Cited by 70Sepsis Diagnosis and TreatmentHemodynamic Monitoring and TherapyAbdominal Surgery and Complications

The initial resuscitation of septic shock

Cinel, Ismail, Kasapoglu, Umut S., Gul, Fethi, Dellinger, R. Phillip·2020·Journal of Critical Care

Abstract

Septic shock is the most severe form of sepsis, characterized by (a) persistent hypotension despite fluid resuscitation and (b) the presence of tissue hypoperfusion. Delays in the diagnosis and initiation of treatment of septic shock is associated with increasing risk for mortality. Early and effective fluid resuscitation and vasopressor administration play a crucial role in maintaining tissue perfusion in septic shock patients. A low diastolic arterial pressure (DAP) correlates with severity of arteriolar vasodilation, compromises left ventricle oxygen supply and can be used for identifying septic shock patients that would potentially benefit from earlier vasopressor therapy. Controversy currently exists as to the balance of fluids and vasopressors to maintain target mean arterial pressure. The aim of this article is to review the rationale for fluid resuscitation and vasopressor therapy and the importance of both mean and diastolic blood pressure during the initial resuscitation of the septic shock. We relate our personal prescription of balancing fluids and vasopressors in the resuscitation of septic shock.

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Crossref · 10.1016/j.jcrc.2020.02.004

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Authors
Cinel, I., Kasapoglu, U. S., Gul, F., & Dellinger, R. P.
Affiliations
Cooper University Hospital (US)
Corresponding author
Dellinger, R. Phillip
Venue
Journal of Critical Care
Publisher
Elsevier BV
Published
2020-06
Volume
57
Pages
108-117
ISSN
0883-9441 (ISSN-L)
OpenAlex
W3006115571
Cited by
69
References
140
Citations by year
2026: 4 · 2025: 5 · 2024: 31 · 2023: 12 · 2022: 6 · 2021: 11
FWCI
1.06
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Critical Care (publishedVersion)
  • PubMed (publishedVersion)
  • Dspace Repository (Marmara Üniversitesi) (submittedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Abdominal Surgery and Complications
Keywords
septic shock, fluid resuscitation, vasopressor therapy, diastolic arterial pressure, mean arterial pressure, hypotension, tissue hypoperfusion, early treatment initiation, sepsis mortality
MeSH terms
Blood Pressure, Catheterization, Central Venous, Fluid Therapy, Humans, Hypotension, Perfusion, Resuscitation, Shock, Septic, Steroids, Vasoconstrictor Agents, Ventricular Function, Left, Treatment Outcome, Sepsis, Arterial Pressure

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