Sepsis in the Interventional Radiology Patient

https://doi.org/10.1053/j.tvir.2006.12.003Get rights and content

Sepsis is a problem frequently encountered by interventional radiologists since they are often asked to perform procedures on patients already septic. Occasionally, patients may become septic during interventional procedures. Both of these mandate interventionists be prepared to institute therapy and manage the patient through the procedure or until critical care teams can be mobilized. It is the purpose of this text to provide an outline for dealing with the septic patient in the interventional radiology setting.

Section snippets

Diagnosing the Septic Patient in the Interventional Suite

Before embarking on the treatment of the septic patient, one must be certain the patient is in fact becoming septic. To that end, one must exclude other causes for the patient’s presentation, in particular, drug reactions, before considering an infectious etiology. The earliest signs and symptoms leading to the diagnosis of sepsis are fever and chills. Fever is defined as a body temperature of >38°C and is the most common sign of sepsis. Interestingly, hypothermia, defined as a body temperature

Managing the Septic Patient in the Interventional Suite

There are a number of excellent publications regarding the treatment of sepsis.20, 21, 22 Although most of these focus on patients in the emergency department or in critical care units, the philosophy is of course the same. There are three central principles to managing sepsis regardless of where the patient is located:

  • Controlling the source of infection

  • Administration of appropriate systemic antimicrobial therapy

  • Volume resuscitation and cardiopulmonary support

Managing the patient in the

Summary

Dealing with the acutely septic patient in interventional radiology can be frightening for both the patient as well as the radiological team. The keys to treating these patients in interventional radiology are to identify those at risk, to understand the basic treatment principles, and to have instigated plans regarding patient care before the acute event. We have attempted to outline these factors in this review and hope this provides a framework for the care of these patients.

References (29)

  • American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis

    Crit Care Med

    (1992)
  • J.-L. Vincent

    Sepsis: the magnitude of the problem

  • G.S. Martin et al.

    The epidemiology of sepsis in the United States from 1979 through 2000

    N Engl J Med

    (2003)
  • T.P. Smith et al.

    Sepsis in the interventional radiology patient

    J Vasc Interv Radiol

    (2004)
  • S. Lewis et al.

    Major complications after percutaneous nephrostomy—lessons from a department audit

    Clin Radiol

    (2004)
  • K. Kolmannskog et al.

    Side effects and complications after hepatic artery embolization in the carcinoid syndrome

    Scand J Gastroenterol

    (1991)
  • C. Chen et al.

    Bacterial infections associated with hepatic arteriography and transarterial embolization for hepatocellular carcinoma: a prospective study

    Clin Infect Dis

    (1999)
  • A. Vashisht et al.

    Fatal septicaemia after fibroid embolization

    The Lancet

    (1999)
  • M.C. Soulen et al.

    Mechanical declotting of thrombosed dialysis grafts: experience in 86 cases

    J Vasc Interv Radiol

    (1997)
  • T.E. Minga et al.

    Clinical consequences of infected arteriovenous grafts in hemodialysis patients

    Am J Kidney Dis

    (2001)
  • R.J. Zagoria et al.

    Do’s and don’t’s of percutaneous nephrostomy

    Acad Radiol

    (1999)
  • M.M.J. McNicholas et al.

    Complications of percutaneous biliary drainage and stricture dilatation

    Sem Interven Radiol

    (1994)
  • T. Vehmas et al.

    Results and complications of percutaneous nephrostomy

    Ann Clin Res

    (1988)
  • W.J. Lee et al.

    Emergency percutaneous nephrostomy: results and complications

    J Vasc Interven Radiol

    (1994)
    • View full text
    Copyright © 2006 Elsevier Inc. All rights reserved.