Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients
Sepsis and septic shock are major global public health concerns. The main therapies for sepsis-related hypotension are fluid resuscitation and vasopressor therapy, though it can be challenging to determine the amount of fluid that should be given or the optimal timing to transition to vasopressor ad...
| Main Authors: | , , |
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| Other Authors: | |
| Format: | Article |
| Language: | English |
| Published: |
Institute of Electrical and Electronics Engineers (IEEE)
2020
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| Online Access: | https://hdl.handle.net/1721.1/128879 |
| _version_ | 1826212131082600448 |
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| author | Gu, Qiao Prasad, Varesh Heldt, Thomas |
| author2 | Massachusetts Institute of Technology. Institute for Medical Engineering & Science |
| author_facet | Massachusetts Institute of Technology. Institute for Medical Engineering & Science Gu, Qiao Prasad, Varesh Heldt, Thomas |
| author_sort | Gu, Qiao |
| collection | MIT |
| description | Sepsis and septic shock are major global public health concerns. The main therapies for sepsis-related hypotension are fluid resuscitation and vasopressor therapy, though it can be challenging to determine the amount of fluid that should be given or the optimal timing to transition to vasopressor administration. To characterize patients' response to fluid bolus therapy (FBT) and analyze the sepsis progress using multiple vital signs, we mined a database containing 761 patients presenting to the Emergency Department (ED) with vital signs and laboratory values indicating high risk of septic shock. By clustering the patients' mean arterial pressure (MAP) time series during a time window around FBT, we found that clusters showing fluid responsiveness during the two hours after FBT only included about 25% of studied boluses. In addition, MAP responses tended to vary based on the initial MAP level. We also found that the trajectories of heart rate and MAP in a 2-D plane demonstrated general trends related to the hemodynamic progression of sepsis and previously described phases of septic shock. Potentially compensatory and decompensatory responses of the cardiovascular system to the insults of sepsis were reflected in the clusters representative of different phases. |
| first_indexed | 2024-09-23T15:16:52Z |
| format | Article |
| id | mit-1721.1/128879 |
| institution | Massachusetts Institute of Technology |
| language | English |
| last_indexed | 2024-09-23T15:16:52Z |
| publishDate | 2020 |
| publisher | Institute of Electrical and Electronics Engineers (IEEE) |
| record_format | dspace |
| spelling | mit-1721.1/1288792022-09-29T13:52:06Z Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients Gu, Qiao Prasad, Varesh Heldt, Thomas Massachusetts Institute of Technology. Institute for Medical Engineering & Science Harvard University--MIT Division of Health Sciences and Technology Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science Sepsis and septic shock are major global public health concerns. The main therapies for sepsis-related hypotension are fluid resuscitation and vasopressor therapy, though it can be challenging to determine the amount of fluid that should be given or the optimal timing to transition to vasopressor administration. To characterize patients' response to fluid bolus therapy (FBT) and analyze the sepsis progress using multiple vital signs, we mined a database containing 761 patients presenting to the Emergency Department (ED) with vital signs and laboratory values indicating high risk of septic shock. By clustering the patients' mean arterial pressure (MAP) time series during a time window around FBT, we found that clusters showing fluid responsiveness during the two hours after FBT only included about 25% of studied boluses. In addition, MAP responses tended to vary based on the initial MAP level. We also found that the trajectories of heart rate and MAP in a 2-D plane demonstrated general trends related to the hemodynamic progression of sepsis and previously described phases of septic shock. Potentially compensatory and decompensatory responses of the cardiovascular system to the insults of sepsis were reflected in the clusters representative of different phases. 2020-12-21T19:02:03Z 2020-12-21T19:02:03Z 2019-10 2019-07 2020-12-17T18:23:23Z Article http://purl.org/eprint/type/ConferencePaper 9781538613115 1558-4615 https://hdl.handle.net/1721.1/128879 Gu, Qiao et al. "Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients." Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, July 2019, Berlin Germany, Institute of Electrical and Electronics Engineers, October 2019. © 2019 IEEE en http://dx.doi.org/10.1109/embc.2019.8856521 Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society Creative Commons Attribution-Noncommercial-Share Alike http://creativecommons.org/licenses/by-nc-sa/4.0/ application/pdf Institute of Electrical and Electronics Engineers (IEEE) MIT web domain |
| spellingShingle | Gu, Qiao Prasad, Varesh Heldt, Thomas Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients |
| title | Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients |
| title_full | Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients |
| title_fullStr | Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients |
| title_full_unstemmed | Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients |
| title_short | Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients |
| title_sort | characterizing fluid response and sepsis progression in emergency department patients |
| url | https://hdl.handle.net/1721.1/128879 |
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