Sepsis echocardiography or ultrasound
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Sepsis echocardiography or ultrasound On the Web |
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American Roentgen Ray Society Images of Sepsis echocardiography or ultrasound |
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Risk calculators and risk factors for Sepsis echocardiography or ultrasound |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]
Synonyms and keywords: sepsis syndrome; septic shock; septicemia
Overview
There are no specific echocardiography or ultrasound finidngs associated with sepsis but may show the features consistent with the primary source of infection.
Echocardiography or Ultrasound
There are no specific echocardiography or ultrasound finidngs associated with sepsis but may show the features consistent with the primary source of infection.
Clinical practice guidelines by the Surviving Sepsis Campaign in 2021 direct the role of cardiac ultrasonography[1].
Meta-analyses have found sensitivity and specificity for fluid responsiveness:
- Inferior Vena Cava index (IVC collapsibility or distensibility):[2] 71% and 75% (20 studies)
- Stroke volume variation (SVV)[3]: 79% and 84% among ventilated patients (lower among spontaneously breathing patients).
For comparison, the sensitivity and specificity of:
- Pulse pressure variation by arterial line was found to be (among ventilated patients)[4]: 89% and 88%
- Passive leg raising effect on[5]:
- Pulse pressure 58% and 83%
- Cardiac output: 85% and 92%
Randomized controlled trials include:
- Stroke volume changes with passive leg raising[6]
- IVC diameter changes[7]
- Carotid flow changes during passive leg raising[8]
References
- ↑ Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C; et al. (2021). "Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021". Crit Care Med. 49 (11): e1063–e1143. doi:10.1097/CCM.0000000000005337. PMID 34605781 Check
|pmid=value (help). - ↑ Orso D, Paoli I, Piani T, Cilenti FL, Cristiani L, Guglielmo N (2020). "Accuracy of Ultrasonographic Measurements of Inferior Vena Cava to Determine Fluid Responsiveness: A Systematic Review and Meta-Analysis". J Intensive Care Med. 35 (4): 354–363. doi:10.1177/0885066617752308. PMID 29343170.
- ↑ Bentzer P, Griesdale DE, Boyd J, MacLean K, Sirounis D, Ayas NT (2016). "Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?". JAMA. 316 (12): 1298–309. doi:10.1001/jama.2016.12310. PMID 27673307.
- ↑ Marik PE, Cavallazzi R, Vasu T, Hirani A (2009). "Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature". Crit Care Med. 37 (9): 2642–7. doi:10.1097/CCM.0b013e3181a590da. PMID 19602972.
- ↑ Cherpanath TG, Hirsch A, Geerts BF, Lagrand WK, Leeflang MM, Schultz MJ; et al. (2016). "Predicting Fluid Responsiveness by Passive Leg Raising: A Systematic Review and Meta-Analysis of 23 Clinical Trials". Crit Care Med. 44 (5): 981–91. doi:10.1097/CCM.0000000000001556. PMID 26741579.
- ↑ Douglas IS, Alapat PM, Corl KA, Exline MC, Forni LG, Holder AL; et al. (2020). "Fluid Response Evaluation in Sepsis Hypotension and Shock: A Randomized Clinical Trial". Chest. 158 (4): 1431–1445. doi:10.1016/j.chest.2020.04.025. PMC 9490557 Check
|pmc=value (help). PMID 32353418 Check|pmid=value (help). - ↑ Musikatavorn K, Plitawanon P, Lumlertgul S, Narajeenron K, Rojanasarntikul D, Tarapan T; et al. (2021). "Randomized Controlled Trial of Ultrasound-guided Fluid Resuscitation of Sepsis-Induced Hypoperfusion and Septic Shock". West J Emerg Med. 22 (2): 369–378. doi:10.5811/westjem.2020.11.48571. PMC 7972359 Check
|pmc=value (help). PMID 33856325 Check|pmid=value (help). - ↑ Devia Jaramillo G, Menendez Ramirez S (2021). "USER Protocol as a Guide to Resuscitation of the Patient with Septic Shock in the Emergency Department". Open Access Emerg Med. 13: 33–43. doi:10.2147/OAEM.S289148. PMC 7886247 Check
|pmc=value (help). PMID 33603505 Check|pmid=value (help).