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Sepsis - What's new in 2019?
1Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Langone Health, NYU Langone Medical Center, New York, New York, USA.
Current Opinion in Anaesthesiology
|March 1, 2019
Summary
The Sepsis-3 guidelines redefine sepsis understanding, focusing on host response. New research explores fluid resuscitation, steroids, and novel therapies like angiotensin II, vitamin C, and thiamine, with procalcitonin aiding antibiotic management.
Area of Science:
- Critical care medicine
- Infectious disease
- Biochemistry
Background:
- Sepsis-3 guidelines emphasize a dysregulated host response to infection.
- Traditional sepsis management strategies are under re-evaluation.
- Understanding sepsis biopathology is crucial for effective treatment.
Purpose of the Study:
- To review current literature on sepsis management.
- To explore novel therapeutic options and biomarkers.
- To highlight the implications of Sepsis-3 guidelines.
Main Methods:
- Literature review of recent studies on sepsis.
- Analysis of emerging therapeutic agents and diagnostic tools.
- Evaluation of Sepsis-3 criteria and their impact.
Main Results:
- Fluid resuscitation strategies are being re-evaluated, with hyperchloremic crystalloids linked to poor outcomes.
- Steroid therapy may reverse shock but mortality benefits are uncertain.
- Angiotensin II, vitamin C, and thiamine show promise but require further validation.
- Procalcitonin (PCT) aids in differentiating infectious from non-infectious inflammation.
Conclusions:
- Sepsis-3 shifts focus to host response, impacting clinical understanding.
- Novel therapies like angiotensin II, vitamin C, and thiamine warrant further investigation.
- Procalcitonin assays are valuable for guiding antibiotic therapy in sepsis.