Optimal target in septic shock resuscitation

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dc.catalogadorjwg
dc.contributor.authorKattan, Eduardo
dc.contributor.authorCastro, Ricardo
dc.contributor.authorVera Alarcón, María Magdalena
dc.contributor.authorHernández, Glenn
dc.date.accessioned2024-03-14T19:11:26Z
dc.date.available2024-03-14T19:11:26Z
dc.date.issued2020
dc.description.abstractSeptic shock presents a high risk of morbidity and mortality. Through therapeutic strategies, such as fluid administration and vasoactive agents, clinicians intend to rapidly restore tissue perfusion. Nonetheless, these interventions have narrow therapeutic margins. Adequate perfusion monitoring is paramount to avoid progressive hypoperfusion or detrimental over-resuscitation. During early stages of septic shock, macrohemodynamic derangements, such as hypovolemia and decreased cardiac output (CO) tend to predominate. However, during late septic shock, endothelial and coagulation dysfunction induce severe alterations of the microcirculation, making it more difficult to achieve tissue reperfusion. Multiple perfusion variables have been described in the literature, from bedside clinical examination to complex laboratory tests. Moreover, all of them present inherent flaws and limitations. After the ANDROMEDA-SHOCK trial, there is evidence that capillary refill time (CRT) is an interesting resuscitation target, due to its rapid kinetics and correlation with deep hypoperfusion markers. New concepts such as hemodynamic coherence and flow responsiveness may be used at the bedside to select the best treatment strategies at any time-point. A multimodal perfusion monitoring and an integrated analysis with macrohemodynamic parameters is mandatory to optimize the resuscitation of septic shock patients.
dc.format.extent12 páginas
dc.fuente.origenORCID
dc.identifier.doi10.21037/ATM-20-1120
dc.identifier.eissn2305-5847
dc.identifier.issn2305-5839
dc.identifier.pubmedidMEDLINE:32647714
dc.identifier.urihttp://dx.doi.org/10.21037/ATM-20-1120
dc.identifier.urihttps://publons.com/wos-op/publon/37253088/
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/84436
dc.identifier.wosidWOS:000547552700009
dc.information.autorucEscuela de Medicina; Vera Alarcon, Maria Magdalena; 0000-0002-2969-3408; 226652
dc.issue.numero12
dc.language.isoen
dc.nota.accesoContenido parcial
dc.pagina.final12
dc.pagina.inicio1
dc.revistaAnnals of Translational Medicine
dc.rightsacceso restringido
dc.rights.licenseAtribución-NoComercial-SinDerivadass 4.0 International (CC BY-NC-ND 4.0 )
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectSeptic shock
dc.subjectResuscitation
dc.subjectFluid therapy
dc.subjectMicrocirculation
dc.subjectCapillary refill time (CRT)
dc.subjectLactate
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleOptimal target in septic shock resuscitation
dc.typeartículo
dc.volumen8
sipa.codpersvinculados226652
sipa.trazabilidadORCID;2024-02-19
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