Septic Shock and Cardiac Arrest in Obstetrics

Pacheco, Luis D.; Shepherd, Megan C.; Saade, George S.

doi:10.1016/j.ogc.2022.02.002

Cited by 4 publications

(2 citation statements)

References 26 publications

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“…The magnitude of the CVP can reflect the pressure in the right atrium, and CVP is relatively easy to measure and can be used as a proxy to approximate preload. It is generally believed that the normal value range of CVP is between 5 and 10cmH2O 31 .…”

Section: Discussionmentioning

confidence: 99%

Clinical value of CVP+VIVC in predicting fluid resuscitation in patients with septic shock

Zhang,

Liu,

Cao

et al. 2023

Afr H. Sci.

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Objective: To explore the clinical value of central venous pressure (CVP) + inferior vena cava respiratory variability (VIVC) in fluid resuscitation in spontaneously breathing patients with septic shock. Methods: In retrospective observational study, during October 2019 to December 2021, 145 patients with septic shock treated in our hospital were enrolled by the method of observational study. According to the change rate of cardiac output (△ CO) ≥15% or △ CO<15% after 30 minutes, they were assigned into volume-responsive and volume-unresponsive group depending early fluid resuscitation in sepsis. The clinical value of combination of CVP and VIVC in predicting fluid resuscitation in patients with septic shock was compared. Results: The CVP of the study group was higher at 12h and 24h after fluid resuscitation, and the VIVC level of the study group at 6h, 12h and 24h after fluid resuscitation was higher (P<0.05). Pearson correlation analysis indicated that CVP, and VIVC levels were noticeably correlated with fluid resuscitation in patients with septic shock (P<0.05). The area under curve (AUC) of receiver operating characteristic curve (ROC) of CVP for predicting fluid resuscitation in septic shock patients was 0.694 and the cut-off value was 0.932, the sensitivity was 46.9%, and the specificity was 87.5%. VIVC predicted fluid resuscitation in septic shock patients with an AUC of 0.776, which was a cut-off value of 0.688, a sensitivity of 50.0%, and a specificity of 90.0%. Combination of CVP and VIVC predicted fluid resuscitation in septic shock patients with an AUC of 0.948, which was a cut-off value of 1.420, a sensitivity of 90.6%, and a specificity of 87.5%. Conclusion: Combination of CVP and VIVC may have a good effect on the evaluation of volume responsiveness in patients with septic shock, which is better than single CVP and VIVC. Combination of CVP and VIVC can be adopted to predict fluid responsiveness volume responsiveness in septic shock patients, which is of great significance for guiding clinical fluid responsiveness therapy. Keywords: Septic shock; fluid resuscitation; CVP; VIVC.

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Section: Discussionmentioning

confidence: 99%

Clinical value of CVP+VIVC in predicting fluid resuscitation in patients with septic shock

Zhang,

Liu,

Cao

et al. 2023

Afr H. Sci.

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“…As the disease progresses, signs of shock (cold skin and cyanosis) and signs of organ dysfunction (oliguria, acute kidney injury and altered consciousness) occur. However, these non-specific manifestations can be similar to many other conditions, such as pancreatitis and acute respiratory distress syndrome [7,8]. Therefore, the diagnosis of sepsis and SS usually requires a combination of clinical findings, laboratory tests, imaging studies and physiological and microbiological data.…”

Section: Introductionmentioning

confidence: 99%

Effect of Norepinephrine on Hemodynamics of Systemic Circulation and Oxygen Metabolism in Emergency Septic Shock

2023

FARMACIA

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The aim of this study was to analyse the value of using norepinephrine (NE) and dopamine (DA) in the clinical management of patients with emergency septic shock (SS). Eighty adult patients with SS who were treated in the hospital were included as research subjects. These patients were randomly divided into an experimental (Expt) group (NE) and a control (Ctrl) group (DA), with 40 cases per group. The hemodynamic parameters and renal function indicators of the two groups were compared. Mean arterial pressure (MAP) 1 hour and 6 hours after drug administration was significantly higher in the Expt group than after fluid resuscitation (FR). Heart rate (HR) 1 hour after drug administration was significantly lower than in the Ctrl group (p < 0.05). The blood lactic acid clearance rate (LCR) and peripheral vascular resistance index (PVRI) of the Expt group were significantly higher than those of the Ctrl group 1 h and 6 h after medication (p < 0.05). The creatinine clearance rate (CCr) and urine output (UO) of the Expt group 1 h and 6 h after liquid medication were higher than those of the Ctrl group (p < 0.05). Compared with DA, NE could effectively maintain hemodynamic stability, reduce blood lactic acid levels and improve renal function in patients with SS. RezumatÎn cadrul acestui studiu ne-am propus evaluarea utilizării norepinefrinei (NE) și a dopaminei (DA) în managementul clinic al pacienților cu șoc septic (SS) de urgență. În cadrul cercetării au fost incluși optzeci de pacienți adulți cu SS, tratați în spital. Aceștia au fost împărțiți în mod aleatoriu într-un grup experimental (Expt) (NE) și un grup control (Ctrl) (DA), cu 40 de cazuri per grup. S-au urmărit valorile parametrilor hemodinamici și indicatorii funcției renale ai celor două grupuri. Presiunea arterială medie (PAM) la 1 oră și 6 ore după administrarea medicamentului a fost semnificativ mai mare în grupul Expt decât după resuscitarea fluidă. Frecvența cardiacă la 1 oră după administrarea medicamentului a fost semnificativ mai mică decât în grupul Ctrl (p < 0,05). Rata de eliminare a acidului lactic din sânge și indicele de rezistență vasculară periferică ale grupului Expt au fost semnificativ mai mari decât cele ale grupului Ctrl la 1 h și 6 h după administrarea medicamentelor (p < 0,05). Clearenceul creatininei (CCr) și debitul urinar în grupul Expt la 1 h și 6 h după medicația lichidă au fost mai mari decât în grupul Ctrl (p < 0,05). În comparație cu DA, NE reduce nivelul de acid lactic din sânge, îmbunătățește funcția renală și ar putea menține în mod eficient stabilitatea hemodinamică la pacienții cu SS.

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