regimen should be initiated within the first hour of diagnosis and determined by assessing patient and epidemiological risk factors, likely source of infection based on presenting signs and symptoms, and severity of illness. Optimizing antibiotic use is crucial to ensure successful outcomes and to reduce adverse antibiotic effects, as well as preventing drug resistance. All likely pathogens involved should be considered to provide an appropriate antibiotic coverage. Herein, we tried to make suggestions of empirical therapeutic regimens in sepsis/septic shock according to most likely pathogens in cause and sepsis source based on the recent recommendations of learned societies. Some suggestions were adapted to an environment of low-resource regions where the ecology of multi drug resistant organisms is of concern.