Septic Shock: Management and Outcomes

Abstract

The incidence rates of sepsis and septic shock as a complication have become more common over the past several decades. With this increase, sepsis remains the most common cause of intensive care unit (ICU) admissions and one of the most mortality factors, with a huge burden on healthcare facilities. Septic shock has devastating consequences on patients' lives, including organ failures and other long-term complications. Due to its dynamic clinical presentations, guidelines and tools have been established to improve the diagnosis and management effectively. However, there is still a need for evidence-based standardized procedures for the diagnosis, treatment, and follow-up of sepsis and septic shock patients due to the inconsistency of current guidelines and studies contrasting with each other. The standardization would help physicians better manage sepsis, minimize complications and reduce mortality. Septic shock is usually challenging to manage due to its variety of clinical characteristics and physiologic dynamics, affecting the outcomes. Therefore, this review presented the available data in the literature on septic shock diagnosis, management, and prognosis to have an overview of the updated best practice approach to septic shock.

Sepsis among Patients Admitted to the Intensive Care Unit of a Tertiary Care Centre

“…In a previous study, the mortality rate was 36.5%, a similar study showed 35.2% and 39.3% mortality. 6 , 9 , 10 The lower mortality rate in our study can be due to better medical service or many patients being taken home against medical advice.…”

“… 3 Another study showed more than half of patients were above 60 years of age. 6 Most patients 64 (23%) lie within the range of 61-70 years while a previous study showed 51-60 years of age. 3 …”

“…In our study, the prevalence of sepsis was 278 (27.77%) which is higher as compared to other similar studies conducted in Singapor. 6 About 52.88% of the study populations were female, having a female-to-male ratio of 1.12:1. A previous study conducted in Kathmandu, Nepal had a similar result.…”

Result reporting and early discontinuation of sepsis trials registered on ClinicalTrials.gov

“…Vulnerabilities to sepsis can vary by age groups, such as older adults over 65 or infants younger than 1 year old. 37,38 Differences in immune response and pathophysiology of sepsis in different age groups may have substantial impacts on clinical manifestation and requirements of different management methods, [39][40][41] dramatically influencing study design and implementation. However, the current age stratification in some trials was relatively sketchy and the dataset of such a broad age range limits the evaluation of the quality of trials encompassing infants or elderly individuals.…”

Exploring the role of antioxidants in sepsis-associated oxidative stress: a comprehensive review

“…Despite the advancement of our knowledge of sepsis and improved therapeutic modalities, septic shock remains a significant contributor to mortality in intensive care units (ICUs) ( Basodan et al., 2022 ). Though extensive therapeutic studies have been conducted on animals, the results have yet to be successfully translated into human therapeutic practice.…”