| Current approach to the haemodynamic management of septic shock patients in European intensive care units: a cross-sectional, self-reported questionnaire-based survey. | |
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MedLine Citation:
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PMID: 21088597 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVE: The aim of this survey was to investigate clinicians' current approach to the haemodynamic management and resuscitation endpoints in septic shock. METHODS: This cross-sectional, self-reported questionnaire-based survey was sent to the clinical director of selected ICUs in 16 European countries. The questionnaire consisted of two parts and 25 questions. The first part retrieved general information on the hospital and ICU, and the second part of the questionnaire collected detailed information on the approach to haemodynamic management of septic shock. RESULTS: Of 481 clinicians invited to participate, 237 (49.3%) responded. Ninety-two questionnaires were excluded because of more than 20% missing responses, rendering 145 (30.1%) for statistical analysis. Administration of albumin (P = 0.007), gelatine preparations (P = 0.002), Ringer's solution (P = 0.02) and isotonic saline (P = 0.001) for fluid resuscitation varied between respondents from different countries. Further differences between respondents from different countries were observed for the choice of the first-line inotropic drug (P < 0.001), use of supplementary vasopressin (P = 0.02), supplementary fludrocortisone (P = 0.05) and measurement of cardiac output with the transpulmonary thermodilution (P = 0.001), lithium dilution (P = 0.004) and oesophageal Doppler (P = 0.005) technique. Mean arterial blood pressure (87%), central venous oxygen saturation (65%), central venous pressure (59%), systolic arterial blood pressure (48%), mixed venous oxygen saturation (42%) and cardiac index (42%) were the six haemodynamic variables most commonly claimed to be used as resuscitation endpoints. CONCLUSION: The current approach to the haemodynamic management of septic shock patients in a selected cohort of European ICU clinicians is in agreement with the Surviving Sepsis Campaign guidelines with the exception of the haemodynamic goals. |
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Authors:
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Christian Torgersen; Martin W Dünser; Christian A Schmittinger; Ville Pettilä; Esko Ruokonen; Volker Wenzel; Stephan M Jakob; Jukka Takala |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of anaesthesiology Volume: 28 ISSN: 1365-2346 ISO Abbreviation: Eur J Anaesthesiol Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-03-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8411711 Medline TA: Eur J Anaesthesiol Country: England |
Other Details:
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Languages: eng Pagination: 284-90 Citation Subset: IM |
Affiliation:
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From the Department of Intensive Care Medicine, Inselspital Bern, Bern, Switzerland (CT, MWD, CAS, SMJ, JT), Department of EPM, Australian and New Zealand Intensive Care Research Centre, Monash University, Clayton, Victoria, Australia (VP), Department of Intensive Care, Kuopio University Hospital and Kuopio University, Kuopio, Finland (ER) and Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria (VW). |
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