Bewaking en behandeling van patiënten met shock op de intensivecareafdeling

- The controversy surrounding the use of the pulmonary artery catheter, has stimulated research into alternative methods of haemodynamic monitoring. As yet, however, no new gold standard has emerged.

- In the future, interest in haemodynamic monitoring is likely to focus more on tissue perfusion and metabolism instead of central circulation.

- Important causes of shock in the ICU, apart from acute blood loss, are sepsis and acute heart failure.

- Septic shock results from vasodilatation and myocardial dysfunction. Early initiation of aggressive fluid resuscitation, if necessary accompanied by vasoactive and inotropic agents, improves survival. In addition, low dose corticosteroids have a positive impact on mortality.

- In the treatment of patients with acute heart failure, phosphodiesterase III-inhibitors are becoming part of standard therapy in addition to β-adrenoceptor agonists, especially in patients who take β-blockers.