Abstract
The American College of Chest Physicians & Society of Critical Care Medicine Consensus [1] defines sepsis as the systemic inflammatory response syndrome (SIRS) as a result of infection. Septic shock is defined as sepsis-induced hypotension despite adequate fluid resuscitation along with the presence of perfusion abnormalities. These abnormalities may include, but are not limited to, lactic acidosis, oliguria or an acute alteration in mental status. Patients who are receiving inotropic or vasopressor agents may not be hypotensive at the time that perfusion abnormalities are measured. From the years 1950–1991 mortality has soared by 13-fold [2]. Alone sepsis carries a 30–40% lethality [2] but when aggravated by shock, it has a 40–60% mortality [3]. Recently the effectiveness of invasive hemodynamic monitoring in septic shock has undergone intense scrutiny.
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References
American College of Chest Physicians & Society of Critical Care Medicine Consensus Conference. Definitions for sepsis and multiple organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864, 1992.
Marik PE, Varon J. The Hemodynamic Derangements in Sepsis. Chest 114:854, 1998.
Conners AF. Right Heart Catheterization: Is it Effective? New Horizons 5:195, 1997.
Pulmonary Artery Catheter Consensus Conference Participants’. Pulmonary Artery Catheter Consensus Conference: Consensus Statement. Crit Care Med 25:910, 1997.
Wood LDH. The pathophysiology of the circulation in critical illness. Hall JB, Schmidt GA, Wood LDH (eds). Principles of Critical Care. New York: McGraw Hill, 2nd Edn, 1998:268.
Parillo JE. Pathogenic mechanisms of septic shock. N Engl J Med 328:1471, 1993.
Parker MM. Pathophysiology of cardiovascular dysfunction in septic shock. New Horizons 6:130, 1988.
Marik PE, Varon J. The Hemodynamic derangements in sepsis: Implications for treatment strategies. Chest 114:854, 1998.
Astiz ME, Rackow EC. Septic Shock. Lancet 351:1501, 1998.
Cunnion RE, Schaer GL, Parker MM, et al. The Coronary Circulation in Human Septic Shock. Circulation 73:637, 1986.
Rackow EC, Astiz ME, Weil MH. Cellular Oxygen Metabolism during Sepsis and Shock. JAMA 259:1989, 1988.
Weil MH, Afifi AA. Experimental and clinical studies in lactate and pyruvate as indicators of the severity of acute circulatory failure (shock). Circulation 41:989, 1970.
Vincent JL, Dufaye P, Berk J. Serial lactate determinations during circulatory shock. Crit Care Med 11:449, 1983.
Dorman T, Breslow MJ, Lipsett PA et al. Radial artery pressure monitoring underestimates central arterial pressure during vasopressor therapy in critically ill surgical patients. Crit Care Med 26:1646, 1998.
Coulter TD, Wiedemann HD. Complications of Hemodynamic Monitoring. Clin Chest Med No 2;June:249, 1999.
Herbst CA Jr. Indications, Management and complications of percutaneous subclavian catheters. Arch Surg 113:1421, 1978.
Felicano DV, Mattox KL, Graham JM, et al. Major complications of percutaneous subclavian vein catheters. An J Surg 138:869, 1979.
Haapaniemi L, Slatis P. Supraclavicular catheterization of the superior vena cava. Acta Anaesthesiol Scand 18:12, 1974.
Shah KB, Rao TL, Laughlin S, et al. A review of pulmonary artery catheterization on 6,245 patients. Anesthesiology 61:271, 1984.
Sprung CL, Elser B, Schein RM, et al. Ventricular arrhythmias during Swan-Ganz catheterization of the critically ill. Chest 79:413, 1981.
Sprung CL, Pozen RG, Rozanski JJ, et al. Advanced ventricular arrhythmia during bedside pulmonary artery catheterization. Am J Med 72:203, 1982.
Luck JC, Engel TR. Transient right bundle branch block with “Swan-Ganz” catheterization. Am Heart J 92:263, 1976.
Aktar M, Danato AN, Gilbert-Leeds CJ, et al. Induction of iatrogenic electrocardiographic patterns during electrophysiologic studies. Circulation 56:60, 1977.
Kaiser CW, Koornick AR, Smith N, et al. Choice of route for central venous cannulation: Subclavian or internal jugular vein? A prospective randomized study. J Surg Oncol 17:345, 1981.
Boyd KD, Thomas SJ, Gold J, et al. A prospective study of complications of pulmonary artery catheterizations in 500 consecutive patients. Chest 84:245, 1983.
Kearney TJ, Shabot MM. Pulmonary artery rupture associated with the Swan-Ganz catheter. Chest 108:1349, 1995.
Connors AF Jr, Castele JR, Farhat NZ, et al. Complications of right heart catheterization. A prospective autopsy study. Chest 88:567, 1985.
Mermel LA, Maki DG. Infectious complications of Swan-Ganz pulmonary artery catheters. Pathogenesis, epidemiology, prevention and management. Am J Respir Crit Care Med 149:1020, 1994.
Morris AH, Chapman RH, Gardner RM. Frequency of technical problems encountered in the measurement of pulmonary artery wedge pressure. Crit Care Med 12:164, 1984.
Morris AH, Chapman RH, Gardner RM. Frequency of wedge pressure errors in the ICU. Crit Care Med 13:705, 1985.
The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. Preliminary report: Effect of ecainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 321:406, 1989.
Iberti TJ, Daily EK, Leibowitz AB, Schecter CB, Fischer EP, Silverstein JH. Assessment of critical care nurses’ knowledge of the pulmonary artery catheter. Crit Care Med 22:1674, 1994.
Connors AF Jr, Speroff T, Dawson NV, et al. The effectiveness of right heart catheterization in the initial care of critically ill patients. JAMA 276: 889, 1996.
Ellis RE, Mangano DT, VanDyke DC. Relation of wedge pressure to end-diastolic volume in patients undergoing myocardial revascularization. J Thoracic Cardiovasc Surg 78:605, 1979.
Calvin JE, Driedger AA, Sibbald WJ. Does the pulmonary capillary wedge pressure predict left ventricular preload in the critically ill patient? Crit Care Med 9:437, 1981.
Mitchell JP, Schuller D, Calandrio FS, Schuster DP. Improved outcome based on fluid management in critically ill patients requiring pulmonary artery catheterization. Am Rev Resp Dis 145:990, 1992.
Gan TJ, Arrowsmith JE. The esophageal Doppler monitor. A safe means of monitoring circulation. BMJ 315:893, 1997.
Nishimura RA, et al. Non-invasive measurement of cardiac output by continuous wave Doppler echocardiography: Initial experience and review of the literature. May Clin Proc 59:484, 1984.
Hattle and Angelsen. Doppler Ultrasound in cardiology, 2nd edn. Lea and Febiger, Philadelphia, 1985.
Baker DW. Applications of pulsed Doppler. Rad Clin North Am 18:79, 1980.
Nishimura RA, et al. Doppler echocardiography: Theory, instrumentation, technique and application. Mayo Clinic Proc 60:321, 1985.
Am J Cardiol 76:392, 1995.
Sohn D-W, Shin G-J, Oh JK, Tajik AJ, Click RL, Miller FA, Seward JB. Role of Transesophageal Echocardiography in Hemodynami-cally Unstable Patients. May Clin Proc 70:925, 1995.
Heidenreich J. Am Coll Cardiol 26:152, 1995.
Pearson AC. Noninvasive evaluation of the hemodynamically unstable patient: the advantage of seeing clearly. Mayo Clin Proc 70:1012, 1995.
Hayes. NEJM 330:1717, 1994.
Gattinoni. NEJM 333:1025, 1995.
Negland, Cook. Crit Care Med 24:517, 1996.
Task Force of the American College of Critical Care Medicine, Society of Critical Care Monitoring Crit Care Med 27:639, 1999.
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Apostle, J.A., Guardiola, J.J. (2001). Cardiovascular Monitoring of the Septic Patient. In: Rello, J., Valles, J., Kollef, M.H. (eds) Critical Care Infectious Diseases Textbook. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1679-8_7
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DOI: https://doi.org/10.1007/978-1-4615-1679-8_7
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