Abstract
The body’s response to infection consists of the release of various cytokines and mediators inducing a state of vasoplegia clinically characterized by hypotension, increased heart rate, and decreased cardiac output. The hyperdynamic low-pressure state, which we recognizes in clinical practice, is usually the consequence of the initial fluid resuscitation. When hypotension persists and lactate levels are increased, the patient meets the criteria for septic shock, the most severe case of sepsis with still mortality rates of more than 30%. The clinical management of septic shock patients remains a challenge as a limited number of safe and effective treatments together with an even more limited number of parameters to assess adequacy of treatment are present. In addition, almost all available treatments may have significant side effects so that a one-size-fits-all treatment should only be used in the initial start of a treatment schedule. In this chapter, these different elements are discussed and a pledge for personalized treatment of septic shock is made with a physiological base from available experimental and clinical evidence.
Original language | English |
---|---|
Title of host publication | Management of Dysregulated Immune Response in the Critically Ill |
Editors | Zsolt Molnar, Marlies Ostermann, Manu Shankar-Hari |
Publisher | Springer Science+Business Media |
Pages | 113-133 |
Number of pages | 21 |
Edition | 1 |
ISBN (Electronic) | 978-3-031-17572-5 |
ISBN (Print) | 978-3-031-17571-8, 978-3-031-17574-9 |
DOIs | |
Publication status | E-pub ahead of print - 12 Mar 2023 |
Publication series
Series | Lessons from the ICU |
---|---|
ISSN | 2522-5928 |
Bibliographical note
Publisher Copyright:© 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.