Management of Sepsis and Septic Shock

Howell, Michael D.; Davis, Andrew M.

doi:10.1001/jama.2017.0131

Cited by 176 publications

(128 citation statements)

References 10 publications

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“…High quality resuscitation care of the patient with sepsis includes an initial modest bolus of resuscitation fluid (30 mL/kg within the first three hours) followed by a frequent assessment with dynamic measures of fluid responsiveness to determine whether additional fluids or vasoactive drugs are indicated 113. Over-resuscitation and under-resuscitation have both been associated with adverse outcomes in the setting of shock.…”

Section: Prevention and Medical Treatmentmentioning

confidence: 99%

Sepsis associated acute kidney injury

Poston

Koyner

2019

BMJ

417

312

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Sepsis is defined as organ dysfunction resulting from the host’s deleterious response to infection. One of the most common organs affected is the kidneys, resulting in sepsis associated acute kidney injury (SA-AKI) that contributes to the morbidity and mortality of sepsis. A growing body of knowledge has illuminated the clinical risk factors, pathobiology, response to treatment, and elements of renal recovery that have advanced our ability to prevent, detect, and treat SA-AKI. Despite these advances, SA-AKI remains an important concern and clinical burden, and further study is needed to reduce the acute and chronic consequences. This review summarizes the relevant evidence, with a focus on the risk factors, early recognition and diagnosis, treatment, and long term consequences of SA-AKI. In addition to literature pertaining to SA-AKI specifically, pertinent sepsis and acute kidney injury literature relevant to SA-AKI was included.

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Section: Prevention and Medical Treatmentmentioning

confidence: 99%

Sepsis associated acute kidney injury

Poston

Koyner

2019

BMJ

417

312

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“…In addition, the uncertainty about the best approach for hemodynamic therapy in sepsis has increased, particularly after the negative three "post-Rivers" EGDT trials [105] . Research regarding new targets in sepsis are necessary, such as therapies aiming at the improved organ dysfunction resolution (e.g.…”

Section: The Need For New Targets and Designs Of Rcts In Sepsismentioning

confidence: 99%

Update of Sepsis in the Intensive Care Unit

Genga¹,

Russell²

2017

J Innate Immun

110

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Sepsis, the most common cause of admission to an intensive care unit (ICU), has had an increased incidence and prevalence over the last years with a simultaneous decrease in its short-term mortality. Sepsis survivors are more frequently discharged from hospital and often experience long-term outcomes such as late mortality, immune dysfunction, secondary infections, impaired quality of life, and unplanned readmissions. Early recognition and management of sepsis have challenged emergency care and critical care physicians and nurses. New sepsis definitions were produced and the Surviving Sepsis Campaign (SSC) 2016 was updated recently. Although hospital readmissions after sepsis are common, associated risk factors and how to manage patients who survive an episode of sepsis still need clarification. The immune dysfunction caused by sepsis/septic shock is complex, persistent, affects inflammatory and anti-inflammatory systems, and might be associated with long-term outcomes of sepsis. Several randomized controlled trials (RCT) that analyzed new (and old) interventions in sepsis/septic shock are discussed in this review in parallel with the SSC 2016 recommendations and other guidelines when relevant. RCTs addressing incidence, treatment, and prevention of important sepsis-associated organ dysfunction such as the acute respiratory distress syndrome, acute kidney injury, and brain dysfunction are highlighted. Finally, we briefly discuss the need for novel targets, predictive biomarkers, and new designs of RCTs in sepsis.

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“…Также исключается по-нятие «тяжелый сепсис». Сепсисом предлагается, согласно International Guidelines for Management of Sepsis and Septic Shock 2016, называть угрожающую жизни органную дисфункцию, вызванную нерегу-лируемым ответом организма на инфекцию [4][5][6]. А септический шок -вариант сепсиса, развиваю-щегося в результате гипоперфузии тканей, сопро-вождающегося гипотензией, нуждающейся в при-менении вазопрессоров, и повышенным уровнем лактата  2 [1][2][3].…”

Section: определения и понятияunclassified

“…Таким образом, сепсис определялся в терми-нах как органная дисфункция, что делает термин «тяжелый сепсис» ненужным [4,5,9,10].…”

Section: патологический процесс клинико-лабораторные признакиunclassified

“…Связанная с сепсисом органная недостаточность коррелирует с высокой летальностью, поскольку сепсис по-тенциально смертелен по своей природе. Термин «угрожающая жизни» был добавлен к определе-нию Sepsis-3 [4,5,9,10]. …”

Section: патологический процесс клинико-лабораторные признакиunclassified

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Сепсис Від Давнини До Сьогодення. Погляд Через Століття

Nіkonov¹,

Sokolov²,

Феськов³

2022

ЕМ

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Сучасна медицина зробила великий крок вперед, але, незважаючи на всі досягнення, проблема пошуку вірогідних критеріїв, понять, визначень сепсису залишається актуальною. Сепсис потенційно смертельний за своєю природою. Значна біологічна і клінічна гетерогенність пацієнтів із сепсисом: вік, преморбідний фон, прийняті препарати, різні джерела інфекції — створюють високу варіабельність початку і перебігу патологічного процесу. Нові визначення сепсису перестроїли фокус на переосмислення клінічних проявів септичного процесу і підкреслили важливість органної дисфункції як ключової діагностичної ознаки. Незрозуміла органна недостатність у пацієнта повинна насторожити лікаря щодо можливості розвитку сепсису. І від того, наскільки швидко ми зможемо зреагувати на зміни, раціонально й адресно призначити терапію, буде залежати кінцевий результат.

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Management of Sepsis and Septic Shock

Cited by 176 publications

References 10 publications

Sepsis associated acute kidney injury

Sepsis associated acute kidney injury

Update of Sepsis in the Intensive Care Unit

Сепсис Від Давнини До Сьогодення. Погляд Через Століття

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