Endotoxin Induced-Shock: a Multidisciplinary Approach in Critical Care

This book provides easy consultation and guidance for an appropriate understanding and management of endotoxic shock. Endotoxic shock results from a severe, generalized inflammatory response induced by bloodstream infection with gram-negative bacteria. However, endotoxin-induced inflammatory activation may be disconnected by Gram-Negative threats (e.g. Gram-Positive and yeast infections) as well as occur in multiple clinical scenarios like post-cardiac arrest syndrome and trauma, possibly due to gut barrier dysfunction and consequent endotoxin translocation.

The clinical management is structured focusing and dedicating a chapter for antibiotics, corticosteroids, volume support, vasoactive and cardiostimulating drug, coagulopathy and nutritional support. In addition, this book is remarkable because describing polymixin b hemoperfusion points out molecular interactions, and hydrodynamics of Sorption.

Each section includes •) brief pathophysiology; •) principles of management; •) key messages. Readers can find updated tips related to the diagnosis and management of endotoxic shock with a multidisciplinary approach drawing a pathway from endotoxin structure and source and the related pathophysiology of endotoxic shock underling the specific clinical aspect and focusing on medical clinical management of endotoxemia and extracorporeal removal. The book written by international opinion leaders of this field is addressed to healthcare providers working in intensive care and represents a point of reference for intensivists, infectious disease physicians, nephrologists and critical care nurses involved in the management of endotoxic shock and enriched with useful downloadable material.

Focused on endotoxic shock and on specific clinical aspect and medical clinical management of endotoxemia Highlights clinical management of endotoxic shock according to conventional therapies Points out clinical management of endotoxic shock according to complementary therapies

Auteur

Silvia De Rosa is Anaesthesiologist and Intensivist at Department of Anaesthesia and Intensive Care, Santa Chiara Regional Hospital, APSS Trento, Italy; Centre for Medical Sciences CISMed University of Trento, via S. Maria Maddalena, Italy. She is also a clinical researcher in Acute Kidney Injury and Extracorporeal Organ Support at International Renal Research Institute of Vicenza. She is a Next Committee Representative of the European Society of Intensive Care Medicine (ESICM) and Regional Councilor of Italian Society of Anesthesia Analgesia and Intensive Care (SIAARTI - Veneto Region). Her field of interest are Acute Kidney Injury and Extracorporeal Organ Support, Brain Trauma, Nutrition and Muscle Wasting, Airways Management. Co-investigator of the International registry on Acute Renal Replacement Therapy (Global-ARRT Registry).
Gianluca Villa is Associated Professor in Anaesthesiology, Intensive Care and Pain Medicine at the University of Florence. He is also a clinical researcher in Acute Kidney Injury and Extracorporeal Organ Support at International Renal Research Institute of Vicenza. Principal investigator of the International registry on Acute Renal Replacement Therapy (Global-ARRT Registry).

Contenu

Endotoxin: Structure Source and Effects.- Pathophysiology of Endotoxic Shock.- Host Resistance to Endotoxic Shock.- Endotoxin and Organ Cross-talk.- Endotoxin Measurement in Septic Shock.- Clinical Management of Endotoxemia: Antibiotics.- Clinical Management of endotoxemia: volume support.- Clinical Management of Endotoxemia: Corticosteroids.- Clinical Management of Endotoxemia: Vasoactive and Cardiostimulant Drugs.- Clinical Management of Endotoxemia: Source Control.- Clinical Management of Endotoxemia: Treatment of DIC.- Clinical Management of Endotoxemia: Metabolic and Nutritional Support.- Strategies to Reduce Endotoxin Activities.- Extracorporeal Removal of Endotoxin.