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Septic Shock

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Hemodynamic Monitoring Using Echocardiography in the Critically Ill

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Abstract

Septic shock is accompanied by profound cardiovascular alterations, including a decrease in vascular tone, hypovolemia, and myocardial depression. Hence, the hemodynamic treatment represents a true challenge for intensivists because all of these mechanisms of shock can be associated, and at any given moment the dominant mechanism may be different. Making the correct diagnosis thus becomes somewhat complicated, especially with adapted treatment. By its ability to assess the problem in a step-by-step fashion and independently of the different variables of cardiovascular function, echocardiography is particularly adapted to the situation.

The role of echocardiography in septic shock is to evaluate fluid responsiveness and document whether left and/or right ventricular dysfunction are present and are contributing to circulatory failure. Indeed, it is quite common that left, but also right, ventricular dysfunction are observed, but these often do not compromise the hemodynamic response to sepsis. It one-third of patients in septic shock, cardiac dysfunction becomes a limiting factor. To differentiate between asymptomatic and symptomatic myocardial dysfunction, it is useful to measure cardiac output and evaluate its adequacy to oxygen demand.

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Author information

Authors and Affiliations

  1. Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, 808 route de Lennik, B-1070, Brussels, Belgium

    Daniel De Backer

  2. Service de Réanimation médicale, CHU Ambroise Paré, Assistance Publique Hôpitaux de Paris, 9 avenue Charles de Gaulle, 92104, Boulogne Cedex, France

    Antoine Vieillard-Baron

Authors
  1. Daniel De Backer
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  2. Antoine Vieillard-Baron
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Correspondence to Daniel De Backer .

Editor information

Editors and Affiliations

  1. , Department of Intenisve Care, Erasme University Hospital, route de Lennik 808, Bruxelles, 1070, Belgium

    Daniel de Backer

  2. Service d'Anesthésie-Réanimation, Hôpital Européen Georges Pompidou, rue Ambroise Paré 2, Paris CX 10, 75475, France

    Bernard P. Cholley

  3. , Unité de Réanimation Médicale, Centre Hospitalier Universitaire, Avenue Laennec, Amiens Cedex 1, 80054, France

    Michel Slama

  4. Ambroise Paré, Intensive Care & Reanimation Unit, Centre Hospitalier Universitaire, avenue Charles de Gaulle 9, Boulogne Cedex, 92104, France

    Antoine Vieillard-Baron

  5. Hôpital Dupuytren, Dépt. Soin Intensive, Université de Limoges, avenue Martin Luther King 2, Limoges, 87042, France

    Philippe Vignon

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© 2011 Springer Berlin Heidelberg

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De Backer, D., Vieillard-Baron, A. (2011). Septic Shock. In: de Backer, D., Cholley, B., Slama, M., Vieillard-Baron, A., Vignon, P. (eds) Hemodynamic Monitoring Using Echocardiography in the Critically Ill. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-87956-5_11

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  • DOI: https://doi.org/10.1007/978-3-540-87956-5_11

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-87954-1

  • Online ISBN: 978-3-540-87956-5

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