Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Critical Care
Published in: Critical Care 1/2014

Open Access 01-02-2014 | Commentary

Early hemodynamic resuscitation in septic shock: understanding and modifying oxygen delivery

Authors: Paul A van Beest, Peter E Spronk

Published in: Critical Care | Issue 1/2014

Login to get access

Abstract

In a previous issue of Critical Care, researchers have focused on the venous-to-arterial carbon dioxide difference (Pv-aCO2) as a surrogate marker for systemic perfusion in patients with septic shock. Although the complex mechanisms responsible for an increased Pv-aCO2 in septic shock need to be further unraveled, the potential prognostic value of Pv-aCO2 seems clinically relevant and useful in daily practice in view of its easy availability.
Literature
1.
Ospina-Tascón GA, Bautista-Rincón DF, Umaňa M, Tafur JD, Gutiérrez A, García AF, Bermúdez W, Granados M, Arango-Dávila C, Hernández G: Persistently high venous-to-arterial carbon dioxide differences during early resuscitation are associated with poor outcomes in septic shock. Crit Care 2013, 17: R294. 10.1186/cc13160PubMedCentralCrossRefPubMed
2.
Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung C: Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013, 39: 165-228. 10.1007/s00134-012-2769-8CrossRefPubMed
3.
van Beest PA, Hofstra JJ, Schultz MJ, Boerma EC, Spronk PE, Kuiper MA: The incidence of low venous oxygen saturation on admission in the ICU: a multicenter observational study in the Netherlands. Crit Care 2008, 12: R33. 10.1186/cc6811PubMedCentralCrossRefPubMed
4.
Cuschieri J, Rivers EP, Donnino MW, Katilius M, Jacobson G, Nguyen HB, Pamukov N, Horst HM: Central venous-arterial carbon dioxide difference as an indicator of cardiac index. Intensive Care Med 2012, 31: 818-822.CrossRef
5.
Vallée F, Vallet B, Mathe O, Parraguette J, Mari A, Silva S, Samii K, Fourcade O, Genestal M: Central venous-to-arterial carbon dioxide difference: an additional target for goal-directed therapy in septic shock? Intensive Care Med 2008, 34: 2218-2225. 10.1007/s00134-008-1199-0CrossRefPubMed
6.
van Beest PA, Lont MC, Holman ND, Loef B, Kuiper MA, Boerma EC: Central venous-arterial pCO 2 difference as a tool in resuscitation of septic patients. Intensive Care Med 2013, 39: 1034-1039. 10.1007/s00134-013-2888-xCrossRefPubMed
7.
Creteur J, De Backer D, Sakr Y, Koch M, Vincent JL: Sublingual capnometry tracks microcirculatory changes in septic patients. Intensive Care Med 2006, 32: 516-523. 10.1007/s00134-006-0070-4CrossRefPubMed
8.
Bakker J, Vincent JL, Gris P, Leon M, Coffernils M, Kahn RJ: Veno-arterial carbon dioxide gradient in human septic shock. Chest 1995, 101: 509-515.CrossRef
9.
Mekontso-Dessap A, Castelein V, Anguel N, Bahloul M, Schauvliege F, Richard C, Teboul JL: Combination of venoarterial PCO 2 difference with the arteriovenous O 2 content difference to detect anaerobic metabolism in patients. Intensive Care Med 2002, 28: 272-277. 10.1007/s00134-002-1215-8CrossRefPubMed
10.
Monnet X, Julien F, Ait-Hamou N, Lequoy M, Gosset C, Jozwiak M, Persichini R, Anguel N, Richard C, Teboul JL: Lactate and venoarterial carbon dioxide difference /arterial-venous oxygen difference ratio, but not central venous oxygen saturation, predict increase in oxygen consumption in fluid responders. Crit Care Med 2013, 41: 1412-1420. 10.1097/CCM.0b013e318275ceceCrossRefPubMed
11.
Bihari D, Smithies M, Gimson A, Tinker J: The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients. N Engl J Med 1987, 317: 397-403. 10.1056/NEJM198708133170701CrossRefPubMed
12.
Spronk PE, Ince C, Gardien MJ, Mathura KR, Oudemans-van Straaten HM, Zandstra DF: Nitroglycerin in septic shock after intravascular volume resuscitation. Lancet 2002, 360: 1395-1396. 10.1016/S0140-6736(02)11393-6CrossRefPubMed
Metadata
Title
Early hemodynamic resuscitation in septic shock: understanding and modifying oxygen delivery
Authors
Paul A van Beest
Peter E Spronk
Publication date
01-02-2014
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2014
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc13732

Other articles of this Issue 1/2014

Critical Care 1/2014 Go to the issue

Research

Serum butyrylcholinesterase predicts survival after extracorporeal membrane oxygenation after cardiovascular surgery

Research

The gray zone of the qualitative assessment of respiratory changes in inferior vena cava diameter in ICU patients

Research

Procalcitonin testing for diagnosis and short-term prognosis in bacterial infection complicated by congestive heart failure: a multicenter analysis of 4,698 cases

Letter

Avoidable statistical pitfalls in analyzing length of stay in intensive care units or hospitals

Letter

Long live dynamic parameters!

Commentary

Time to look beyond one-year mortality in critically ill hematological patients?