Tricuspid Annular Plane of Systolic Excursion for the Evaluation of Patients with Severe Sepsis and Septic Shock

Introduction:Sepsis is a systemic infection that can rapidly progress into multi organ failure and shock if left untreated. Previous studies have demonstrated the utility of point of care ultrasound (POCUS) in the evaluation of patients with sepsis. However, limited data exists on the evaluation of the tricuspid annular plane of systolic excursion (TAPSE) in patients with sepsis.Methods: We prospectively enrolled patients who presented to the emergency department (ED) with concern for severe sepsis or septic shock in a pilot study. In patients that screened positive, the treating physician then performed POCUS to measure the TAPSE value. We compared the intensive care unit (ICU) admission rate, hospital length of stay, and morbidity with their respective TAPSE values.Results: We enrolled 24 patients in the study. Eight patients had TAPSE values less than 16 millimeters (mm), two patients had TAPSE values between...
Source: Western Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research

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Authors: Davis B, Brockshus A, Merritt C, Donaldson C Abstract A patient presented to the emergency department with undifferentiated shock 4 days after discharge from a hospitalization for a lower gastrointestinal bleed. The patient fulfilled 4/4 of the Systemic Inflammatory Response Syndrome criteria and 3/3 of the quick Sequential Organ Failure Assessment criteria on presentation to the emergency department, notably, without a localized source of infection and no localizing symptoms. After admission, the patient's hemoglobin was found to have dropped more than expected after intravenous (IV) fluid administration,...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Conclusion: Recent clinical practice guidelines recommend against the routine use of any anticoagulant thromboprophylaxis in patients with central venous catheters, but for patients at particularly high risk for CRT, consideration can be given to using higher doses of anticoagulant as prophylaxis, although there are virtually no data to support this approach.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusion: The idiopathic NF may still potentially occur after a clean ORIF of the hip region. The implementation of intensive guideline-based treatments may show improvements, but the risk of unexpected NF spread to the abdomen should be anticipated, which may increase the mortality rates in diabetic or immunocompromised patients.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
To explore the association between the ratio of tricuspid annular plane systolic excursion (TAPSE) and pulmonary arterial systolic pressure (PASP), and long- and short-term outcomes in mechanically ventilated ...
Source: Cardiovascular Ultrasound - Category: Radiology Authors: Tags: Research Source Type: research
This study highlights the value of our technology and its potential to improve heart failure outcomes. There have been dozens of peer-reviewed studies that have established the value of the BVA-100 test for clinical use, confirming that accurate ...
Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Cardiac Surgery Cardiology Critical Care Emergency Medicine Exclusive Source Type: blogs
Conclusions: Hypovolemia was predominantly identified in patients presenting to the ED with acute circulatory failure. Although vasoplegia was more frequently associated with sepsis, early ventricular dysfunction was also depicted in septic patients. Focused echocardiography seemed reliable when performed by recently trained emergency physicians without previous experience in ultrasound.
Source: Shock - Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research
Conclusion: The PCO2 gap is an important hemodynamic variable in the management of sepsis-induced circulatory failure. The PCO2 gap can be a marker of the adequacy of the cardiac output status in severe sepsis. A high PCO2 gap value (>0.8 kPa) can identify situations in which increasing CO can be attempted with fluid resuscitation in severe sepsis. The PCO2 gap carries an important prognostic value in severe sepsis. PMID: 32377433 [PubMed]
Source: Critical Care Research and Practice - Category: Intensive Care Tags: Crit Care Res Pract Source Type: research
This study protocol aims to explore the correlation of peripheral arterial pulsation index/resistance index, organ function, and inflammation in patients with septic shock. Trial registration: Chinese Clinical trial registry: ChiCTR2000031565
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
AbstractBackgroundPlanning optimal fluid and inotrope-vasopressor-inodilator therapy is essential in critically ill children. Pulse index Contour Cardiac Output (PiCCO) monitoring is an invasive, hemodynamic monitor that provides parameter measurements such as cardiac output (CO), cardiac index (CI). Use of ultrasonography and critical care echocardiography by the pediatric intensivists has increased in recent years. In the hands of an experienced pediatric intensivist, critical echocardiography can accurately measure both CO and CI. Our objective in this study is to compare the CO and CI values measured by pediatric inten...
Source: Italian Journal of Pediatrics - Category: Pediatrics Source Type: research
Publication date: March 2020Source: Anesthesiology Clinics, Volume 38, Issue 1Author(s): Nibras Bughrara, Jose L. Diaz-Gomez, Aliaksei Pustavoitau
Source: Anesthesiology Clinics - Category: Anesthesiology Source Type: research
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