Evaluación hemodinámica de la micro y macro circulación en shock séptico: revisión de la literatura
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Abstract
Objective: To evaluate the factors that increase and decrease the predictors of mortality in patients with septic shock. Methods: The databases used were the National Library of Medicine, Virtual Health Library and Directory of Open Access Journals. The descriptors used were: "Shock, Septic", "Hemodynamics" and "Microcirculation". Inclusion criteria were randomized and non-randomized clinical trial, open-access clinical study, in English, Portuguese and Spanish, case-control studies, cohort studies and the publication time frame from 2012 to 2022. Results: Factors that increase and decrease mortality in patients with septic shock were analyzed, among them are high doses of noreprinephrine, liberal oxygen therapy, tissue hypoperfusion, perfused vascular density, retinal abnormality, mottling, lactate persistence, sublingual hypoperfusion, hypoxia in the skin, microvascular changes, doses of dobutamine and propofol, electrical stimulation in the skin, the target of oxygen blood pressure between 70 and 100 mmHg and prolonged intermittent high volume hemodafiltration. Final considerations: Clinical alterations of macro and microcirculations caused by sepsis were observed, which may aid in early diagnosis. In addition, it is of paramount importance to identify the clinical predictors of mortality in these patients in order to draw up an effective therapeutic plan.
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