Detailed Information

Cited 1 time in webofscience Cited 2 time in scopus
Metadata Downloads

Hemodynamic management of septic shock: beyond the Surviving Sepsis Campaign guidelinesopen access

Authors
Suh, Gil JoonShin, Tae GunKwon, Woon YongKim, KyuseokJo, You HwanChoi, Sung-HyukChung, Sung Philorean Shock Soc Investigators
Issue Date
Sep-2023
Publisher
대한응급의학회
Keywords
Septic shock; Resuscitation; Fluid responsiveness; Vasopressor agent; Extracorporeal membrane oxygenation
Citation
Clinical and Experimental Emergency Medicine, v.10, no.3, pp 255 - 264
Pages
10
Indexed
SCOPUS
ESCI
KCI
Journal Title
Clinical and Experimental Emergency Medicine
Volume
10
Number
3
Start Page
255
End Page
264
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64769
DOI
10.15441/ceem.23.065
ISSN
2383-4625
Abstract
Although the Surviving Sepsis Campaign guidelines provide standardized and generalized guid-ance, they are less individualized. This review focuses on recent updates in the hemodynamic management of septic shock. Monitoring and intervention for septic shock should be personal-ized according to the phase of shock. In the salvage phase, fluid resuscitation and vasopressors should be given to provide life-saving tissue perfusion. During the optimization phase, tissue per -fusion should be optimized. In the stabilization and de-escalation phases, minimal fluid infusion and safe fluid removal should be performed, respectively, while preserving organ perfusion. There is controversy surrounding the use of restrictive versus liberal fluid strategies after initial resusci-tation. Fluid administration after initial resuscitation should depend upon the patient's fluid re-sponsiveness and requires individualized management. A number of dynamic tests have been proposed to monitor fluid responsiveness, which can help clinicians decide whether to give fluid or not. The optimal timing for the initiation of vasopressor agents is unknown. Recent data sug-gest that early vasopressor initiation should be considered. Inotropes can be considered in pa-tients with decreased cardiac contractility associated with impaired tissue perfusion despite ade-quate volume status and arterial blood pressure. Venoarterial extracorporeal membrane oxygen-ation should be considered for refractory septic shock with severe cardiac systolic dysfunction.
Files in This Item
There are no files associated with this item.
Appears in
Collections
5. Others > ETC > 1. Journal Articles

qrcode

Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.

Related Researcher

Researcher Choi, Sung Hyuk photo

Choi, Sung Hyuk
Guro Hospital (Department of Emergency Medicine, Guro Hospital)
Read more

Altmetrics

Total Views & Downloads

BROWSE