Should we M.O.N.I.T.O.R ward patients differently?

Michard, Frédèric

doi:10.1097/eja.0000000000001613

Cited by 1 publication

(1 citation statement)

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“…The monitor should follow the patient, not the patient the monitor. The technology already allows for personalized and remote monitoring, which will change the relationship with critically ill patients in the near future and improve the recognition of patients at risk of deterioration [29,30].…”

Section: Improvement Programs In Sepsis: Early Recognition and Rescuementioning

confidence: 99%

Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies

Ramasco,

Nieves-Alonso,

García-Villabona

et al. 2024

JPM

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Sepsis and septic shock are associated with high mortality, with diagnosis and treatment remaining a challenge for clinicians. Their management classically encompasses hemodynamic resuscitation, antibiotic treatment, life support, and focus control; however, there are aspects that have changed. This narrative review highlights current and avant-garde methods of handling patients experiencing septic shock based on the experience of its authors and the best available evidence in a context of uncertainty. Following the first recommendation of the Surviving Sepsis Campaign guidelines, it is recommended that specific sepsis care performance improvement programs are implemented in hospitals, i.e., “Sepsis Code” programs, designed ad hoc, to achieve this goal. Regarding hemodynamics, the importance of perfusion and hemodynamic coherence stand out, which allow for the recognition of different phenotypes, determination of the ideal time for commencing vasopressor treatment, and the appropriate fluid therapy dosage. At present, this is not only important for the initial timing, but also for de-resuscitation, which involves the early weaning of support therapies, directed elimination of fluids, and fluid tolerance concept. Finally, regarding blood purification therapies, those aimed at eliminating endotoxins and cytokines are attractive in the early management of patients in septic shock.

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Section: Improvement Programs In Sepsis: Early Recognition and Rescuementioning

confidence: 99%