Woodford Stephen F, Marshall Ruth C
Department of Critical Care, University of Melbourne, Parkville, VIC, Australia.
Department of Anesthesia, Austin Health, Heidelberg, VIC, Australia.
Front Med (Lausanne). 2025 May 9;12:1552050. doi: 10.3389/fmed.2025.1552050. eCollection 2025.
Complete recovery of a patient with occult septic shock and left ventricular ejection fraction of 10% was achieved following management informed by continuous measurement and visualization of the patient's 'pressure field'. The 'pressure field' visualizes mean perfusion pressure as the product of stroke volume and a beat-to-beat measure of vascular tone, termed systemic elastance. The pressure field guided the titration of inotropes and vasopressors at high doses, including norepinephrine equivalents >2.5 μg/kg/min, to restore the patient's estimated pre-morbid pressure field values. Urine output was maintained throughout with no ileus. We hypothesize that pressure field management assists in individualizing care for patients with septic shock and improves outcomes.
通过持续测量和可视化患者的“压力场”来指导治疗,一名患有隐匿性感染性休克且左心室射血分数为10%的患者实现了完全康复。“压力场”将平均灌注压直观显示为心输出量与血管张力的逐搏测量值(称为体循环弹性)的乘积。压力场指导了高剂量的血管活性药物和血管加压药的滴定,包括去甲肾上腺素等效剂量>2.5μg/kg/min,以恢复患者估计的病前压力场值。整个过程中尿量得以维持,未出现肠梗阻。我们推测,压力场管理有助于为感染性休克患者提供个性化护理并改善治疗结果。