Gentle Sunder Shrestha* and Shrikanth Srinivasan Pages 243 - 251 ( 9 )
Background: Sepsis and septic shock remain a major cause of morbidity and mortality globally. In recent years, the outcome of patients with sepsis and septic shock has gradually improved, in part due to early recognition and timely appropriate management. Bedside physical examination can be of limited value to identify the source of infection and to decide appropriate management. Moreover, the clinical status of these patients can change rapidly, as a part of disease progression or in response to treatment or intervention.
Methods: Research articles, review papers and online contents related to point-of-care ultrasound for the management of patients with sepsis and septic shock were reviewed.
Results: Point-of-care ultrasonography can be a valuable bedside tool to rapidly identify the potential source of infection and associated organ dysfunction. It can also help to guide management to predict fluid responsiveness by assessing the variation of inferior venacava with respiration, ventricular size and aortic flow variation. Response to various interventions like a fluid challenge or administration of inotropes can be assessed at the bedside. Point-of-care ultrasound can also enhance safety and increase the success of bedside procedures like central venous cannulation and drainage of pleural effusion.
Conclusion: Bedside ultrasound can help to individualize management of patients with sepsis and septic shock and may potentially improve patient outcome.
Point-of-care ultrasonography, sepsis, septic shock, morbidity, mortality, aortic flow variation.
Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Department of Critical Care Medicine, Manipal Hospital, Dwarka, New Delhi