1. Describe the basic pathophysiology of shock. 2. Characterize the various causes of shock and recognize their clinical presentations. 3. Discuss the importance of early, goal-directed treatment of shock. 4. Know the guidelines for the type and volume of fluid to be infused initially in hypovolemic or septic shock. 5. Choose the correct drug for the initial management of septic versus cardioge...

Cumulative evidence from studies of severe sepsis and septic shock has confirmed the importance to patient survival of timely oxygen augmentation targeted at specific goals related to oxygen delivery to the tissues. This work describes the evolution of our understanding of the pathophysiology of septic shock and the integration at our center of the guidelines of the American College of Critical...

et al in their study in 2001 randomly assigned 263 patients admitted to emergency department with severe sepsis or septic shock to receive either six hours of early goal-directed therapy (egdt) or standard therapy before admission to the intensive care. 130 were randomly assigned to egdt and 133 to standard therapy. demographic characteristic of patients were the same, but in hospital mortality...

Group A Streptococcus (GAS) causing puerperal sepsis is a leading cause of maternal mortality worldwide. Although rare, GAS infection is a relatively significant public health concern because of its propensity to evolve rapidly into septic shock, streptococcal toxic shock syndrome, and death. We report the case of a 27-year-old patient who presented with GAS septic shock after undergoing a surg...

We have conducted longitudinal studies focused on the expression profiles of signaling pathways and gene networks in children with septic shock. Genome-level expression profiles were generated from whole blood-derived RNA of children with septic shock (n=30) corresponding to day one and day three of septic shock, respectively. Based on sequential statistical and expression filters, day one and ...

Septic shock, occurring in about 1% of neonates hospitalized in neonatal intensive care unit (NICU), is a major cause of death in the neonatal period. In the 1980s and 90s, exchange transfusion (ET) was reported by some authors to be effective in the treatment of neonatal sepsis and septic shock. The main aim of this retrospective study was to compare the mortality rate of neonates with septic ...

BACKGROUND/AIMS Oxidative stress is involved in sepsis-related endothelium dysfunction. Selenoprotein-P (Sel-P), the main plasma selenoprotein, may have high antioxidant potential, and binds to endothelium. We hypothesize that, in septic shock, and similar syndromes such as systemic inflammatory response syndrome (SIRS), Sel-P binds massively to endothelium, causing a drop in Sel-P plasma conce...

INTRODUCTION Platelet indices, including mean platelet volume (MPV), are readily available blood tests, although their prognostic value in patients with septic shock has not been fully explored. Current evidence has found contradictory results. This study aims to explore the behavior of platelet indices in septic shock and their clinical prognostic value. METHODS Charts of septic shock patien...

There has been little improvement in septic shock mortality in the past 70 years, despite ever more broad-spectrum and potent antimicrobials. In the past, resuscitative elements have been the primary area of clinical septic shock management and research. The question of the optimal use of antimicrobial therapy was relatively ignored in recent decades. This review explores the pathophysiology of...

BACKGROUND Pentraxin-3 (PTX-3) is an acute-phase protein involved in inflammatory and infectious processes. This study assesses its diagnostic and prognostic value in patients with sepsis or septic shock in a medical intensive care unit (ICU). METHODS The study includes 213 ICU patients with clinical criteria of sepsis and septic shock. 77 donors served as controls. Plasma levels of PTX-3, pr...