Sepsis: an update in 2018

Abstract

Sepsis remains a major source of morbidity and mortality not only in the United States but worldwide. The key to save lives of these patients is to have a multi-pronged approach to the management of sepsis. In this review article we shall go through the specifics of this approach. Sepsis is a life-threatening organ dysfunction caused by dysregulated host response to infection. The septic shock is a subset of sepsis with circulatory and cellular/metabolic dysfunction. Patients with sepsis (formerly severe sepsis) should still be identified by the same organ dysfunction criteria (including lactate level > 2 mmol/L). Organ dysfunction may also be identified using the ‘quick Sepsis-Related Organ Failure Assessment’ (qSOFA). Appropriate source control and immediate treatment with IV antibiotics is a cornerstone of sepsis management. The next step is to resuscitate patients with sepsis-induced hypoperfusion with at least 30 ml/kg of intravenous crystalloid fluid. If the patient is hypotensive despite adequate fluid resuscitation, then use of vasoactive agents like norepinephrine and vasopressin is indicated.Citation: Bangash MF. Sepsis: an update in 2018. Anaesth Pain & Intensive Care 2018;22 Suppl 1:S99-S101