Cardiovascular Monitoring of the Septic Patient

Abstract

The American College of Chest Physicians & Society of Critical Care Medicine Consensus [1] defines sepsis as the systemic inflammatory response syndrome (SIRS) as a result of infection. Septic shock is defined as sepsis-induced hypotension despite adequate fluid resuscitation along with the presence of perfusion abnormalities. These abnormalities may include, but are not limited to, lactic acidosis, oliguria or an acute alteration in mental status. Patients who are receiving inotropic or vasopressor agents may not be hypotensive at the time that perfusion abnormalities are measured. From the years 1950–1991 mortality has soared by 13-fold [2]. Alone sepsis carries a 30–40% lethality [2] but when aggravated by shock, it has a 40–60% mortality [3]. Recently the effectiveness of invasive hemodynamic monitoring in septic shock has undergone intense scrutiny.