Assessment of sepsis in the critically ill

2016 ◽  
Author(s):  
Osamudiamen Idahosa ◽  
David T. Huang
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Organ Dysfunction ◽  
Early Identification ◽  
Signs And Symptoms ◽  
The United States ◽  
Medical Emergency ◽  
Suspected Infection ◽  
Portal Of Entry ◽  
Acute Organ Dysfunction

Sepsis is the presence of a known or suspected infection and a systemic inflammatory response. Severe sepsis is sepsis with acute organ dysfunction. Septic shock is a subset of severe sepsis characterized by systemic arterial hypotension or occult hypoperfusion. Severe sepsis is common, affecting more than 750 000 individuals in the United States each year with a hospital mortality of about 30%.Severe sepsis is a medical emergency that requires early identification, prompt evaluation, and treatment. The signs and symptoms of sepsis are influenced by the virulence of the pathogen, the portal of entry, the degree of organ dysfunction as well as the susceptibility and response of the host.

scholarly journals The impact of duration of organ dysfunction on the outcome of patients with severe sepsis and septic shock

Clinics ◽  
2008 ◽  
Vol 63 (4) ◽  
Author(s):  
Flávio G. R. Freitas ◽  
Reinaldo Salomão ◽  
Nathalia Tereran ◽  
Bruno Franco Mazza ◽  
Murillo Assunção ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Organ Dysfunction ◽  
Sepsis And Septic Shock ◽  
The Impact

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

Hypotension

2018 ◽  
pp. 163-167
Author(s):  
Angela Creditt
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Organ Failure ◽  
Broad Spectrum ◽  
Signs And Symptoms ◽  
Intravenous Fluids ◽  
Key Points ◽  
Life Threatening ◽  
New Guidelines ◽  
Sepsis And Septic Shock

Sepsis is a complex and potentially life-threatening sequela of infection that commonly occurs and can be difficult to identify. If unrecognized or undertreated, sepsis can progress to severe sepsis, septic shock, characterized by hypotension and multisystem organ failure, and ultimately death. This case illustrates classic signs and symptoms of sepsis and septic shock in a postoperative patient. Recognizing these symptoms, rapidly initiating resuscitation with intravenous fluids and broad-spectrum antibiotics and aggressive management of these patients is imperative to prevent further decompensation. In 2017, the Surviving Sepsis campaign published new guidelines to assist with the management of patients with sepsis and septic shock. Key points from these guidelines will be highlighted within this case.

scholarly journals Improving Documentation and Coding for Acute Organ Dysfunction Biases Severe Sepsis Surveillance Over Time

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Chanu Rhee ◽  
Michael V. Murphy ◽  
Lingling Li ◽  
Richard Platt ◽  
Michael Klompas
Keyword(s):  
Severe Sepsis ◽  
Organ Dysfunction ◽  
Acute Organ Dysfunction ◽  
Over Time

scholarly journals Predictor of Death in Diarrheal Children Under 5 Years of Age Having Severe Sepsis in an Urban Critical Care Ward in Bangladesh

2019 ◽  
Vol 6 ◽  
pp. 2333794X1986271 ◽  
Author(s):  
Monira Sarmin ◽  
Farzana Afroze ◽  
Sharifuzzaman ◽  
Tahmina Alam ◽  
Nusrat Jahan Shaly ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Early Identification ◽  
Fatal Outcome ◽  
Shortness Of Breath ◽  
Clinical Predictors ◽  
Resource Poor ◽  
Care Ward ◽  
Children Under 5

We aimed to identify clinical predictors of fatal outcome in children under 5 years of age having diarrhea and severe sepsis and treated in the Intensive Care Unit of the Dhaka Hospital of icddr,b from October 2010 through September 2011. Among 191 enrolled children, 70 (37%) died and were considered to be cases, while the remaining 121 (63%) who survived constituted the controls. The cases more often had shortness of breath (SOB), septic shock, dehydrating diarrhea compared with the controls (for all, P < .05). After adjusting for potential confounders using logistic regression analysis, the likelihood of death was higher in children who had septic shock and SOB and lower in children having dehydrating diarrhea (for all, P < .05). Thus, SOB can trigger an early alarm for sepsis recognition; otherwise, these children can end up with fatality from septic shock. In resource-poor settings, early identification of these predictors can alleviate death.

A survey of clinicians addressing the approach to the management of severe sepsis and septic shock in the United States

2010 ◽  
Vol 25 (4) ◽  
pp. 658.e1-658.e6 ◽  
Author(s):  
Svetolik Djurkovic ◽  
Juan C. Baracaldo ◽  
Jose A. Guerra ◽  
Jennifer Sartorius ◽  
Marilyn T. Haupt
Keyword(s):  
United States ◽  
Septic Shock ◽  
Severe Sepsis ◽  
The United States ◽  
Sepsis And Septic Shock

scholarly journals The Comparative Epidemiology of Pediatric Severe Sepsis

2017 ◽  
Vol 34 (6) ◽  
pp. 472-479 ◽  
Author(s):  
Mary E. Hartman ◽  
Mohammed J. Saeed ◽  
Kimberly N. Powell ◽  
Margaret A. Olsen
Keyword(s):  
New York ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Organ Dysfunction ◽  
International Classification Of Diseases ◽  
Global Perspective ◽  
Clinical Criteria ◽  
Coding Strategies ◽  
Using Data ◽  
Sepsis And Septic Shock

Objective: To determine whether the coding strategies used to identify severe sepsis in administrative data sets could identify cases with comparable case mix, hospitalization characteristics, and outcomes as a cohort of children diagnosed with severe sepsis using strict clinical criteria. Methods: We performed a retrospective cohort study using data from 2005 to 2011 from the New York and Florida State Inpatient Databases, available from the US Healthcare Cost and Utilization Project. We compared 4 coding strategies: the single International Classification of Diseases, Ninth Revision, Clinical Modification ( ICD-9-CM) codes for (1) severe sepsis or (2) septic shock, and the algorithms developed by (3) Angus et al or (4) Martin et al, which use a combination of ICD-9-CM codes for infection and organ dysfunction. We compared the cases identified by each strategy with each other and with children enrolled in the REsearching severe Sepsis and Organ dysfunction in children: a gLobal perspectiVE (RESOLVE) trial. Results: The Angus criteria was 9 times larger (n = 23 995) than the smallest cohort, identified by the “septic shock” code (n = 2 601). Cases identified by the Angus and Martin strategies had low mortality rates, while the cases identified by the “severe sepsis” and “septic shock” codes had much higher mortality at all time points (eg, 28-day mortality of 4.4% and 7.4% vs 15.4% and 16.0%, respectively). Mortality in the “severe sepsis” and “septic shock” code cohorts was similar to that presented in the RESOLVE trial. Conclusions: The ICD-9-CM codes for “severe sepsis” and “septic shock” identify smaller but higher acuity cohorts of patients that more closely resemble the children enrolled in the largest clinical trial of pediatric severe sepsis to date.

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