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Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Septic Shock: Phenotypes and Outcomes.

Alexandre Cereuil1, Romain Ronflé2, Aurélien Culver3

  • 1Réanimation et Surveillance Continue Médico-Chirurgicales Polyvalentes, Hôpital Nord, Service d'Anesthésie et de Réanimation, Aix Marseille Université, APHM, Avenue des tamaris, 13100, Marseille, Aix-en-Provence, France.

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Summary
This summary is machine-generated.

Predicting sepsis outcomes is crucial. This study identified key variables like norepinephrine dose and lactate levels, along with patient phenotypes, to forecast sepsis progression and mortality in ICU patients.

Keywords:
LactateNorepinephrinePhenotypeSeptic shockSequential organ failure assessment (SOFA) scoreVenous-to-arterial carbon dioxide partial pressure difference (P(v-a)CO2)

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Area of Science:

  • Critical Care Medicine
  • Sepsis Pathophysiology
  • Prognostic Biomarkers

Background:

  • Sepsis is a life-threatening condition causing organ dysfunction.
  • Predicting sepsis outcomes is challenging due to its heterogeneous nature.

Purpose of the Study:

  • To identify key variables and patient phenotypes for predicting sepsis outcomes.
  • To develop a predictive model for sepsis progression and mortality.

Main Methods:

  • Ancillary study of 119 septic shock patients in the ICU.
  • Defined clinical worsening by a Sequential Organ Failure Assessment (SOFA) score increase (ΔSOFA ≥ 1) at 48 hours.
  • Performed univariate and multivariate analyses for 28-day mortality and ΔSOFA ≥ 1, identifying patient phenotypes.

Main Results:

  • Norepinephrine dose and serum lactate concentration predicted 28-day mortality at ICU admission (T0).
  • Norepinephrine dose, lactate, and venous-to-arterial carbon dioxide difference (P(v-a)CO2) predicted clinical worsening (ΔSOFA ≥ 1).
  • An algorithm using these variables achieved an AUC of 74% for outcome prediction.

Conclusions:

  • Identifying specific variables and patient phenotypes aids in predicting sepsis outcomes.
  • The proposed algorithm can assist clinicians in forecasting patient prognosis.