Pre-anesthetic stabilization in the patient with sepsis

Abstract

Sepsis is an organic dysfunction of significant relevance in the rate of hospitalizations and deaths in veterinary clinics and hospitals. Patients may arrive in a state of shock, presenting serious systemic changes, such as hypotension, hypovolemia, tissue hypoperfusion, metabolic acidosis, among other disorders that can compromise the animal's life during an anesthetic and surgical procedure. Performing surgical procedures on dogs and cats with sepsis requires a meticulous approach, adapted to the individual conditions of each patient, where maintaining tissue perfusion and oxygenation is of great importance. Therefore, to manage hypotension, volume replacement with crystalloids is recommended. If there is no response, the use of vasoactive agents is indicated, such as norepinephrine, adrenaline, dobutamine and vasopressin. Furthermore, the use of corticosteroids, such as hydrocortisone, is recommended in cases of hypotension refractory to fluid therapy and vasopressors. The purpose of this literature review is to carry out a brief analysis of sepsis, highlighting the main measures for stabilizing septic patients in the pre-anesthetic period. The central focus lies in discussing the approach used for hemodynamic stabilization before the patient enters the operating room. A more in-depth understanding of anesthetic considerations in cases of sepsis may result in more efficient and less risky management of these patients, with a potential positive impact on the well-being of these individuals in such conditions.