Dear Sepsis-3, we are sorry to say that we don’t like you

Carneiro, Antônio Fernando; Póvoa, Pedro; Gomes, José Andrade

doi:10.5935/0103-507x.20170002

Cited by 43 publications

(36 citation statements)

References 13 publications

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“…Serum lactate is a marker of tissue hypoxia 38 and a predictor of mortality in septic patients. 39 Several recent studies 40,41 evaluating the What Is Already Known? Globally, SS is recognized as a health priority by the WHO due to its high morbidity and mortality, particularly in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

The Epidemiology, Therapeutic Patterns, Outcome, and Challenges in Managing Septic Shock in a Sub-Saharan African Intensive Care Unit: A CrossSectional Study

et al. 2019

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Background: Septic shock (SS) is a health priority in sub-Saharan Africa. However, there is a dearth of data in this regard. Objective: This study aimed to determine the epidemiology, therapeutic patterns, outcome, and challenges in managing SS in a tertiary intensive care unit (ICU) of sub-Saharan Africa. Methods: The hospital files of 36 consecutive patients admitted to the ICU of the Douala General Hospital (DGH), Cameroon over the year 2018 were reviewed for SS. SS was diagnosed based on Sepsis-3 definition. Demographic and clinical characteristics, treatment details, and outcomes of patients with SS were reviewed. Data was analyzed using the chi-square or Fisher exact tests and Bonferroni correction. Results: SS accounted for 36 (9.4%) ICU admissions. The majority of patients were males (63.9%). The most common site of infection was the lungs. The mean age, average mean arterial pressure (MAP), and mean sequential organ failure assessment (SOFA) score of patients were 52.9±25.2 years, 52±18 mm Hg, and 9.2 ±2.3, respectively. Noradrenaline was the sole vasopressor used. Therapeutic challenges included the inability to have a specific antibiogram before a mean duration of 7 days. The mortality rate was 39% and associated with age ≤1 year, MAP ≤ 65 mm Hg, Glasgow Coma Score (GCS) ≤8, and mechanical ventilation, which were not attenuated after Bonferroni correction. Conclusion: SS is a frequent cause of ICU admission and is associated with a high mortality rate. SS mortality-related factors can be screened during SS management for more aggressive ICU management geared at preventing death.

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Section: Discussionmentioning

confidence: 99%

The Epidemiology, Therapeutic Patterns, Outcome, and Challenges in Managing Septic Shock in a Sub-Saharan African Intensive Care Unit: A CrossSectional Study

et al. 2019

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“…There is still controversy regarding the new Sepsis-3 definitions [14][15][16]. Some organizations have not endorsed the new Sepsis-3 definitions, including the American College of Chest Physicians [17], the Infectious Disease Society of America, the Latin American Sepsis Institute [18], American College of Emergency Physicians, none of the emergency medicine societies, and none of the hospital medicine societies.…”

Section: Definitions and Guideline Changesmentioning

confidence: 99%

Sepsis 2018: Definitions and Guideline Changes

Napolitano

2018

Surgical Infections

218

145

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New definitions for sepsis and septic shock (Third International Consensus Definitions for Sepsis and Septic Shock [Sepsis-3]) have been developed. A new screening tool for sepsis (quick Sequential Organ Failure Assessment [qSOFA]) has been proposed to predict the likelihood of poor outcome in out-of-intensive care unit (ICU) patients with clinical suspicion of sepsis. The Surviving Sepsis Campaign Guidelines were recently updated and include greater evidence-based recommendations for treatment of sepsis in attempts to reduce sepsis-associated mortality. This review discusses the new Sepsis-3 definitions and guidelines.

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“…Since the first classification in 1991 [ 1 ], the definition of sepsis, severe sepsis, and septic shock, though imprecise, have provided the clinicians a useful framework for clinical management, stressing the need for early recognition [ 6 ], and when these criteria are followed by the application of the Surviving Sepsis Campaign recommendations, they have an impressive history of success in reducing the mortality of sepsis in several areas of the world [ 7 ].…”

Section: Raising Concerns About the Sepsis-3 Definitionsmentioning

confidence: 99%

“…The previous stratification of the severity and consequent mortality due to infection that progressed from no sepsis to sepsis (infection meeting the criteria for systemic inflammatory response syndrome or SIRS), to severe sepsis (sepsis with organ failure, arterial hypertension, and/or hypoperfusion), to septic shock (arterial hypotension refractory to adequate volume resuscitation) is now reduced to simple infection, sepsis (infection and organ dysfunction), and septic shock (arterial hypotension defined as the use of vasopressors and hyperlactatemia). The previous concept of severe sepsis corresponds now to the definition of sepsis in the Sepsis-3 criteria, although this correlation is not absolute because sepsis, according to the new criteria, can include very different conditions, such as organ failure without hypotension nor hyperlactatemia [ 7 ].…”

Section: Raising Concerns About the Sepsis-3 Definitionsmentioning

confidence: 99%