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Physiologic Targets of Eissa et al for a Septic Patient Undergoing Anesthesia

Description

Eissa et al identified certain targets to maintain while delivering anesthesia to a septic patient. A septic patient is often physiologically unstable and surgery may be associated with serious complications. The authors are from Mater Misericordiae University Hospital in Dublin, Ireland.


 

Parameters monitored:

(1) oxygen delivery

(2) renal function

(3) circulatory status and perfusion

Parameter

Measure

Target

oxygen delivery

hematocrit (hemoglobin)

>= 30 per cent (10.4 g/dL)

 

central venous oxygen saturation

>= 70 mm Hg

renal function

urine output

>= 0.5 mL per kg per hour

circulatory status

mean arterial pressure

65 to 90 mm Hg

 

central venous pressure

8 to 12 mm Hg (may be higher in ventilated patient)

 

mean arterial pressure =

= ((systolic blood pressure) + (2*(diastolic blood pressure))) / 3

 

hemoglobin in g/dL =

= (0.357 * (hematocrit in percent)) - 0.286

 

Interventions may include:

(1) blood transfusion

(2) supplemental oxygen

(3) vasopressors support with norepinephrine or other agent

(4) inotrope therapy with dobutamine

(5) fluid infusion

(6) diuretics

 


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