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Sepsis and Septic Shock Strategies
Bracken A Armstrong1, Richard D Betzold1, Addison K May1
1Division of Trauma and Surgical Critical Care, Department of Surgery, Vanderbilt University Medical Center, 1211 21st Ave S Medical Arts Building 404, Nashville, TN 37212, USA.
The Surgical Clinics of North America
|November 15, 2017
Summary
Early antibiotics, adequate perfusion, and source control are key for sepsis survival. New definitions and assessment tools improve sepsis and septic shock prognostication and management.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Emergency Medicine
Background:
- Sepsis and septic shock are life-threatening conditions characterized by organ dysfunction.
- Existing criteria for systemic inflammatory response syndrome (SIRS) lack sensitivity and prognostic value.
- Effective management requires a comprehensive understanding of sepsis pathophysiology and treatment principles.
Purpose of the Study:
- To outline the core therapeutic principles for improving outcomes in sepsis.
- To discuss the evolution of sepsis definitions and their impact on diagnosis and prognosis.
- To highlight the importance of early and adequate interventions for sepsis management.
Main Methods:
- Review of current evidence-based therapeutic principles for sepsis.
- Analysis of new definitions for sepsis and septic shock.
- Evaluation of prognostic tools like Sequential (Sepsis-related) Organ Failure Assessment (SOFA).
Main Results:
- Early, appropriate antimicrobial therapy, adequate cellular perfusion, and timely source control are critical for improving organ dysfunction and survival.
- New sepsis and septic shock definitions offer improved sensitivity and prognostic capabilities over SIRS criteria.
- The Sequential (Sepsis-related) Organ Failure Assessment (SOFA) score is a more effective prognostic tool.
Conclusions:
- A multipronged, systems-based therapeutic approach is essential for managing sepsis and septic shock.
- Restoring adequate cellular perfusion early limits organ injury.
- Evidence-based interventions significantly improve outcomes in critically ill patients with sepsis.
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