Early Sequential Microcirculation Assessment In Shocked Patients as a Predictor of Outcome: A Prospective Observational Cohort Study

Conclusions: Early sequential evaluation of the microcirculation in shocked patients, demonstrated statistically significant improvement in the PPV and microvascular heterogeneity with standard care. These improvements were mirrored by biomarkers of organ perfusion; however, the changes in global hemodynamics were not as pronounced in this early phase. Early improvement in the microcirculation did not predict clinical outcome.
Source: Shock - Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Related Links:

Abstract BACKGROUND: The peripheral perfusion index (PI), as a real-time bedside indicator of peripheral tissue perfusion, may be useful for determining mean arterial pressure (MAP) after early resuscitation of septic shock patients. The aim of this study was to explore the response of PI to norepinephrine (NE)-induced changes in MAP. METHODS: Twenty septic shock patients with pulse-induced contour cardiac output catheter, who had usual MAP under NE infusion after early resuscitation, were enrolled in this prospective, open-label study. Three MAP levels (usual MAP -10 mmHg, usual MAP, and usual MAP +10 mmHg) ...
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
CONCLUSION: While TP treatment appeared to help control hypotension and may prolong the survival time, there are no conclusive data regarding the safety and efficacy of TP in neonates. PMID: 32779422 [PubMed - in process]
Source: The Turkish Journal of Pediatrics - Category: Pediatrics Authors: Tags: Turk J Pediatr Source Type: research
We describe here two infants requiring veno-arterial extracorporeal membrane oxygenation for septic shock who encountered right watershed infarction ipsilateral to carotid artery cannulation. Hemodynamic failure seems to be the most probable underlying mechanism. The asymmetry of transcranial Doppler metrics in one case and the low right regional cerebral oxygen saturation value observed soon after right cannulation in both cases suggest an insufficient cerebral collateral flow compensation. The risk of ipsilateral watershed injury should be considered before cervical cannulation, notably in the context of sepsis and an ev...
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
Components of neutrophil extracellular traps (NETs) are released into the circulation by neutrophils and contribute to microcirculatory disturbance in sepsis. Removing NET components (DNA, histones, and proteases) from the circulation could be a new strategy for counteracting NET-dependent tissue damage. We evaluated the effect of hemoperfusion with a polymyxin B (PMX) cartridge, which was originally developed for treating gram-negative infection, on circulating NET components in patients with septic shock, as well as the effect on phorbol myristate acetate (PMA)-stimulated neutrophils obtained from healthy volunteers. Ex ...
Source: Shock - Category: Emergency Medicine Tags: Clinical Science Aspects 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
Condition:   Trans Cranial Doppler Ultrasonography in Heamodynamic Optimisation in Septic Shock Intervention:   Procedure: hemodynamic optimisation aiming to achieve normal cerebral perfusion Sponsor:   Mongi Slim Hospital Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
CONCLUSION: Determining pressure injury risk in critically ill patients is complex and challenging. One common pathophysiological factor is impaired tissue oxygenation and perfusion, which may be nonmodifiable. Improved risk quantification is needed and may be realized in the near future by leveraging the clinical information available in the electronic medical record through the power of predictive analytics. PMID: 32355967 [PubMed - in process]
Source: American Journal of Critical Care - Category: Nursing Authors: Tags: Am J Crit Care Source Type: research
Purpose of review Currently, the treatment of patients with shock is focused on the clinical symptoms of shock. In the early phase, this is usually limited to heart rate, blood pressure, lactate levels and urine output. However, as the ultimate goal of resuscitation is the improvement in microcirculatory perfusion the question is whether these currently used signs of shock and the improvement in these signs actually correspond to the changes in the microcirculation. Recent findings Recent studies have shown that during the development of shock the deterioration in the macrocirculatory parameters are followed by the de...
Source: Current Opinion in Critical Care - Category: Nursing Tags: CARDIOPULMONARY MONITORING: Edited by Jan Bakke Source Type: research
This study aimed to evaluate the association between hemodynamic and skin perfusion parameters and enteral nutrition therapy (NT) outcomes in septic shock patients.
Source: Clinical Nutrition - Category: Nutrition Authors: Tags: Original article Source Type: research
In this study, gapCO2 induced by hyperventilation significantly increased, while the central venous carbon dioxide pressure (PvCO2) and the partial pressure of CO2 (PaCO2) in arteries decreased. The decreasing trend of the PaCO2 was more obvious than that of the PvCO2. HCO3− and ctCO2 were markedly decreased, when the RR was increased (P 
Source: European Journal of Medical Research - Category: Research Source Type: research
More News: Cardiology | Emergency Medicine | Heart | Intensive Care | Perfusion | Physiology | Science | Septic Shock | Statistics | Study | Urology & Nephrology