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Point-of-care ultrasound is rapidly changing the way we assess critically ill shock patients and has become a fundamental tool in the emergency and critical care departments.
See related commentary by Asfar and Radermacher, With the increasing medical complexity of the critically ill, shock due to a combination of vasodilation and cardiac dysfunction is increasingly frequent.
We performed a search of the PUBMED database from 1980 to 2010 using combinations of the following terms: SvO2, ScvO2, venous oxygen saturation, venous saturation, critically ill, shock, septic shock, high risk surgery, surgery, operation.
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Neighbours who remember the brutal killings in Worcester described how the police officers who discovered the children impaled on railings on the next door house were physically ill with shock.
Of notice, our microcirculatory variables, except the PPV, were only mildly affected, which are not a usual finding in severely ill septic shock patients with high SOFA and SAPS 3 scores and a high mortality rate.
Early initiation of epinephrine may offer survival benefit to critically ill pediatric shock patients.
Energy requirements of critically ill septic shock patients treated in the ICU are particularly difficult to determine.
This is a challenge given the characteristics of many infected critically ill patients (shock, elevated cardiac output in the resuscitated state, supranormal creatinine clearance, increased volume of distribution).
The aim of the present study was to evaluate the clinical utility of endotoxin activity (EAA) measurement in critically ill septic shock (SS) patients.
We aimed to clarify if extended intermittent high volume online haemodiafiltration (HVHDF) influences patient haemodynamics and cytokines profile and/or has effect upon sublingual microcirculation in critically ill septic shock patients.
We argue that observations supporting the value of serial testing for estimating hemodynamics are largely based on experience in patients with destabilized heart failure, rather than in patients who are critically ill with shock, and thus remain speculative.
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