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Sepsis Management in Anesthesia and Intensive Care
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Sepsis Management in Anesthesia and Intensive Care

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: closed (26 April 2024) | Viewed by 5722

Special Issue Editor

Dr. Athanasios Chalkias

E-Mail Website
Guest Editor
1. Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
2. Outcomes Research Consortium, Cleveland, OH, USA
Interests: anesthesia and critical care medicine; cardiovascular dynamics; critical care translational science; venous return; heart-lung interactions; cardiac output; ventriculo-arterial coupling; hemodynamic coherence; microcirculation; organ perfusion; oxygen transport to tissue; shock; advanced hemodynamic support; resuscitation; translational physiology; integrative physiology

Special Issue Information

Dear Colleagues,

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection with high morbidity and mortality. Septic patients are also at risk for secondary organ injury, especially those with critical illness, and, therefore, early identification and appropriate management are crucial for improving outcomes.

Anesthesia and intensive care have evolved significantly over recent decades, yet the management of patients with sepsis remains challenging due to the diminished physiological reserves and comorbidities, systemic response to surgery or other invasive procedures, administration of anesthetics and mechanical ventilation, and/or the available resources. Perhaps now more than ever, it is imperative to understand the full nature of the response to sepsis, improve diagnostics, and advance therapies within a personalized, physiological-guided treatment strategy.

Therefore, this Special Issue in the Journal of Clinical Medicine aims to publish contributions from distinguished authors whose findings have the potential to significantly improve the management of septic patients throughout the continuum of severity ranging from sepsis to septic shock.

We invite researchers, clinicians, and physicians-scientists to submit their work, including original research studies, narrative reviews, and/or systematic reviews and meta-analyses, to further optimize patient management in the field of sepsis and septic shock.

Dr. Athanasios Chalkias
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sepsis
  • anesthesiology
  • intensive care medicine
  • hemodynamics
  • mechanical ventilation
  • inflammation
  • treatment

Published Papers (3 papers)

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Editorial

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2 pages, 182 KiB  
Editorial
Current Challenges in the Management of Sepsis and Septic Shock: Personalized, Physiology-Guided Treatment
by Athanasios Chalkias
J. Clin. Med. 2022, 11(15), 4565; https://doi.org/10.3390/jcm11154565 - 04 Aug 2022
Viewed by 1411
Abstract
Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection affecting millions of people each year [...] Full article
(This article belongs to the Special Issue Sepsis Management in Anesthesia and Intensive Care)

Research

Jump to: Editorial

14 pages, 2139 KiB  
Article
Relationship of Effective Circulating Volume with Sublingual Red Blood Cell Velocity and Microvessel Pressure Difference: A Clinical Investigation and Computational Fluid Dynamics Modeling
by Athanasios Chalkias and Michalis Xenos
J. Clin. Med. 2022, 11(16), 4885; https://doi.org/10.3390/jcm11164885 - 20 Aug 2022
Cited by 11 | Viewed by 1631
Abstract
The characteristics of physiologic hemodynamic coherence are not well-investigated. We examined the physiological relationship between circulating blood volume, sublingual microcirculatory perfusion, and tissue oxygenation in anesthetized individuals with steady-state physiology. We assessed the correlation of mean circulatory filling pressure analogue (Pmca) with sublingual [...] Read more.
The characteristics of physiologic hemodynamic coherence are not well-investigated. We examined the physiological relationship between circulating blood volume, sublingual microcirculatory perfusion, and tissue oxygenation in anesthetized individuals with steady-state physiology. We assessed the correlation of mean circulatory filling pressure analogue (Pmca) with sublingual microcirculatory perfusion and red blood cell (RBC) velocity using SDF+ imaging and a modified optical flow-based algorithm. We also reconstructed the 2D microvessels and applied computational fluid dynamics (CFD) to evaluate the correlation of Pmca and RBC velocity with the obtained pressure and velocity fields in microvessels from CFD (pressure difference, (Δp)). Twenty adults with a median age of 39.5 years (IQR 35.5–44.5) were included in the study. Sublingual velocity distributions were similar and followed a log-normal distribution. A constant Pmca value of 14 mmHg was observed in all individuals with sublingual RBC velocity 6–24 μm s−1, while a Pmca < 14 mmHg was observed in those with RBC velocity > 24 μm s−1. When Pmca ranged between 11 mmHg and 15 mmHg, Δp fluctuated between 0.02 Pa and 0.1 Pa. In conclusion, the intact regulatory mechanisms maintain a physiological coupling between systemic hemodynamics, sublingual microcirculatory perfusion, and tissue oxygenation when Pmca is 14 mmHg. Full article
(This article belongs to the Special Issue Sepsis Management in Anesthesia and Intensive Care)
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18 pages, 1426 KiB  
Article
Comparative Analyses of the Impact of Different Criteria for Sepsis Diagnosis on Outcome in Patients with Spontaneous Subarachnoid Hemorrhage
by Franz-Simon Centner, Mariella Eliana Oster, Franz-Joseph Dally, Johannes Sauter-Servaes, Tanja Pelzer, Jochen Johannes Schoettler, Bianka Hahn, Anna-Meagan Fairley, Amr Abdulazim, Katharina Antonia Margarete Hackenberg, Christoph Groden, Nima Etminan, Joerg Krebs, Manfred Thiel, Holger Wenz and Máté Elod Maros
J. Clin. Med. 2022, 11(13), 3873; https://doi.org/10.3390/jcm11133873 - 04 Jul 2022
Cited by 2 | Viewed by 1750
Abstract
Data on sepsis in patients with a subarachnoid hemorrhage (SAH) are scarce. We assessed the impact of different sepsis criteria on the outcome in an SAH cohort. Adult patients admitted to our ICU with a spontaneous SAH between 11/2014 and 11/2018 were retrospectively [...] Read more.
Data on sepsis in patients with a subarachnoid hemorrhage (SAH) are scarce. We assessed the impact of different sepsis criteria on the outcome in an SAH cohort. Adult patients admitted to our ICU with a spontaneous SAH between 11/2014 and 11/2018 were retrospectively included. In patients developing an infection, different criteria for sepsis diagnosis (Sepsis-1, Sepsis-3_original, Sepsis-3_modified accounting for SAH-specific therapy, alternative sepsis criteria compiled of consensus conferences) were applied and their impact on functional outcome using the modified Rankin Scale (mRS) on hospital discharge and in-hospital mortality was evaluated. Of 270 SAH patients, 129 (48%) developed an infection. Depending on the underlying criteria, the incidence of sepsis and septic shock ranged between 21–46% and 9–39%. In multivariate logistic regression, the Sepsis-1 criteria were not associated with the outcome. The Sepsis-3 criteria were not associated with the functional outcome, but in shock with mortality. Alternative sepsis criteria were associated with mortality for sepsis and in shock with mortality and the functional outcome. While Sepsis-1 criteria were irrelevant for the outcome in SAH patients, septic shock, according to the Sepsis-3 criteria, adversely impacted survival. This impact was higher for the modified Sepsis-3 criteria, accounting for SAH-specific treatment. Modified Sepsis-3 and alternative sepsis criteria diagnosed septic conditions of a higher relevance for outcomes in patients with an SAH. Full article
(This article belongs to the Special Issue Sepsis Management in Anesthesia and Intensive Care)
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