Archivio tag: Shock Settico

Variazioni Respiratorie Del Diametro Della Vena Cava Inferiore Come Guida Al Rimpiazzo Volemico

Articolo Scientifico

Variazioni Respiratorie Del Diametro Della Vena Cava Inferiore Come Guida Al Rimpiazzo Volemico

M. Feissel F. Michard J.P. Faller J.-L. Teboul

Intensive Care Med (2005) 1:70-73 Ed. Italiana

Abstract

Scopo: studiare se la variazione del diametro della vena cava che si verifica durante gli atti respiratori (ΔDIVC) possa essere correlata alla risposta alla terapia infusionale idrica in pazienti sottoposti a ventilazione meccanica.

Disegno sperimentale: studio clinico prospettico.

Sede: UTI medica di un ospedale non universitario.

Pazienti: pazienti con shock settico in ventilazione meccanica (n = 39) Interventi: carico idrico con 8 ml/kg di idroetilamido al 6% in 20 minuti.

Misurazioni e risultati: la gittata cardiaca e il ΔDIVC sono stati misurati mediante ecografia prima e subito dopo carico di volume standardizzato….

Conclusioni: l’analisi del ΔDIVC è un metodo semplice e non invasivo per valutare la risposta alla terapia di rimpiazzo volemico in pazienti con shock settico ventilati meccanicamente.

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Timeoutintensiva.it, N°16, Technè, Aprile 2011

Linee Guida Per Il Recupero E La Gestione Della Sepsi Severa E Dello Shock Settico Nel Neonato e Nel Bambino

Articolo Scientifico

Linee Guida Per Il Recupero E La Gestione Della Sepsi Severa E Dello Shock Settico Nel Neonato e Nel Bambino

Recognition & Anagement Of Severe Sepsis & Septic Shock In Infants & Children

Dr Peter Wilson

Approved by: Dr Peter Wilson, Dr Michael Marsh, Carol Purcell

Review Date: September 2006

Southampton General Hospital

Traduzione: Serafina Ardizzone*

*i.Change Open Progect Timeoutintensiva.it

o9 Aprile 2011

Abstract

La triade sintomatologica della flogosi, costituita da febbre, tachicardia e alterata perfusione , è molto comune nei bambini con infezione benigna. Se a questa triade si aggiungono tachipnea, riduzione della diuresi, irritabilità, letargia, astenia e scarsa risvegliabilità deve essere sospettato lo shock settico.

Nell’Allegato Scaricabile trovate: l’Articolo completo in .pdf e la Flowchart, in Lingua Inglese

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Timeoutintensiva.it, N°16, Focus Aprile 2011

Fluid Resuscitation in Septic Shock

Scientific Article

From Critical Care Medicine

Fluid Resuscitation in Septic Shock

A Positive Fluid Balance and Elevated Central Venous Pressure Are Associated With Increased Mortality

John H. Boyd, MD, FRCP; Jason Forbes, MD; Taka-aki Nakada, MD, PhD; Keith R. Walley, MD, FRCP; James A. Russell, MD, FRCP.

Posted: 02/21/2011; Crit Care Med. 2011;39(2):259-65.

© 2011 Lippincott Williams & Wilkins

Abstract

Objective: To determine whether central venous pressure and fluid balance after resuscitation for septic shock are associated with mortality.
Design: We conducted a retrospective review of the use of intravenous fluids during the first 4 days of care.
Setting: Multicenter randomized controlled trial.
Patients: The Vasopressin in Septic Shock Trial (VASST) study enrolled 778 patients who had septic shock and who were receiving a minimum of 5 μg of norepinephrine per minute.
Interventions: None.
Measurements and Main Results: Based on net fluid balance, we determined whether one’s fluid balance quartile was correlated with 28-day mortality. We also analyzed whether fluid balance was predictive of central venous pressure and furthermore whether a guideline-recommended central venous pressure of 8–12 mm Hg yielded a mortality advantage. At enrollment, which occurred on average 12 hrs after presentation, the average fluid balance was +4.2 L. By day 4, the cumulative average fluid balance was +11 L. After correcting for age and Acute Physiology and Chronic Health Evaluation II score, a more positive fluid balance at both at 12 hrs and day 4 correlated significantly with increased mortality. Central venous pressure was correlated with fluid balance at 12 hrs, whereas on days 1–4, there was no significant correlation. At 12 hrs, patients with central venous pressure <8 mm Hg had the lowest mortality rate followed by those with central venous pressure 8–12 mm Hg. The highest mortality rate was observed in those with central venous pressure >12 mm Hg. Contrary to the overall effect, patients whose central venous pressure was <8 mm Hg had improved survival with a more positive fluid balance.
Conclusions: A more positive fluid balance both early in resuscitation and cumulatively over 4 days is associated with an increased risk of mortality in septic shock. Central venous pressure may be used to gauge fluid balance ≤12 hrs into septic shock but becomes an unreliable marker of fluid balance thereafter. Optimal survival in the VASST study occurred with a positive fluid balance of approximately 3 L at 12 hrs.

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Guidelines for Management of Severe Sepsis and Septic Shock: Booklet Algorithm

Articolo Scientifico

Booklet Algorithm: Guidelines for Management of Severe Sepsis and Septic Shock

Abstract e Algoritmo (Booklet): Linee Guida e Managment della Sepsi Severa e dello Shock Settico (in lingua inglese)

This is a summary of the Surviving Sepsis Campaign International Guidelines for Management of Severe Sepsis and Septic Shock: 2008, condensed from Dellinger RP, Levy MM, Carlet JM, et al: Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock. Intensive Care Medicine (2008) 34:17-60
and Crit Care Med 2008; 36(1) 296-327. This version does not contain the rationale or appendices contained in the primary publication. The SSC guidelines do not cover every aspect of managing critically ill patients, and their application should be supplemented by generic best practice and specific treatment as required. Please refer to the guidelines for additional information at www.survivingsepsis.org.

The Surviving Sepsis Campaign is a collaboration of the European Society of Intensive Care Medicine, the International Sepsis Forum, and the Society of Critical Care Medicine. J 2008

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Timeoutintensiva.it, Numero 6, Technè, Giugno 2008


Guide Linee Internazionali 2008 per il Managment della Sepsi Severa e dello Shock Settico

Guide Linee

Campagna di Sopravvivenza alla Sepsi (SSC): Guide linee Internazionali 2008 per il managment della Sepsi severa e dello Shock Settico

Autori delle Linee Guida: R.Philip Dellinger, (@), USA; M.M. Levy, USA; J.M.Carlet, France; J.Bion, UK; M. Ranieri,IT; et Alii (2008 SSC Guidelines Committee) @ e-mail: Dellinger-Phil@CooperHealth.edu (see www.survivingsepsis.org).

Riduzione e traduzione in Italiano dell’ Introduzione e degli algoritmi dell’ articolo “Surviving Sepsis Campaign: International guidelines for managment of severe sepsis and septic shock: 2008 (Intensive Care medicine (2008) 34:17-60″  a cura di S. Vasta*.

*Intensivista, Timeoutintensiva OpeNetwork, i.Change ONLUS Association

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Timeoutintensiva.it Ott 2008, Cover, Sepsi Campaign, n.7