tailieunhanh - Ebook ABC of sepsis: Part 2

(BQ) Part 2 book “ABC of sepsis” has contents: The role of imaging in sepsis, presentations in medical patients, presentations in surgical patients, the role of critical care, monitoring the septic patient, novel therapies in sepsis, approaches to achieve change, and other contents. | CHAPTER 9 The Role of Imaging in Sepsis Morgan Cleasby Good Hope Hospital, Heart of England NHS Foundation Trust, Birmingham, UK OVERVIEW • Modern imaging techniques are important in locating the source of sepsis • A chest radiograph (CXR) remains an important baseline investigation • Ultrasound is quick, safe and can be portable. It is the first-line investigation for the biliary, renal and gynaecological tracts, and may show intra-abdominal abscesses. It may be difficult in obese patients • Computerized tomography (CT) is better at showing the bowel and retroperitoneum, and is the investigation of choice in patients following abdominal surgery. It also shows intrapulmonary and intracranial abscesses. However, it involves a high dose of radiation • • Magnetic resonance imaging (MRI) is the modality of choice for spinal imaging and shows more subtle intracranial pathology than CT. It is also used for imaging osteomyelitis. However, it is not suitable for unstable patients and there are a number of contraindications Image-guided techniques are important for diagnostic aspiration and therapeutic drainage of abscesses and infected hollow viscera suitably urgent timeframe. It is recommended that indices of the severity of sepsis should be included in the radiological referral, such as the white cell count, evidence of raised inflammatory markers and evidence of renal impairment, particularly if iodinated intravenous contrast is likely to be used. If the patient is critically ill, the critical care team should be consulted in order to ensure that an appropriate level of support is available whilst the patient attends the imaging department. Modalities Table gives an overview of the imaging modalities that can be used in the investigation of sepsis. These techniques will be discussed in turn. Plain radiography The usefulness of plain radiographic examination should not be overlooked. A chest radiograph (CXR) should be considered a first-line investigation

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• ABC of sepsis
• Medical patients
• Presentations in surgical patients
• Achieve change
• Novel therapies in sepsis
• Monitoring the septic patient
• Defining the spectrum of disease
• The spectrum of disease
• The patient with sepsis
• Serious complications
• Antibiotic therapy
• Infection prevention