{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:22:45Z","timestamp":1755224565602,"version":"3.43.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>When a patient is described as \u2018septic\u2019, a clinical cascade occurs to simultaneously attempt to diagnose, risk-stratify, and treat a patient with a presumed infection. Elements of this clinical cascade include laboratory investigations, medication administration, and often specialty service consultations. The clinical consequences of each of these interventions have largely been independently investigated, and their impacts have varied. The primary focus of the management of septic shock has traditionally revolved around resuscitative efforts intended to rapidly restore perfusion to the organs through the use of i.v. fluids, vasopressor, and inotropic support. Such strategies, if deployed carelessly, have the potential to lead to iatrogenic harms. Clinicians should consider the wide variety of haemodynamic phenotypes encountered when treating patients presenting in septic shock and tailor supporting measures to specific physiologic perturbations.<\/jats:p>","DOI":"10.1093\/ehjacc\/zuaf079","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T14:13:29Z","timestamp":1748960009000},"page":"489-493","source":"Crossref","is-referenced-by-count":0,"title":["Decoding the haemodynamics in sepsis to avoid drowning in salt water"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4314-973X","authenticated-orcid":false,"given":"Maxwell A","family":"Hockstein","sequence":"first","affiliation":[{"name":"Departments of Emergency Medicine and Critical Care, MedStar Washington Hospital Center , 110 Irving St. NW, Washington, DC 20010 ,","place":["USA"]},{"name":"Georgetown University School of Medicine, Washington, DC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-3885","authenticated-orcid":false,"given":"Rory J","family":"Spiegel","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine and Critical Care, MedStar Washington Hospital Center , 110 Irving St. NW, Washington, DC 20010 ,","place":["USA"]},{"name":"Georgetown University School of Medicine, Washington, DC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"2025081214344523300_zuaf079-B1"},{"volume-title":"Three Parts with an Appendix","year":"2018","author":"Pringle","key":"2025081214344523300_zuaf079-B2"},{"key":"2025081214344523300_zuaf079-B3","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1056\/NEJMra2403213","article-title":"Sepsis and septic shock","volume":"391","author":"Meyer","year":"2024","journal-title":"N Engl J Med"},{"key":"2025081214344523300_zuaf079-B4","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1164\/rccm.201307-1321OC","article-title":"Risk of cardiovascular events in survivors of severe sepsis","volume":"189","author":"Yende","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"key":"2025081214344523300_zuaf079-B5","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s13613-015-0058-8","article-title":"Timing and causes of death in septic shock","volume":"5","author":"Daviaud","year":"2015","journal-title":"Ann Intensive Care"},{"key":"2025081214344523300_zuaf079-B6","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The third international consensus definitions for sepsis and septic shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"2025081214344523300_zuaf079-B7","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s13054-018-2102-1","article-title":"Definitions and pathophysiology of vasoplegic shock","volume":"22","author":"Lambden","year":"2018","journal-title":"Crit Care"},{"key":"2025081214344523300_zuaf079-B8","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1038\/s41569-020-00492-2","article-title":"Pathophysiology of sepsis-induced cardiomyopathy","volume":"18","author":"Hollenberg","year":"2021","journal-title":"Nat Rev Cardiol"},{"key":"2025081214344523300_zuaf079-B9","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s10741-010-9176-4","article-title":"Sepsis-induced cardiomyopathy: a review of pathophysiologic mechanisms","volume":"15","author":"Flynn","year":"2010","journal-title":"Heart Fail Rev"},{"key":"2025081214344523300_zuaf079-B10","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1111\/aas.12056","article-title":"Association between inotrope treatment and 90-day mortality in patients with septic shock: inotropes and mortality in septic shock","volume":"57","author":"Wilkman","year":"2013","journal-title":"Acta Anaesthesiol Scand"},{"key":"2025081214344523300_zuaf079-B11","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s13613-024-01336-9","article-title":"Fluid accumulation syndrome in sepsis and septic shock: pathophysiology, relevance and treatment-a comprehensive review","volume":"14","author":"Pfortmueller","year":"2024","journal-title":"Ann Intensive Care"},{"key":"2025081214344523300_zuaf079-B12","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1177\/0885066613478899","article-title":"Fluid resuscitation in septic shock: the effect of increasing fluid balance on mortality","volume":"29","author":"Sadaka","year":"2014","journal-title":"J Intensive Care Med"},{"key":"2025081214344523300_zuaf079-B13","first-page":"298","article-title":"Blood lactate levels in sepsis: in 8 questions","volume":"27","author":"Vincent","year":"2021","journal-title":"Curr Opin Crit Care"},{"key":"2025081214344523300_zuaf079-B14","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.annemergmed.2024.02.009","article-title":"Early physician gestalt versus usual screening tools for the prediction of sepsis in critically ill emergency patients","volume":"84","author":"Knack","year":"2024","journal-title":"Ann Emerg Med"},{"key":"2025081214344523300_zuaf079-B15","doi-asserted-by":"crossref","first-page":"2608318","DOI":"10.1155\/2020\/2608318","article-title":"Quantitative assessment of blood lactate in shock: measure of hypoxia or beneficial energy source","volume":"2020","author":"Levitt","year":"2020","journal-title":"Biomed Res Int"},{"key":"2025081214344523300_zuaf079-B16","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.ihj.2020.07.002","article-title":"Role of N-terminal pro-B-type natriuretic peptide in the prediction of outcomes in ST-elevation myocardial infarction complicated by cardiogenic shock","volume":"72","author":"Sharma","year":"2020","journal-title":"Indian Heart J"},{"key":"2025081214344523300_zuaf079-B17","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1161\/CIRCULATIONAHA.104.472050","article-title":"Prognostic value of plasma N-terminal pro-brain natriuretic peptide in patients with severe sepsis","volume":"112","author":"Brueckmann","year":"2005","journal-title":"Circulation"},{"key":"2025081214344523300_zuaf079-B18","doi-asserted-by":"crossref","first-page":"370697","DOI":"10.1155\/2012\/370697","article-title":"Should we monitor ScVO2 in critically ill patients?","volume":"2012","author":"Nebout","year":"2012","journal-title":"Cardiol Res Pract"},{"key":"2025081214344523300_zuaf079-B19","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1038\/s41581-023-00683-3","article-title":"Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative Workgroup","volume":"19","author":"Zarbock","year":"2023","journal-title":"Nat Rev Nephrol"},{"key":"2025081214344523300_zuaf079-B20","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1016\/j.chest.2023.01.010","article-title":"Is left ventricular systolic dysfunction associated with increased mortality among patients with sepsis and septic shock?","volume":"163","author":"Dugar","year":"2023","journal-title":"Chest"},{"key":"2025081214344523300_zuaf079-B21","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13089-020-00170-x","article-title":"Rationale for using the velocity-time integral and the minute distance for assessing the stroke volume and cardiac output in point-of-care settings","volume":"12","author":"Blanco","year":"2020","journal-title":"Ultrasound J"},{"key":"2025081214344523300_zuaf079-B22","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/j.chest.2020.09.274","article-title":"Right ventricular dysfunction in early sepsis and septic shock","volume":"159","author":"Lanspa","year":"2021","journal-title":"Chest"},{"key":"2025081214344523300_zuaf079-B23","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1177\/08850666211003475","article-title":"Transthoracic right heart echocardiography for the intensivist","volume":"36","author":"Hockstein","year":"2021","journal-title":"J Intensive Care Med"},{"key":"2025081214344523300_zuaf079-B24","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1186\/s13054-020-03345-z","article-title":"Right ventricular failure in septic shock: characterization, incidence and impact on fluid responsiveness","volume":"24","author":"Vieillard-Baron","year":"2020","journal-title":"Crit Care"},{"key":"2025081214344523300_zuaf079-B25","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1093\/ejechocard\/jer235","article-title":"Shape of the right ventricular outflow Doppler envelope and severity of pulmonary hypertension","volume":"13","author":"L\u00f3pez-Candales","year":"2012","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2025081214344523300_zuaf079-B26","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1097\/SHK.0000000000000801","article-title":"Does respiratory variation in inferior vena cava diameter predict fluid responsiveness: a systematic review and meta-analysis","volume":"47","author":"Long","year":"2017","journal-title":"Shock"},{"key":"2025081214344523300_zuaf079-B27","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1007\/s00134-015-4168-4","article-title":"Systematic review including re-analyses of 1148 individual data sets of central venous pressure as a predictor of fluid responsiveness","volume":"42","author":"Eskesen","year":"2016","journal-title":"Intensive Care Med"},{"key":"2025081214344523300_zuaf079-B28","doi-asserted-by":"crossref","first-page":"e014308","DOI":"10.1161\/CIRCIMAGING.122.014308","article-title":"Role of inferior vena cava dynamics for estimating right atrial pressure in congenital heart disease","volume":"15","author":"Egbe","year":"2022","journal-title":"Circ Cardiovasc Imaging"},{"key":"2025081214344523300_zuaf079-B29","volume-title":"Bedside Ultrasound: A Primer for Clinical Integration","author":"Haycock","year":"2019","edition":"2nd Edition"},{"key":"2025081214344523300_zuaf079-B30","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s13089-020-00163-w","article-title":"Quantifying systemic congestion with point-of-care ultrasound: development of the venous excess ultrasound grading system","volume":"12","author":"Beaubien-Souligny","year":"2020","journal-title":"Ultrasound J"},{"key":"2025081214344523300_zuaf079-B31","doi-asserted-by":"crossref","first-page":"e04687","DOI":"10.1002\/ccr3.4687","article-title":"Point-of-care Doppler ultrasound in the management of hyponatremia: another string to nephrologists\u2019 bow","volume":"9","author":"Samant","year":"2021","journal-title":"Clin Case Rep"},{"key":"2025081214344523300_zuaf079-B32","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1590\/2175-8239-jbn-2020-0234","article-title":"Utilizing point-of-care ultrasound in the cardiorenal clinic to enhance patient care","volume":"43","author":"Koratala","year":"2021","journal-title":"J Bras Nefrol"},{"key":"2025081214344523300_zuaf079-B33","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.34067\/KID.0006482020","article-title":"Comprehensive assessment of fluid status by point-of-care ultrasonography","volume":"2","author":"Argaiz","year":"2021","journal-title":"Kidney360"},{"key":"2025081214344523300_zuaf079-B34","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1186\/s13054-020-03330-6","article-title":"The use of venous Doppler to predict adverse kidney events in a general ICU cohort","volume":"24","author":"Spiegel","year":"2020","journal-title":"Crit Care"},{"key":"2025081214344523300_zuaf079-B35","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1056\/NEJM199510193331601","article-title":"A trial of goal-oriented hemodynamic therapy in critically ill patients. SvO2 Collaborative Group","volume":"333","author":"Gattinoni","year":"1995","journal-title":"N Engl J Med"},{"key":"2025081214344523300_zuaf079-B36","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1164\/rccm.201806-1034OC","article-title":"Early use of norepinephrine in septic shock resuscitation (CENSER). A randomized trial","volume":"199","author":"Permpikul","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2025081214344523300_zuaf079-B37","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1097\/01.CCM.0000059722.94182.79","article-title":"Ischemic skin lesions as a complication of continuous vasopressin infusion in catecholamine-resistant vasodilatory shock: incidence and risk factors","volume":"31","author":"D\u00fcnser","year":"2003","journal-title":"Crit Care Med"}],"container-title":["European Heart Journal: Acute Cardiovascular Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjacc\/advance-article-pdf\/doi\/10.1093\/ehjacc\/zuaf079\/63428558\/zuaf079.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjacc\/article-pdf\/14\/8\/489\/63428558\/zuaf079.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjacc\/article-pdf\/14\/8\/489\/63428558\/zuaf079.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T18:34:56Z","timestamp":1755023696000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjacc\/article\/14\/8\/489\/8156025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,3]]},"references-count":37,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,6,3]]},"published-print":{"date-parts":[[2025,8,7]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjacc\/zuaf079","relation":{},"ISSN":["2048-8726","2048-8734"],"issn-type":[{"type":"print","value":"2048-8726"},{"type":"electronic","value":"2048-8734"}],"subject":[],"published-other":{"date-parts":[[2025,8]]},"published":{"date-parts":[[2025,6,3]]}}}