Abstract
Purpose of the review: Non-invasiveness and instantaneous diagnostic capability are prominent features of the use of echocardiography in critical care. Sepsis and septic shock represent complex situations where early hemodynamic assessment and support are among the keys to therapeutic success. In this review, we discuss the range of applications of echocardiography in the management of the septic patient, and propose an echocardiography-based goal-oriented hemodynamic approach to septic shock. Recent findings: Echocardiography can play a key role in the critical septic patient management, by excluding cardiac causes for sepsis, and mostly by guiding hemodynamic management of those patients in whom sepsis reaches such a severity to jeopardize cardiovascular function. In recent years, there have been both increasing evidence and diffusion of the use of echocardiography as monitoring tool in the patients with hemodynamic compromise. Also thanks to echocardiography, the features of the well-known sepsis-related myocardial dysfunction have been better characterized. Furthermore, many of the recent echocardiographic indices of volume responsiveness have been validated in populations of septic shock patients. Conclusion: Although not proven yet in terms of patient outcome, echocardiography can be regarded as an ideal monitoring tool in the septic patient, as it allows (a) first line differential diagnosis of shock and early recognition of sepsis-related myocardial dysfunction; (b) detection of pre-existing cardiac pathology, that yields precious information in septic shock management; (c) comprehensive hemodynamic monitoring through a systematic approach based on repeated bedside assessment; (d) integration with other monitoring devices; and (e) screening for cardiac source of sepsis.
| Original language | English |
|---|---|
| Pages (from-to) | 71-85 |
| Number of pages | 15 |
| Journal | Critical Ultrasound Journal |
| Volume | 3 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Aug 2011 |
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Keywords
- Critical care
- Echocardiography
- Endocarditis
- Hemodynamic monitoring
- Sepsis
- Septic shock
ASJC Scopus subject areas
- Radiological and Ultrasound Technology
Cite this
Echocardiography in the sepsis syndromes. / Via, Gabriele; Price, Susanna; Storti, Enrico.
In: Critical Ultrasound Journal, Vol. 3, No. 2, 08.2011, p. 71-85.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Echocardiography in the sepsis syndromes
AU - Via, Gabriele
AU - Price, Susanna
AU - Storti, Enrico
PY - 2011/8
Y1 - 2011/8
N2 - Purpose of the review: Non-invasiveness and instantaneous diagnostic capability are prominent features of the use of echocardiography in critical care. Sepsis and septic shock represent complex situations where early hemodynamic assessment and support are among the keys to therapeutic success. In this review, we discuss the range of applications of echocardiography in the management of the septic patient, and propose an echocardiography-based goal-oriented hemodynamic approach to septic shock. Recent findings: Echocardiography can play a key role in the critical septic patient management, by excluding cardiac causes for sepsis, and mostly by guiding hemodynamic management of those patients in whom sepsis reaches such a severity to jeopardize cardiovascular function. In recent years, there have been both increasing evidence and diffusion of the use of echocardiography as monitoring tool in the patients with hemodynamic compromise. Also thanks to echocardiography, the features of the well-known sepsis-related myocardial dysfunction have been better characterized. Furthermore, many of the recent echocardiographic indices of volume responsiveness have been validated in populations of septic shock patients. Conclusion: Although not proven yet in terms of patient outcome, echocardiography can be regarded as an ideal monitoring tool in the septic patient, as it allows (a) first line differential diagnosis of shock and early recognition of sepsis-related myocardial dysfunction; (b) detection of pre-existing cardiac pathology, that yields precious information in septic shock management; (c) comprehensive hemodynamic monitoring through a systematic approach based on repeated bedside assessment; (d) integration with other monitoring devices; and (e) screening for cardiac source of sepsis.
AB - Purpose of the review: Non-invasiveness and instantaneous diagnostic capability are prominent features of the use of echocardiography in critical care. Sepsis and septic shock represent complex situations where early hemodynamic assessment and support are among the keys to therapeutic success. In this review, we discuss the range of applications of echocardiography in the management of the septic patient, and propose an echocardiography-based goal-oriented hemodynamic approach to septic shock. Recent findings: Echocardiography can play a key role in the critical septic patient management, by excluding cardiac causes for sepsis, and mostly by guiding hemodynamic management of those patients in whom sepsis reaches such a severity to jeopardize cardiovascular function. In recent years, there have been both increasing evidence and diffusion of the use of echocardiography as monitoring tool in the patients with hemodynamic compromise. Also thanks to echocardiography, the features of the well-known sepsis-related myocardial dysfunction have been better characterized. Furthermore, many of the recent echocardiographic indices of volume responsiveness have been validated in populations of septic shock patients. Conclusion: Although not proven yet in terms of patient outcome, echocardiography can be regarded as an ideal monitoring tool in the septic patient, as it allows (a) first line differential diagnosis of shock and early recognition of sepsis-related myocardial dysfunction; (b) detection of pre-existing cardiac pathology, that yields precious information in septic shock management; (c) comprehensive hemodynamic monitoring through a systematic approach based on repeated bedside assessment; (d) integration with other monitoring devices; and (e) screening for cardiac source of sepsis.
KW - Critical care
KW - Echocardiography
KW - Endocarditis
KW - Hemodynamic monitoring
KW - Sepsis
KW - Septic shock
UR - http://www.scopus.com/inward/record.url?scp=79960704284&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79960704284&partnerID=8YFLogxK
U2 - 10.1007/s13089-011-0069-0
DO - 10.1007/s13089-011-0069-0
M3 - Article
AN - SCOPUS:79960704284
VL - 3
SP - 71
EP - 85
JO - Critical Ultrasound Journal
JF - Critical Ultrasound Journal
SN - 2036-3176
IS - 2
ER -