scholarly journals Peripheral perfusion is correlated to metabolic perfusion parameters and microvascular reactivity but not with hepatosplanchnic or microcirculatory flow parameters in hyperdynamic septic shock

Critical Care ◽  
2012 ◽  
Vol 16 (S1) ◽  
Author(s):  
G Hernandez ◽  
T Regueira ◽  
A Bruhn ◽  
P Mcnab ◽  
E Veas ◽  
...  
Keyword(s):  
Septic Shock ◽  
Peripheral Perfusion ◽  
Microvascular Reactivity ◽  
Flow Parameters ◽  
Microcirculatory Flow ◽  
Hyperdynamic Septic Shock

scholarly journals Effects of capillary refill time-vs. lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ricardo Castro ◽  
Eduardo Kattan ◽  
Giorgio Ferri ◽  
Ronald Pairumani ◽  
Emilio Daniel Valenzuela ◽  
...  
Keyword(s):  
Septic Shock ◽  
Randomized Controlled Trial ◽  
Fluid Resuscitation ◽  
Controlled Trial ◽  
Tissue Perfusion ◽  
Capillary Refill Time ◽  
Capillary Refill ◽  
Randomized Controlled ◽  
Microcirculatory Flow ◽  
The Impact

Abstract Background Persistent hyperlactatemia has been considered as a signal of tissue hypoperfusion in septic shock patients, but multiple non-hypoperfusion-related pathogenic mechanisms could be involved. Therefore, pursuing lactate normalization may lead to the risk of fluid overload. Peripheral perfusion, assessed by the capillary refill time (CRT), could be an effective alternative resuscitation target as recently demonstrated by the ANDROMEDA-SHOCK trial. We designed the present randomized controlled trial to address the impact of a CRT-targeted (CRT-T) vs. a lactate-targeted (LAC-T) fluid resuscitation strategy on fluid balances within 24 h of septic shock diagnosis. In addition, we compared the effects of both strategies on organ dysfunction, regional and microcirculatory flow, and tissue hypoxia surrogates. Results Forty-two fluid-responsive septic shock patients were randomized into CRT-T or LAC-T groups. Fluids were administered until target achievement during the 6 h intervention period, or until safety criteria were met. CRT-T was aimed at CRT normalization (≤ 3 s), whereas in LAC-T the goal was lactate normalization (≤ 2 mmol/L) or a 20% decrease every 2 h. Multimodal perfusion monitoring included sublingual microcirculatory assessment; plasma-disappearance rate of indocyanine green; muscle oxygen saturation; central venous-arterial pCO2 gradient/ arterial-venous O2 content difference ratio; and lactate/pyruvate ratio. There was no difference between CRT-T vs. LAC-T in 6 h-fluid boluses (875 [375–2625] vs. 1500 [1000–2000], p = 0.3), or balances (982[249–2833] vs. 15,800 [740–6587, p = 0.2]). CRT-T was associated with a higher achievement of the predefined perfusion target (62 vs. 24, p = 0.03). No significant differences in perfusion-related variables or hypoxia surrogates were observed. Conclusions CRT-targeted fluid resuscitation was not superior to a lactate-targeted one on fluid administration or balances. However, it was associated with comparable effects on regional and microcirculatory flow parameters and hypoxia surrogates, and a faster achievement of the predefined resuscitation target. Our data suggest that stopping fluids in patients with CRT ≤ 3 s appears as safe in terms of tissue perfusion. Clinical Trials: ClinicalTrials.gov Identifier: NCT03762005 (Retrospectively registered on December 3rd 2018)

scholarly journals EFFECT OF HYDROCORTISONE ON REVERSAL OF HYPERDYNAMIC SEPTIC SHOCK: A RANDOMIZED, DOUBLE-BLIND, PLACEBOCONTROLLED, SINGLE-CENTER STUDY

Shock ◽  
1997 ◽  
Vol 7 (Supplement) ◽  
pp. 165 ◽  
Author(s):  
J. Briegel ◽  
M. Haller ◽  
H. Forst ◽  
G. Schelling ◽  
G. Kuprat ◽  
...  
Keyword(s):  
Septic Shock ◽  
Single Center ◽  
Double Blind ◽  
Single Center Study ◽  
Hyperdynamic Septic Shock ◽  
Center Study

Changes in peripheral perfusion relate to visceral organ perfusion in early septic shock: A pilot study

2016 ◽  
Vol 35 ◽  
pp. 105-109 ◽  
Author(s):  
Andreas Brunauer ◽  
Andreas Koköfer ◽  
Otgon Bataar ◽  
Ilse Gradwohl-Matis ◽  
Daniel Dankl ◽  
...  
Keyword(s):  
Septic Shock ◽  
Pilot Study ◽  
Organ Perfusion ◽  
Peripheral Perfusion ◽  
Visceral Organ

Targeting peripheral perfusion versus serum lactate levels in septic shock

2019 ◽  
Vol 14 (6) ◽  
pp. 999-1001 ◽  
Author(s):  
Marianna Porzio ◽  
◽  
Guido Baldini ◽  
Cristiana Di Maggio
Keyword(s):  
Septic Shock ◽  
Serum Lactate ◽  
Peripheral Perfusion ◽  
Lactate Levels

Low-dose hydrocortisone improves shock reversal and reduces cytokine levels in early hyperdynamic septic shock*

2005 ◽  
Vol 33 (11) ◽  
pp. 2457-2464 ◽  
Author(s):  
Michael Oppert ◽  
Ralf Schindler ◽  
Claudia Husung ◽  
Katrin Offermann ◽  
Klaus-Jürgen Gräf ◽  
...  
Keyword(s):  
Septic Shock ◽  
Low Dose ◽  
Shock Reversal ◽  
Cytokine Levels ◽  
Hyperdynamic Septic Shock

A NEW LOOK AT NOREPINEPHRINE TO TREAT HUMAN HYPERDYNAMIC SEPTIC SHOCK

1987 ◽  
Vol 67 (3) ◽  
pp. A648-A648 ◽  
Author(s):  
C. Martin ◽  
P. Saux ◽  
J. Albanese ◽  
J. J. Bonneru ◽  
F. Gouin
Keyword(s):  
Septic Shock ◽  
Hyperdynamic Septic Shock ◽  
New Look
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