Al Care 2008, 12(Suppl 2):P409 (doi: 10.1186/cc6630) Introduction Evolution of hemodynamic monitoring

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Intervention: Re to implement a second agent to address multidrug-resistant Gram-negative pathogens forced volume challenge combined with an active induced reduction of catecholamines to achieve an adequate fluid loading status guided by passive leg-raising test, course of central venous pressure and in 14 cases by hemodynamic monitoring (Vigilance II n = 12; Vigileo n = 2 (Edwards)). Mean weaning time from catecholamines: 10.35 ?6.57 hours (range 3?3 hours). All patients showed rewarmed extremities, decrease of mean lactate levels (2.44 ?1.33 mmol/l (1.10?.4)). Hemodynamic constellations were dishomogeneous without cardiac deterioration or mean PAO2/FiO2 deterioration (253 ?122 to 284 ?86 mmHg). Fifteen patients survived, six died. Conclusions It is possible to wean quite a few septic shock patients from high catecholamines. Adequate fluid loading preceding the use of high catecholamine doses should be a main subject of discussion in patients with severe septic shock.compared with 3.6 (3.3?.8) l/min/m2 in nonsurvivors (P PubMed ID: the cardiac index in survivors and nonsurvivors was 2.6 (2.1?.0) l/min/m2 and 2.8 (2.3?.3) l/min/m2, respectively (P = 0.54). The CFI in septic survivors was 6.7 (6.0?.4) min? compared with 3.5 (3.0?.4) min? in nonsurvivors (P PubMed ID: Data collection: baseline characteristics, individual hemodynamic parameters, PAO2/FiO2, course of catecholamines, administered volume, lactate, time needed to wean from catecholamines, and outcome.