Sepsis treatment
assessing the morphology of the arterial pressure waveform using a patented algorithm. The monitor increases the sampling time of the
arterial waveform to identify minute changes in vascular tone, ensuring that the monitor can be used with patients who are acutely unwell without the need for calibration. In addition, a dynamic, built-in e-filter removes hyper-resonance of the system to aid waveform optimisation and provide the best possible data for analysis.
Fluid management and goal-directed therapy (GDT) Accurate fluid resuscitation is the foundation of successful early sepsis treatment. Yet, excess fluid can lead to serious complications such as pulmonary oedema, abdominal compartment syndrome, and aggravated organ dysfunction. The Surviving Sepsis Campaign (2021 guidelines) recommends administering intravenous fluids within the first hour of recognition but also highlights the importance of reassessing fluid status frequently to avoid over-resuscitation.3 Goal-directed therapy (GDT) has emerged as a solution to this challenge, offering a structured approach to fluid and vasopressor administration based on individual haemodynamic targets. Key indicators like PPV and SVV help predict fluid responsiveness under controlled ventilation conditions. When integrated with advanced monitoring, these indicators provide actionable insights to support decision-making. The European Society of Anaesthesiology
and Intensive Care (ESAIC) recommends individualising targets for stroke volume and cardiac output, rather than attempting to maximise these parameters across the board.4 This ensures that interventions are focused on improving tissue perfusion and oxygen delivery, rather than chasing abstract numerical goals. A key aspect of ESAIC guidance1
is the
importance of tracking dynamic trends rather than isolated values. The guidelines also emphasise the potential benefit of integrating haemodynamic monitoring with other modalities, such as
echocardiography and tissue perfusion markers, to build a more complete clinical picture. This multi-modal approach can be especially valuable in sepsis, where patients present with varied and rapidly changing pathophysiology. ESAIC also highlights that the value of haemodynamic monitoring is maximised when used as part of a structured treatment plan. For example, using real-time data to prompt other interventions, from fluid boluses to vasopressor adjustments, ensures that care is both responsive and evidence based. These insights reinforce the idea that technology alone is not the solution, but rather a powerful complementary tool when used in combination with clinical judgment and structured protocols. The guidance from ESAIC encourages ongoing education to improve clinicians’ understanding of dynamic circulatory parameters and reinforce the importance of tailoring therapy. This aligns closely with calls from global health bodies such as the World Health Organization (WHO) and the National
Institute for Health and Care Excellence (NICE) to upskill staff in the early recognition and management of sepsis.
Special considerations in paediatric sepsis Children, especially those aged under five, are highly susceptible to sepsis, with approximately 25,000 affected in the UK each year.5
Their
unique physiology poses challenges for both detection and treatment. Children can maintain normal blood pressure until late in the shock process, making standard vital signs an unreliable indicator of deterioration. Advanced haemodynamic monitoring
offers a solution. By tracking beat-to-beat changes in cardiac output and systemic resistance, clinicians can detect early signs of cardiovascular compromise without relying solely on non-specific markers such as blood pressure or heart rate. Systems adapted for smaller patients allow continuous monitoring without the need for invasive procedures, helping to reduce the physical and emotional stress of care. This is particularly beneficial in neonates and infants, where obtaining accurate measurements is especially challenging. That’s why we support the Surviving Sepsis Campaign guidelines, which advocate for the use of advanced haemodynamic variables alongside clinical assessment to guide resuscitation in children with septic shock or sepsis-associated organ dysfunction. The utility of cardiac output monitoring in paediatric intensive care is key in improving diagnostic confidence and supporting earlier, targeted intervention.
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