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Therapeutic Dilemmas in Mixed Septic-Cardiogenic Shock.
Urina Jassir, Daniela; Chaanine, Antoine H; Desai, Sapna; Rajapreyar, Indranee; Le Jemtel, Thierry H.
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  • Urina Jassir D; Department of Cardiology, John W. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, La.
  • Chaanine AH; Department of Cardiology, John W. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, La.
  • Desai S; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Medical Center, New Orleans, La.
  • Rajapreyar I; Department of Cardiovascular Medicine, Thomas Jefferson University Hospitals, Philadelphia, Penn.
  • Le Jemtel TH; Department of Cardiology, John W. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, La. Electronic address: lejemtel@tulane.edu.
Am J Med ; 136(1): 27-32, 2023 01.
Article en En | MEDLINE | ID: mdl-36252709
Sepsis is an increasing cause of decompensation in patients with chronic heart failure with reduced or preserved ejection fraction. Sepsis and decompensated heart failure results in a mixed septic-cardiogenic shock that poses several therapeutic dilemmas: Rapid fluid resuscitation is the cornerstone of sepsis management, while loop diuretics are the main stay of decompensated heart failure treatment. Whether inotropic therapy with dobutamine or inodilators improves microvascular alterations remains unsettled in sepsis. When to resume loop diuretic therapy in patients with sepsis and decompensated heart failure is unclear. In the absence of relevant guidelines, we review vasopressor therapy, the timing and volume of fluid resuscitation, and the need for inotropic therapy in patients who, with sepsis and decompensated heart failure, present with a mixed septic-cardiogenic shock.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Choque Cardiogénico / Insuficiencia Cardíaca Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Am J Med Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Choque Cardiogénico / Insuficiencia Cardíaca Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Am J Med Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos