Tom, That's probably due to the SIRS and systemic inflammation and not myocardial dysfunction. It should likely resolve when the sepsis resolves. Also, ALI may have effusions, but again, it's probably not ALI.
Hesham A. Hassaballa, MD, FCCP Program Medical Director Critical Care Rush-Copley Medical Center Assistant Professor of Medicine Rush University Medical Center Phone: (331) 454-6572 > On Jun 11, 2014, at 7:44 AM, "Tom Morris" <[email protected]> wrote: > > Dear All > > Hope all okay - am just reflecting on a case on our ward of a previously fit > 35 year old guy, discharged from ICU after severe sepsis from arm cellulitis > and Group A Strep in blood. He's had a good week of Benpen and Clindamycin, > but left with bilateral moderate pleural effusions and a RR of 24, in the > context of albumin 24. Questions: > > i) how common is sepsis induced myocardial dysfunction, or is that all more > likely to be iatrogenic fluid overload? Thought it was a bit odd that lung > fields clear on examination and no parenchymal changes of pulmonary oedema on > CXR > > ii) If he'd had acute lung injury during the acute process, could that have > resolved into pleural effusions? Am assuming that this wouldn't respond to > frusemide quite as well as the top two would do. He wasn't ventilated by the > way. > Many thanks > > Tom Morris > ID/GIM Str > > Sent from my iPhone > ________________________ _______________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > This message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message.
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