Perioperative Management of Patients with Sepsis and Septic Shock, Part I: Systematic Approach

Area of Science:

• Critical Care Medicine
• Anesthesiology
• Emergency Medicine

Background:

• Sepsis and septic shock are life-threatening emergencies with high mortality rates.
• The Surviving Sepsis Campaign provides critical care guidelines, including the hour-1 bundle.
• Anesthesiologists play a key role in managing sepsis, particularly during surgical source control procedures.

Purpose of the Study:

• To review the clinical manifestations of organ dysfunction in sepsis.
• To outline current, state-of-the-art management strategies for sepsis and septic shock.
• To emphasize the utility of point-of-care ultrasound in managing hemodynamic instability during sepsis.

Main Methods:

• Literature review of sepsis definitions, guidelines, and management.
• Summary of organ dysfunction syndromes associated with sepsis.
• Discussion of anesthesiologist's role in perioperative sepsis care and transitions of care.

Main Results:

• Sepsis necessitates prompt recognition and intervention, often involving anesthesiologists.
• Point-of-care ultrasound is crucial for assessing and managing hemodynamic derangements.
• Effective management includes adherence to sepsis bundles and seamless care transitions.

Conclusions:

• Anesthesiologists are integral to sepsis management, from the operating room to the intensive care unit.
• Point-of-care ultrasound enhances the diagnosis and treatment of sepsis-induced hemodynamic instability.
• A structured approach to care transitions improves outcomes for patients with sepsis and septic shock.