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Hemodynamic Support

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Abdominal Sepsis

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

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Abstract

Septic shock is a common clinical situation and is associated with a high morbidity and mortality. Appropriate shock approach and support rely on a good understanding of its pathophysiology. Septic shock secondary to abdominal focus presents all the characteristics common to septic shock of other anatomical sources plus two additional and particular ones, namely, increased intra-abdominal pressure and reduction of splanchnic perfusion. These issues raise specific problems that could change the shock approach, namely, target mean arterial pressure and vasopressor selection. In sepsis-induced hypotension, the first step includes adequate fluid resuscitation. If hypotension persists, patients should be treated early with vasopressors to increase mean arterial pressure and maintain a minimal perfusion pressure. The ideal vasopressor has not yet been found. The discussion around the choice of the “best” vasopressor should be substituted by the discussion about what vasopressor best suits each patient pathophysiological abnormalities, namely, in abdominal sepsis.

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Author information

Authors and Affiliations

  1. Polyvalent Intensive Care Unit, Hospital de São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal

    Pedro Povoa

  2. NOVA Medical School, Faculdade de Ciências Médicas, New University of Lisbon, Lisbon, Portugal

    Pedro Povoa

  3. Department of Medicine, Emergency and Intensive Care Unit, Hospital da Luz Arrábida, Gaia, Portugal

    António Carneiro

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  1. Pedro Povoa
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  2. António Carneiro
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Correspondence to Pedro Povoa .

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Editors and Affiliations

  1. Department of Surgery, Macerata Hospital, Macerata, Italy

    Massimo Sartelli

  2. University of Udine, Infectious Diseases Division , Udine, Italy

    Matteo Bassetti

  3. St James's University Hospital, Trinity Centre for Health Sciences , Dublin, Ireland

    Ignacio Martin-Loeches

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Povoa, P., Carneiro, A. (2018). Hemodynamic Support. In: Sartelli, M., Bassetti, M., Martin-Loeches, I. (eds) Abdominal Sepsis. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-319-59704-1_22

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  • DOI: https://doi.org/10.1007/978-3-319-59704-1_22

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  • Online ISBN: 978-3-319-59704-1

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