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Mechanical Circulatory support for Septic Shock in Children and Adults: Different but Similar!
Can J Cardiol
December 2024
Senior Consultant Intensive Care, Royal Childrens Hospital, Melbourne, Australia; Professor Department of Critical Care, Faculty of Medicine, Melbourne University.
Whilst Extra-Corporeal Membrane Oxygenation (ECMO) for circulatory support in patients with severe septic shock, commenced in newborn infants and children in the late 1980's, ECMO has remained a controversial treatment for adults with refractory septic shock (RSS). This is fundamentally due to differences in the predominant hemodynamic response to sepsis. In newborn infants and very young children ventricular failure called Low Cardiac Output Syndrome (LCOS) is the major hemodynamic response whilst adolescents and adults have mainly vasoplegic shock.
View Article and Find Full Text PDFProposal for the use of angiotensin II in distributive shock after extracorporeal circulation - position paper of the Section of Intensive Care Medicine and the Section of Cardiothoracic Anaesthesiology of the Polish Society of Anaesthesiology and Intensive Therapy.
Kardiochir Torakochirurgia Pol
June 2024
Department of Anaesthesiology and Intensive Care, Silesian Centre for Heart Diseases, Zabrze, Poland.
Article Synopsis
- Angiotensin II (AT) is a strong vasoconstrictor used to treat severe low blood pressure during vasoplegic shock.
- * Recent experiences in cardiac surgery have led to the development of initial treatment guidelines for using AT.
- * This paper suggests using AT specifically for managing distributive shock after procedures involving extracorporeal circulation.
Background: Severe metformin intoxication can lead to lactic acidosis and vasoplegic shock, for which the optimal management strategy remains uncertain, especially in cases of severe circulatory collapse.
Case Presentation: A 45-year-old diabetic woman on metformin therapy presented with impaired consciousness and seizures. She had experienced a cardiac arrest and undergone extracorporeal cardiopulmonary resuscitation.
Severe Vasoplegic Shock After Heart Transplant Successfully Treated With Multimodal Therapeutic Approach.
Exp Clin Transplant
May 2024
>From the Department of Cardiac Surgery, University Hospital Dusseldorf, Dusseldorf, Germany.
Vasoplegia describes a constellation of low vascular resistance and normal cardiac output. Vasoplegia is common after cardiac surgery in general and in heart transplant recipients more specifically and occurs in over one-half of all heart transplant recipients with a varying degree of severity. The pathophysiology of vasoplegia is multifactorial and associated with a cascade of inflammatory mediators.
View Article and Find Full Text PDFA potentially lifesaving error: unintentional high-dose adrenaline administration in anaphylaxis-induced cardiac arrest; a case report.
Int J Emerg Med
June 2024
University Emergency Department, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Background: Cardiopulmonary resuscitation is a crucial skill for emergency medical services. As high-risk-low-frequency events pose an immense mental load to providers, concepts of crew resource management, non-technical skills and the science of human errors are intended to prepare healthcare providers for high-pressure situations. However, medical errors occur, and organizations and institutions face the challenge of providing a blame-free error culture to achieve continuous improvement by avoiding similar errors in the future.
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