Septic shock resuscitation: what goals and how to achieve them?


Autoria(s): Jakob, Stephan
Data(s)

2009

Resumo

The need to achieve adequate tissue oxygen delivery early in patients with septic shock is well established. However, it is less well recognized that tissue hypoperfusion can exist despite normalization of systemic hemodynamics. Efforts to resuscitate septic patients until adequate tissue perfusion has been achieved can potentially improve outcome. In a multicenter study, 130 patients with septic shock were resuscitated within 12 hours of diagnosis using a protocol including goals for mean arterial and pulmonary artery occluded pressures, urinary output, arterial pH, and hemoglobin goals. They were then randomly assigned to further resuscitation with either a cardiac index (>or= 3 l/minute per m2) or a gastric mucosal pH (>or= 7.32) target. The intensive care unit length of stay and 28-day mortality did not differ between groups, but more patients in the cardiac index group were in the target range, both at baseline and after resuscitation, as compared with the gastric mucosal pH group. In contrast to cardiac index, gastric mucosal pH at baseline and at 24 and 48 hours predicted mortality. Whether other targets for the chosen variables, or different and--in particular--earlier resuscitation efforts would have favored one group cannot be concluded from the data provided.

Formato

application/pdf

Identificador

http://boris.unibe.ch/32232/1/cc7870.pdf

Jakob, Stephan (2009). Septic shock resuscitation: what goals and how to achieve them? Critical care, 13(3), p. 147. London: BioMed Central 10.1186/cc7870 <http://dx.doi.org/10.1186/cc7870>

doi:10.7892/boris.32232

info:doi:10.1186/cc7870

info:pmid:19519939

urn:issn:1364-8535

Idioma(s)

eng

Publicador

BioMed Central

Relação

http://boris.unibe.ch/32232/

Direitos

info:eu-repo/semantics/openAccess

Fonte

Jakob, Stephan (2009). Septic shock resuscitation: what goals and how to achieve them? Critical care, 13(3), p. 147. London: BioMed Central 10.1186/cc7870 <http://dx.doi.org/10.1186/cc7870>

Palavras-Chave #610 Medicine & health
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/publishedVersion

PeerReviewed