Challenges in the management of septic shock: a narrative review. (Record no. 83612)

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fixed length control field 01952nab a22003377a 4500
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fixed length control field 190212b2019 xxu||||| |||| 00| 0 eng d
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Personal name De Backer D
Relator term Corresponding author
245 ## - TITLE STATEMENT
Title Challenges in the management of septic shock: a narrative review.
260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT)
Date of publication, distribution, etc 2019
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Extent
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General note Address for correspondence: ddebacke@ulb.ac.be.
520 ## - SUMMARY, ETC.
Summary, etc While guidelines provide important information on how to approach a patient in septic shock, "many challenges remain" for the management of these patients. In this narrative review, the panel discusses the challenges in identifying the right hemodynamic target, optimization of fluid therapy, selection of vasopressor agents, identification of patients who may benefit from inotropic agents or on the contrary beta-blockade, and use of steroids. The place for microcirculation-targeted therapy is debated as well as the use of alternative techniques (blood purification) and therapies (vitamin C). The implications of hemodynamic alterations on antibiotic doses is discussed. Finally, the specific challenges in low- and middle-income countries are addressed. Ongoing trials address some of these challenges, but many uncertainties will remain, and individualized therapies based on careful clinical assessment will continue to be essential to optimizing the care of patients with septic shock.
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Topical term or geographic name as entry element Cardiac output
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Topical term or geographic name as entry element Fluids
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Topical term or geographic name as entry element Hemodynamic monitoring
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Topical term or geographic name as entry element Steroids
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Topical term or geographic name as entry element Tissue perfusion
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Topical term or geographic name as entry element Vasopressors
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Personal name Cecconi M
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Personal name Lipman J
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Personal name Machado F
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Personal name Myatra SN
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Personal name Ostermann M
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Personal name Perner A
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Personal name Teboul JL
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Personal name Vincent JL
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Personal name Walley KR
773 ## - HOST ITEM ENTRY
Main entry heading Intensive Care Medicine.
Place, publisher, and date of publication New York : Springer Verlag, 2019
Relationship information Vol. 45, no. 4, p. 420-433.
International Standard Serial Number 0342-4642
906 ## - LOCAL DATA ELEMENT F, LDF (RLIN)
Dept Anaesthesiology
Corporate name TMC
PMID 30741328
Article Type Journal Article
Country type International
Added Entry TMH
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Item type Articles
Holdings
Withdrawn status Lost status Source of classification or shelving scheme Damaged status Not for loan Permanent location Current location Date acquired Barcode Date last seen Koha item type
          Tata Memorial Hospital Tata Memorial Hospital 2019-02-12 AR19357 2019-02-12 Articles

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