Sepsis and septic shock

2018 ◽  
pp. 161-168
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Septic Shock ◽  
Mortality Rate ◽  
Blood Culture ◽  
Antibiotic Therapy ◽  
Fluid Resuscitation ◽  
High Flow ◽  
Empirical Antibiotic Therapy ◽  
Goal Directed Therapy ◽  
Reduce Mortality Rate ◽  
Sepsis And Septic Shock

Sepsis is very common; however, goal–directed therapy significantly helps to reduce mortality rate following septic shock. Sepsis Six should be delivered within one hour of initial diagnosis of sepsis. The sepsis resuscitation and management bundle includes delivery of high flow O2, blood culture, measurement of lactate, empirical antibiotic therapy, and IV fluid resuscitation and renal support.

Empirical Antibiotic Therapy for Patients with Severe Sepsis and Septic Shock

2005 ◽  
pp. 539-558 ◽  
Author(s):  
Pierre-Yves Bochud ◽  
Michel P. Glauser ◽  
Jean Carlet ◽  
Thierry Calandra
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Antibiotic Therapy ◽  
Empirical Antibiotic Therapy ◽  
Sepsis And Septic Shock

Early Goal-Directed Therapy in Severe Sepsis and Septic Shock Revisited

CHEST Journal ◽  
2006 ◽  
Vol 130 (5) ◽  
pp. 1579-1595 ◽  
Author(s):  
Ronny M. Otero ◽  
H. Bryant Nguyen ◽  
David T. Huang ◽  
David F. Gaieski ◽  
Munish Goyal ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Goal Directed Therapy ◽  
Early Goal Directed Therapy ◽  
Sepsis And Septic Shock

scholarly journals Procalcitonin-guided algorithm to reduce length of antibiotic therapy in patients with severe sepsis and septic shock

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Andreas Hohn ◽  
Stefan Schroeder ◽  
Anna Gehrt ◽  
Kathrin Bernhardt ◽  
Berthold Bein ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Antibiotic Therapy ◽  
Sepsis And Septic Shock

Respiratory Drive in Patients with Sepsis and Septic Shock: Modulation by High-flow Nasal Cannula

2021 ◽  
Author(s):  
Tommaso Mauri ◽  
Elena Spinelli ◽  
Bertrand Pavlovsky ◽  
Domenico Luca Grieco ◽  
Irene Ottaviani ◽  
...  
Keyword(s):  
Septic Shock ◽  
Esophageal Pressure ◽  
Lung Compliance ◽  
High Flow ◽  
Nasal Cannula ◽  
Low Flow ◽  
Respiratory Drive ◽  
High Flow Nasal Cannula ◽  
Impedance Tomography ◽  
Sepsis And Septic Shock

Background Experimental and pilot clinical data suggest that spontaneously breathing patients with sepsis and septic shock may present increased respiratory drive and effort, even in the absence of pulmonary infection. The study hypothesis was that respiratory drive and effort may be increased in septic patients and correlated with extrapulmonary determinant and that high-flow nasal cannula may modulate drive and effort. Methods Twenty-five nonintubated patients with extrapulmonary sepsis or septic shock were enrolled. Each patient underwent three consecutive steps: low-flow oxygen at baseline, high-flow nasal cannula, and then low-flow oxygen again. Arterial blood gases, esophageal pressure, and electrical impedance tomography data were recorded toward the end of each step. Respiratory effort was measured as the negative swing of esophageal pressure (ΔPes); drive was quantified as the change in esophageal pressure during the first 500 ms from start of inspiration (P0.5). Dynamic lung compliance was calculated as the tidal volume measured by electrical impedance tomography, divided by ΔPes. The results are presented as medians [25th to 75th percentile]. Results Thirteen patients (52%) were in septic shock. The Sequential Organ Failure Assessment score was 5 [4 to 9]. During low-flow oxygen at baseline, respiratory drive and effort were elevated and significantly correlated with arterial lactate (r = 0.46, P = 0.034) and inversely with dynamic lung compliance (r = –0.735, P < 0.001). Noninvasive support by high-flow nasal cannula induced a significant decrease of respiratory drive (P0.5: 6.0 [4.4 to 9.0] vs. 4.3 [3.5 to 6.6] vs. 6.6 [4.9 to 10.7] cm H2O, P < 0.001) and effort (ΔPes: 8.0 [6.0 to 11.5] vs. 5.5 [4.5 to 8.0] vs. 7.5 [6.0 to 12.6] cm H2O, P < 0.001). Oxygenation and arterial carbon dioxide levels remained stable during all study phases. Conclusions Patients with sepsis and septic shock of extrapulmonary origin present elevated respiratory drive and effort, which can be effectively reduced by high-flow nasal cannula. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Sepsis

2020 ◽  
Author(s):  
Steven P LaRosa ◽  
Steven M. Opal
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Organ Dysfunction ◽  
Fluid Resuscitation ◽  
Multiorgan Failure ◽  
Sepsis Management ◽  
The Past ◽  
Sepsis And Septic Shock

Sepsis, along with the multiorgan failure that often accompanies this condition, is a leading cause of mortality in the intensive care unit. Although modest improvements in the prognosis have been made over the past two decades and promising new therapies continue to be investigated, innovations in the management of septic shock are still required. This chapter discusses the definitions, epidemiology, and pathogenesis (including microbial factors, host-derived mediators, and organ dysfunction) relating to sepsis. Management of severe sepsis and septic shock is also described.  This review contains 5 figures, 11 tables, and 99 references. Keywords:Organ dysfunction, sepsis, septic shock, infection, bacteremia, fluid resuscitation, vasopressor

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