Related Experiment Video
Updated: Mar 14, 2026
07:51
Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs
Published on: May 21, 2019
7.9K
Advanced Hemodynamic Management in Patients with Septic Shock
Bernd Saugel1, Wolfgang Huber2, Axel Nierhaus3
1Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Biomed Research International
|October 6, 2016
Summary
Hemodynamic management is crucial for sepsis and septic shock patients. Individualized approaches using advanced monitoring are essential for optimizing cardiocirculatory and pulmonary status in the intensive care unit.
Area of Science:
- Critical Care Medicine
- Cardiovascular Physiology
- Sepsis Pathophysiology
Background:
- Hemodynamic management is vital in sepsis and septic shock.
- Early goal-directed therapy (EGDT) protocols may not improve mortality compared to usual care.
- Distinguishing early EGDT from intensive care unit (ICU) hemodynamic management is necessary.
Purpose of the Study:
- To differentiate EGDT from comprehensive hemodynamic management.
- To propose algorithms for hemodynamic management in ICU patients with septic shock.
- To emphasize the need for individualized hemodynamic strategies.
Main Methods:
- Review of recent large trials on EGDT efficacy.
- Development of two algorithms for hemodynamic management based on transpulmonary thermodilution.
- Focus on optimizing cardiocirculatory and pulmonary status in adult ICU patients.
Main Results:
- Protocolized EGDT may not be superior to usual care for mortality reduction in the emergency department.
- Transpulmonary thermodilution can guide hemodynamic interventions.
- Individualized approaches are mandatory due to patient heterogeneity.
Conclusions:
- Hemodynamic management in sepsis requires differentiation between early and ICU phases.
- Proposed algorithms aim to optimize hemodynamics using advanced monitoring.
- Future research should focus on defining individual hemodynamic targets for septic shock patients.
Related Concept Videos
01:30Heart Failure V: Medical Management
459
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
459
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
1.2K
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
1.2K
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
413
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
413
01:20Rheumatic Heart Disease IV: Nursing Management
404
AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
404
01:22Heart Failure VI: Adjunct Therapies
497
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
497
01:22Aneurysm IV: Nursing Management
563
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
563