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BJA Advance Access originally published online on April 30, 2004
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British Journal of Anaesthesia, 2004, Vol. 93, No. 1 114-120
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

The heart and circulation in severe sepsis

J. D. Young

Adult Intensive Care Unit, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK. E-mail: duncan.young@nda.ox.ac.uk

Keywords: blood, circulation; blood, pressors; blood, sepsis; complications, septicaemia; complications, septic shock

The first 150 words of the full text of this article appear below.

History and epidemiology

In the context of critical care, sepsis refers to the systemic response to an infection or to circulating bacterial products, rather than the presence of an infection per se. The ‘classic’ cardiovascular signs seen with severe sepsis due to Gram-negative bacteraemia were first described by Waisbren in 1951.60 He described the well known hyperdynamic state, with full bounding pulses, flushing, fever, oliguria and hypotension. He also described a second smaller group of patients who were pale, clammy, profoundly hypotensive with low volume pulses, and who appeared much more ill. This group may have been simply under-resuscitated, and as more detailed studies of the cardiovascular system in sepsis became possible, the importance of achieving an adequate circulating volume to maintain an adequate cardiac output became clear.29 However, it also became apparent that some patients did not significantly increase their cardiac output in response to expansion of their circulating volume, suggesting . . . [Full Text of this Article]

The peripheral circulation in sepsis

Treatment of the circulation in severe sepsis

Summary


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