Materiały źródłowe

• #1 Sepsis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/sepsis/diagnosis-treatment/drc-20351219

  Early, thorough treatment raises the likelihood of recovery. People who have sepsis need close monitoring and treatment in a hospital intensive care unit. This is because people with sepsis may need lifesaving measures to stabilize breathing and heart action. […] Different medications are used in treating sepsis and septic shock. They include: […] Treatment with antibiotics begins as soon as possible. Broad-spectrum antibiotics, which are effective against a variety of bacteria, are often used first. When blood tests results show which germ is causing the infection, the first antibiotic may get switched out for a second one. This second one targets the germ causing the infection. […] The use of intravenous fluids begins as soon as possible. […] Vasopressors narrow blood vessels and help increase blood pressure. A vasopressor medication may be used if blood pressure is too low even after receiving fluids.

• #1 Sepsis: Symptoms, Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/12361-sepsis

  Sepsis treatment needs to begin immediately. The most important concern in sepsis protocol is a quick diagnosis and prompt treatment. […] If your provider diagnoses you with sepsis, theyll usually place you in the intensive care unit (ICU) of the hospital for special treatment. You may receive the following treatment for sepsis: […] Youll receive antibiotics if you have a bacterial infection. […] Youll need fluids to maintain blood flow to your organs and prevent your blood pressure from dropping too low. […] In some cases, you may need them to reach an adequate blood pressure. […] If organ failures occur, youll need other sepsis treatments such as dialysis for kidney failure or mechanical ventilation for respiratory failure. […] You may need surgery to remove damaged tissue.

• #1

  https://www.nhs.uk/conditions/sepsis/treatment-and-recovery/

  Sepsis needs treatment in hospital straight away because it can get worse quickly. […] You should get antibiotics within 1 to 6 hours of arriving at hospital. […] If sepsis is not treated early, it can turn into septic shock and cause your organs to fail. This is life threatening. […] You may need other tests or treatments depending on your symptoms, including: treatment in an intensive care unit, a machine to help you breathe (ventilator), surgery to remove areas of infection. […] Most people make a full recovery from sepsis. But it can take time. […] Most symptoms of post-sepsis syndrome should get better on their own. But it can take time. […] There are things you can do to help with some long-term effects. […] See a GP about treatment for physical side effects, treatment and support for emotional symptoms.

• #1 How Is Sepsis Treated?

  https://www.rwjbh.org/treatment-care/sepsis/treatment-for-sepsis/

  Fast, aggressive treatment boosts the chances of surviving sepsis. People who have sepsis require close monitoring and treatment in a hospital intensive care unit. If you have sepsis or septic shock, lifesaving measures may be needed to stabilize breathing, blood pressure, and heart function. […] Sepsis treatment guidelines follow a multi-pronged approach: […] Initial sepsis treatment begins with a blood draw, cultures and imaging (if needed) to confirm a Sepsis diagnosis. […] If Sepsis is present, then intravenous antibiotics and fluids are administered. […] Fever reducing and / or pain medications may be administered for symptomatic relief. […] Other supportive medications can also include vasoconstrictors, blood pressure supports, and steroids. […] Depending on progress, further imaging and blood work may be necessary to rule out any other concerns.

• #1 Diagnosis and management of sepsis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6303466/

  Sepsis is a common condition with high morbidity and mortality. […] Despite these advances, there is still no molecular signature able to diagnose sepsis. […] No specific therapy targeting the mediators of sepsis has yet proven effective. Prompt administration of appropriate antibiotics is of benefit, together with fluid resuscitation and oxygen. […] Prompt administration of empirical antibiotics is essential in suspected sepsis. […] Use of the Sepsis six bundle will ensure immediate management of patients with sepsis is optimal. […] Immediate resuscitation of a critically ill septic patient is not appreciably different from non-septic patients. […] Studies have shown a clear benefit of rapid use of antimicrobials that target the likely causative pathogens. […] Identification and management of the source of sepsis is also important.

• #1 Sepsis | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/sepsis/

  ANTIBIOTICS […] The main treatment for sepsis, severe sepsis or septic shock is antibiotics. These will be given directly into a vein (intravenously). […] Ideally, antibiotic treatment should start within an hour of diagnosis. […] Intravenous antibiotics are usually replaced by tablets after 2 to 4 days. You may have to take them for 7 to 10 days or longer, depending on the severity of your condition. […] TYPES OF ANTIBIOTICS […] If sepsis is suspected, broad-spectrum antibiotics are given first. This is because there won’t be time to wait until a specific type of infection has been identified. […] Broad-spectrum antibiotics work against a wide range of known infectious bacteria. They usually cure most common infections. […] Once a specific bacterium has been identified, a more focused antibiotic can be used.

• #1 Evaluation and management of suspected sepsis and septic shock in adults – UpToDate

  https://www.uptodate.com/contents/evaluation-and-management-of-suspected-sepsis-and-septic-shock-in-adults

  Rapid infusions of intravenous fluid (30 mL/kg) are indicated as initial therapy for severe sepsis or septic shock unless there is convincing evidence of significant pulmonary edema. […] Prompt identification and treatment of the site(s) of infection is the primary therapeutic intervention, with most other interventions being purely supportive. […] Once a presumed diagnosis of sepsis or septic shock has been made, optimal doses of appropriate intravenous antibiotic therapy should be initiated, preferably within one hour of presentation and after cultures have been obtained. […] The choice of antimicrobials can be complex and should consider the patient’s history, comorbidities, immune defects, clinical context, suspected site of infection, presence of invasive devices, Gram stain data, and local prevalence and resistance patterns.

• #1 Sepsis | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/sepsis/

  VIRAL INFECTIONS […] If the sepsis is caused by a virus, antibiotics won’t work. However, it would be too dangerous to delay treatment to find out the specific cause. This means antibiotics are usually given anyway. […] With a viral infection, you’ll need to wait until your immune system starts to tackle it. However, antiviral medication may be given in some cases. […] INTRAVENOUS FLUIDS […] If you have sepsis, your body needs more fluid to prevent dehydration and kidney failure. […] If you have severe sepsis or septic shock, you’ll usually be given fluids intravenously for the first 24 to 48 hours. […] It’s important that the doctors know how much urine your kidneys are making when you have sepsis. This helps them spot signs of kidney failure. […] If you’re admitted with severe sepsis or septic shock, you’ll usually be given a catheter. This is inserted into your bladder to monitor your urine output.

• #1 Septic Shock Treatment & Management: Approach Considerations, Goals of Hemodynamic Support, Fluid Resuscitation

  https://emedicine.medscape.com/article/168402-treatment

  Hypovolemia is an important factor contributing to shock and tissue hypoxia; therefore, all patients with sepsis require supplemental fluids. […] The Surviving Sepsis Campaign guidelines recommend rapid administration of an initial fluid challenge with 30 mL/kg of crystalloid solution within 3 hours of resuscitation. […] If the patient does not respond to resuscitation with several liters (usually 4 L) of isotonic crystalloid solution or if evidence of volume overload is present, the depressed cardiovascular system can be stimulated by means of vasopressor therapy. […] The recommended first-line agent for septic shock is norepinephrine, preferably administered through a central catheter. […] The goal of vasopressor therapy is to reverse the pathologic vasodilation and altered blood flow distribution that occur as a result of the activation of adenosine triphosphate (ATP)-dependent potassium channels in vascular smooth muscle cells and the synthesis of the vasodilator nitric oxide (NO).

• #1 Treatment | Sepsis Alliance

  https://www.sepsis.org/sepsis-basics/treatment/

  Sepsis is a medical emergency. It needs to be treated as such. In other words, sepsis should be treated as quickly and efficiently as possible as soon as it has been identified. Treatment includes rapid administration of antibiotics and fluids. The risk of death from sepsis increases by an average of up to 7.6% with every hour that passes before treatment begins. […] Antibiotics alone wont treat sepsis; you also need fluids. The body needs extra fluids to help keep the blood pressure from dropping dangerously low, causing shock. Giving IV fluids allows the health care staff to track the amount of fluid and to control the type of fluid. […] Ensuring the body has enough fluids helps the organs to function and may reduce damage from sepsis. […] Here are treatments, medications, and types of equipment that may be used on a patient with sepsis or septic shock.

• #1 Treatment | Sepsis Alliance

  https://www.sepsis.org/sepsis-basics/treatment/

  Extracorporeal therapies are treatments done using machines and techniques such as continuous renal replacement therapy (a type of dialysis) or extracorporeal membrane oxygenation, or ECMO (life support). […] Although doctors dont know why corticosteroids work for some patients who have sepsis and not others, they can be helpful. Corticosteroids can help reduce inflammation in the body and depress the immune system, making it less active. […] Physicians prescribe vasopressors to patients who are in shock and whose blood pressures have dropped dangerously low. The vasopressors act constrict or tighten up the blood vessels, forcing the blood pressure to go up. […] Patients usually get oxygen, by mechanical ventilator, mask or nasal cannula. This ensures the body has enough oxygen in its system.

• #1 Evaluation and management of suspected sepsis and septic shock in adults – UpToDate

  https://www.uptodate.com/contents/evaluation-and-management-of-suspected-sepsis-and-septic-shock-in-adults/print

  For patients with sepsis who remain hypotensive despite adequate fluid resuscitation (eg, 3 L in first three hours), we recommend vasopressors; the preferred initial agent is norepinephrine. For patients who are refractory to intravenous fluid and vasopressor therapy, additional therapies, such as glucocorticoids, inotropic therapy, and blood transfusions, can be administered on an individual basis. […] For patients with sepsis who have demonstrated a response to therapy, we suggest that the rate of fluid administration should be reduced or stopped, vasopressor support weaned, and, if necessary, diuretics administered. We also recommend that antimicrobial therapy be narrowed once pathogen identification and susceptibility data return. Antimicrobial therapy should be pathogen and susceptibility directed for a total duration of 7 to 10 days, although shorter or longer courses are appropriate for select patients.

• #1 Sepsis | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/sepsis/

  OXYGEN […] Your body’s oxygen demand goes up if you have sepsis. […] If you’re admitted to hospital with sepsis and the level of oxygen in your blood is low, you’ll usually be given oxygen. This is given through a mask or tubes in your nostrils. […] TREATING THE SOURCE OF INFECTION […] If a source of the infection can be identified, like an abscess or infected wound, this will also need to be treated. […] For example, any pus may need to be drained away. In more serious cases, surgery may be needed to remove the infected tissue and repair any damage. […] INCREASING BLOOD PRESSURE […] Medications called vasopressors are used if you have low blood pressure caused by sepsis. […] Vasopressors are normally given intravenously while you’re in an ICU. Extra fluids may also be given intravenously to help increase blood pressure.

• #1 8. Supportive Therapy of Severe Sepsis | ATrain Education

  https://www.atrainceu.com/content/8-supportive-therapy-severe-sepsis

  Supportive therapies include blood product administration, mechanical ventilation, sedation, anesthesia and neuromuscular blockade, glucose control, renal replacement therapy, DVT prophylaxis, and good nutrition. […] Guidelines suggest that septic patients with hematocrits below 30% should receive a transfusion of packed red blood cells. […] The Guidelines recommend against the use of erythropoietin for anemia and against the use of fresh frozen plasma (FFP) in the absence of bleeding or planned invasive procedure. […] The Guidelines recommend against the use of immunoglobulins and selenium because there is not enough evidence of benefit in severe sepsis. […] In severe sepsis, patients will likely require mechanical ventilation at some point during their hospitalization. […] To minimize lung injury, patients are usually ventilated using positive end expiratory pressure at low tidal volumes (6 ml/kg body wt) and low plateau pressures 30 cm H2O.

• #1 8. Supportive Therapy of Severe Sepsis | ATrain Education

  https://www.atrainceu.com/content/8-supportive-therapy-severe-sepsis

  The discontinuation of mechanical ventilation is crucial and should be based on a weaning protocol to assess readiness of successful extubation, reducing the duration and the complications related with it. […] The Guidelines recommend: minimal use of sedation during mechanical ventilation, avoiding neuromuscular blocking agents in patients without ARDS, a short course of neuromuscular blockers in patients with ARDS. […] Hyperglycemia is induced by stress and infection, and it is common in critically ill patients, even patients who have no history of diabetes. […] It is recommended that blood glucose levels be kept 180mg/dl for septic patients and that insulin should be used after two consecutive readings that are 180 to control episodes of hyperglycemia. […] The Surviving Sepsis Guidelines for 2012 recommend continuous renal replacement therapies (CRRT) or intermittent hemodialysis as equivalent therapies in patients with severe sepsis and acute renal failure.

• #1 Sepsis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/sepsis/diagnosis-treatment/drc-20351219

  People who have sepsis often get supportive care that includes oxygen. Some people may need a machine help them breathe. If a person’s kidneys don’t work as well because of the infection, the person may need dialysis. […] Surgery may help to remove sources of infection, such as pus, infected tissues or dead tissues.

• #1 Sepsis Treatment: Antibiotics, Medication, and Surgery

  https://www.everydayhealth.com/sepsis/treatment/

  Because the body demands more oxygen in this state, some patients with sepsis and septic shock are placed on mechanical ventilators to give their lungs and body some rest and the ability to heal, warns Brown. […] Once a doctor determines the source of an infection, surgery may be necessary to remove it. Situations that may require surgery include the discovery of an abscess somewhere in the body. […] But while the above are common treatments for sepsis, you may require other types of supportive therapy based on the extent of your condition. […] For example, someone with a low number of red blood cells may receive a blood transfusion while in the hospital. […] As sepsis progresses, kidney damage can also occur. If your kidneys stop functioning properly, youll need dialysis, or renal replacement therapy, to help your kidneys filter blood and remove toxins from your body.

• #1 Pediatric Sepsis: Causes, Symptoms and Treatment | Renown Health

  https://www.renown.org/blog/pediatric-sepsis-causes-symptoms-and-treatment

  Early detection is a crucial factor in the successful treatment of pediatric sepsis. Prompt diagnosis and treatment can be lifesaving and generally involves antibiotics and other medications to reduce inflammation and support vital organs. In addition, electrolyte and fluid levels must be carefully monitored and maintained to prevent dehydration and shock. In some cases, your child may require oxygen therapy to ensure adequate oxygenation of the body. […] Nutrition is important in pediatric sepsis treatment, as malnutrition can worsen the condition and increase the risk of complications. In addition, surgery may be necessary to remove any infected tissue or address any underlying medical conditions contributing to sepsis. Intensive care may be needed in severe cases to ensure vital organs function properly. […] Follow your your doctor’s instructions and watch for changes in the child’s condition. Early detection and immediate treatment are the keys to successful pediatric sepsis treatment.

• #1 About Sepsis | Sepsis | CDC

  https://www.cdc.gov/sepsis/about/?CDC_AAref_Val

  Research shows that rapid, effective sepsis treatment includes: […] Healthcare providers should treat sepsis with antibiotics as soon as possible. […] Sometimes surgery is required to remove tissue damaged by the infection. […] Antibiotics are critical tools for treating infections, including those that can lead to sepsis. […] Improving the way healthcare providers prescribe antibiotics and the way we take antibiotics helps keep us healthy now, helps fight antimicrobial resistance and ensures that these lifesaving drugs will work for you or others when they are needed most, like for treating infections associated with sepsis.

• #1 Treatment | Sepsis Alliance

  https://www.sepsis.org/sepsis-basics/treatment/

  A patient who has an ET tube is intubated. […] Patients may need dialysis if their kidneys cannot filter the blood as they should. […] Ventilators, sometimes called respirators, help patients breathe. […] A urinary catheter is a tube inserted through the urethra to the bladder. It helps drain urine into a bag attached to the side of the bed or strapped to a leg.

• #1 Evaluation and management of suspected sepsis and septic shock in adults – UpToDate

  https://www.uptodate.com/contents/evaluation-and-management-of-suspected-sepsis-and-septic-shock-in-adults

  For patients with sepsis who remain hypotensive despite adequate fluid resuscitation, we recommend vasopressors; the preferred initial agent is norepinephrine. […] Guidelines recommend against the routine use of glucocorticoids in patients with sepsis. However, corticosteroid therapy may be appropriate in patients with septic shock that is refractory to adequate fluid resuscitation and vasopressor administration. […] For patients who respond to therapy, we suggest that the rate of fluid administration should be reduced or stopped, vasopressor support weaned, and, if necessary, diuretics administered.

• #1 Sepsis – Wikipedia

  https://en.wikipedia.org/wiki/Sepsis

  The use of steroids in sepsis is controversial. […] The 2016 Surviving Sepsis Campaign recommends low dose hydrocortisone only if both intravenous fluids and vasopressors are not able to adequately treat septic shock. […] The 2021 Surviving Sepsis Campaign recommends IV corticosteroids for adults with septic shock who have an ongoing requirement for vasopressor therapy.

• #1 Bacterial Sepsis Treatment & Management: Approach Considerations, Surgical Intervention, Consultations

  https://emedicine.medscape.com/article/234587-treatment

  For adults with possible septic shock or a high likelihood for sepsis, we recommend administering antimicrobials immediately, ideally within 1 hr of recognition. […] For adults with sepsis or septic shock, we recommend using crystalloids as first-line fluid for resuscitation. […] For adults with septic shock, we recommend using norepinephrine as the first-line agent over other vasopressors. […] For adults with sepsis or septic shock, we recommend using low molecular weight heparin over unfractionated heparin for VTE prophylaxis. […] For adults with sepsis or septic shock, we recommend initiating insulin therapy at a glucose level of 180mg/dL (10 mmol/L).

• #1 Sepsis and Septic Shock – Critical Care Medicine – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/critical-care-medicine/sepsis-and-septic-shock/sepsis-and-septic-shock

  If a patient with septic shock remains hypotensive after CVP or PAOP has been raised to target levels, norepinephrine (highly individualized dosing) or vasopressin (up to 0.03 units/minute) may be given to increase mean blood pressure to at least 65 mm Hg. […] Parenteral antibiotics should be given as soon as possible after specimens of blood, body fluids, and wound sites have been taken for Gram stain and culture. […] The source of infection should be controlled as early as possible. […] Normalization of blood glucose improves outcome in critically ill patients, even those who are not known to have diabetes, because hyperglycemia impairs the immune response to infection. […] Corticosteroid therapy (eg, hydrocortisone 400 mg IV per day in divided doses) is indicated for patients with adrenal insufficiency documented by cortisol testing.

• #1 8. Supportive Therapy of Severe Sepsis | ATrain Education

  https://www.atrainceu.com/content/8-supportive-therapy-severe-sepsis

  The recommended deep-vein thrombosis prophylaxis for patients with sepsis begins with a combination of low molecular weight heparin (LMWH) and intermittent mechanical compression devices. […] Patients with severe sepsis are at risk for developing upper GI bleeds. […] Enteral nutrition offers several advantages, including lower cost, preservation of the GI mucosal barrier, buffering of gastric acid, preservation of enteral hormone secretion, provision of unique nutrients, decreased incidence of infections, improved wound healing, and avoidance of parenteral nutritional catheters and their complications. […] The 2012 nutritional guidelines for septic patients include: administer oral or enteral feedings rather than complete fasting or administration of IV glucose within the first 48 hours after diagnosis.

• #1 Caring for Patients with Sepsis | Sepsis | CDC

  https://www.cdc.gov/sepsis/hcp/clinical-care/index.html

  Sepsis is a medical emergency. You play a critical role. Protect your patients by acting fast. […] You should immediately evaluate and treat patients who might have sepsis. […] With your fast recognition and treatment, most patients survive. […] Sepsis is diagnosed through a medical assessment by a healthcare provider. […] Start antibiotics as soon as possible in addition to other therapies appropriate for the patient. If a specific bacterial cause of sepsis is known, therapy should be targeted to optimize treatment, and broad-spectrum antibiotics might not be needed. […] Check patient progress frequently. Treatment requires urgent medical care, usually in an intensive care unit in a hospital, and includes careful monitoring of vital signs. Reassess patients with sepsis early and frequently to determine the appropriate duration and type of therapy.

• #1 Sepsis (Septic Shock) Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/sepsis-septic-shock/

  Sepsis requires immediate care in a hospital. […] Doctors will treat sepsis with medicine to treat infection. They will try to find the infection that led to sepsis. […] Machines will track vital signs, including temperature, blood pressure, breathing rate, and pulse rate. You’ll get fluids through an I.V. You may also get strong medicine. This can help raise your blood pressure. […] You might need to be treated in an intensive care unit (ICU) for several days or weeks. An ICU is a part of the hospital where very sick people get care. […] Equipment in the ICU can support your body. That includes your breathing, circulation, fluids, and help for organs like the kidneys and heart. If you need help breathing, a ventilator may be used.

• #1 Sepsis: 4 things for cancer patients to know | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/shifting-opponents-from-fighting-cancer-to-fighting-sepsis.h00-158753901.html

  Your doctor will then identify where the infection started. Controlling the source of the infection can stop the problem from getting worse. […] Sepsis can cause the kidneys, lungs and/or heart to stop working properly. If this happens, you might need extra care in the intensive care unit (ICU). In the ICU, you might need a ventilator for breathing or dialysis for kidney failure. […] It’s important to have follow-up care with your primary health care team to monitor and manage any lingering symptoms. This will help you and your caregiver navigate your recovery after sepsis. […] Preventing sepsis starts with preventing infections. Take these steps to prevent infections: Wash your hands often with soap and water. Stay away from people who are sick. See a doctor and start treatment right away if you get an infection. Stay up to date on your vaccinations. Keep any cuts or wounds clean and covered until they heal. […] Following these steps can help you avoid infections, lower your risk of sepsis and improve your overall health. Reach out to your doctor if you have questions about sepsis symptoms or prevention.

• #1 Sepsis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/syc-20351214

  Sepsis may progress to septic shock. This is a dramatic drop in blood pressure that can damage the lungs, kidneys, liver and other organs. When the damage is severe, it can lead to death. […] Early treatment of sepsis improves chances for survival. […] Any infection could lead to sepsis. Go to a health care provider if you have symptoms of sepsis or an infection or wound that isn’t getting better. […] Symptoms such as confusion or fast breathing need emergency care. […] Most people recover from mild sepsis, but the mortality rate for septic shock is about 30% to 40%. Also, an episode of severe sepsis raises the risk for future infections.

• #1 Septic Shock | Sepsis Alliance

  https://www.sepsis.org/sepsisand/septic-shock/

  Sepsis treatment usually requires intravenous (IV) fluids and antibiotics. It’s essential that the treatment begin as early as possible. The chance of sepsis progressing to severe sepsis and septic shock, causing death, rises by 4% to 9% for every hour treatment is delayed. […] Treating septic shock focuses on increasing the blood pressure, eliminating the infection that triggered the sepsis, and providing support for the organs that are failing. Some treatments could include: IV fluids to raise blood pressure. Medications, including antimicrobials (antibiotics, antivirals), drugs to increase blood pressure, pain relievers, and any other medications to treat immediate issues. Oxygen, either by mask or nasal cannula, or with a ventilator, to help raise oxygen levels in the blood. Surgery, which may be necessary to remove the source of infection, such as gallstones or an inflamed appendix. […] Once the blood pressure is back up to normal levels and it stays there, the patient is no longer in septic shock. The patient is still very ill, but no longer with a too-low blood pressure.

• #1 Bacterial Sepsis Treatment & Management: Approach Considerations, Surgical Intervention, Consultations

  https://emedicine.medscape.com/article/234587-treatment

  Appropriate antimicrobial therapy depends on adequate coverage of the bacteria associated with the specific organ or organ system associated with the infection. […] Many advocate also using antistaphylococcal coverage (eg, vancomycin) empirically. […] Although no drug regimen may be superior to another, time to first dose administration is very important. […] Antibiotics are normally continued until the septic process and surgical interventions have controlled the source of infection. […] Preferred monotherapy regimens for biliary tract infections include imipenem, meropenem, ampicillin-sulbactam, or piperacillin-tazobactam. […] For adults with suspected sepsis or septic shock, we recommend continuously re-evaluating and searching for alternative diagnoses and discontinuing empiric antimicrobials if an alternative cause of illness is demonstrated or strongly suspected.

• #1 Navigating the Modern Landscape of Sepsis: Advances in Diagnosis and Treatment

  https://www.mdpi.com/1422-0067/25/13/7396

  Sepsis poses a significant threat to human health due to its high morbidity and mortality rates worldwide. […] Currently, the general treatment for sepsis is conservative and includes timely antibiotic use and hemodynamic support. […] Despite new sepsis definitions and cumulative epidemiological evidence regarding the benefits of early detection, specific treatments for sepsis are still lacking. The Surviving Sepsis Campaign (SSC) guidelines mostly comprise the best supportive management of hemodynamic support and preventive care against sepsis-associated complications. […] Therefore, as the pathophysiology of sepsis continues to be discovered, immunomodulation has recently emerged as a promising adjuvant therapy. […] This review summarizes the latest updates in immunomodulatory therapies, including blood purification.

• #1 Sepsis Recovery & Post Sepsis Syndrome – The UK Sepsis Trust

  https://sepsistrust.org/get-support/sepsis-recovery-post-sepsis-syndrome/

  Many sepsis survivors can find their recovery challenging after they leave hospital and experience new limitations – UKST is here to support you. […] Around 40% of people who develop sepsis are estimated to experience physical, cognitive, and/or psychological after effects. For most people, these effects will last a few months, but others can face a long road to recovery and develop Post Sepsis Syndrome (PSS). […] If you are struggling with your recovery, or simply want more information about what to expect, you can contact our Support Nurses below. […] Recovery time varies for each person. Generally, it can take a few weeks to a few months, but for some it can take longer. […] For those people who have suffered significant organ damage, recovery can take time and be complex, often involving ongoing treatment requiring input from multiple specialists.

• #1

  https://www2.hse.ie/conditions/sepsis/treatment/

  Your body may need oxygen if you have sepsis. If the level of oxygen in your blood is low, you may need to be given oxygen through a mask or tubes in your nostrils. […] The source of the infection, such as an abscess or infected wound, will also need to be treated. […] Medicines called vasopressors are used if you have low blood pressure caused by sepsis. […] If treated early, most people make a full recovery from sepsis. But it can take time. […] The long-term effects of sepsis are sometimes called post-sepsis syndrome. […] Most symptoms of post-sepsis syndrome should get better on their own. But it can take time.

• #1 Sepsis Recovery & Post Sepsis Syndrome – The UK Sepsis Trust

  https://sepsistrust.org/get-support/sepsis-recovery-post-sepsis-syndrome/

  Common symptoms people can experience after fall into three categories: physical, psychological, and cognitive. […] Post Sepsis Syndrome (PSS) describes a variable set of ongoing issues that people encounter for a prolonged period of time following sepsis. […] The exact cause of PSS is not fully understood, but it is thought to involve a combination of factors, including the body’s immune response, changes in blood flow to organs, and the effects of medical interventions received during sepsis treatment. […] PSS management by healthcare professionals typically involves addressing the specific symptoms experienced by the individual, and may include physical rehabilitation, cognitive rehabilitation, psychological counselling, and supportive care to help improve the patient’s overall wellbeing.

• #1 Sepsis Treatment: Antibiotics, Medication, and Surgery

  https://www.everydayhealth.com/sepsis/treatment/

  Keep in mind that while intravenous fluids and broad-spectrum antibiotics are part of the initial response for most people with sepsis, some people dont initially respond and need a low-dose steroid added to their treatment plan to keep their blood pressure up, says Keith Roach, MD, an internist at NewYork-Presbyterian/Weill Cornell Medical Center in New York City. […] Between treating the source of an infection, fluids, and other types of supportive therapy, it is possible to recover from sepsis. However, the prognosis depends on how early you seek treatment. […] The outlook with mild sepsis is generally positive. But unfortunately, severe sepsis has a mortality rate of nearly 30 percent, and some people have post-sepsis symptoms (fatigue, insomnia, cognitive decline) for weeks or months.

• #1 Spot Sepsis Early: Signs and Immediate Actions to Save Lives

  https://www.upmc.com/services/division-infectious-diseases/conditions/sepsis

  Sepsis is a very serious condition but with prompt treatment, recovery is possible. Your odds of making a complete recovery improve when doctors recognize blood poisoning and act quickly. […] Without treatment, most people who go into septic shock the final stage of sepsis will die. […] People who recover from sepsis are at risk for complications in the months and years that follow. Possible long-term complications of blood poisoning include decreased mental function, insomnia, kidney failure, loss of limbs, loss of self-esteem, lung problems, muscle and joint pain, and nightmares, hallucinations, and panic attacks.

• #1 Sepsis – Wikipedia

  https://en.wikipedia.org/wiki/Sepsis

  The use of corticosteroids is controversial, with some reviews finding benefit, and others not. […] Early recognition and focused management may improve the outcomes of sepsis. […] Current professional recommendations include several actions („bundles”) to be followed as soon as possible after diagnosis. […] Within the first three hours, someone with sepsis should have received antibiotics, and intravenous fluids if there is evidence of either low blood pressure or other evidence for inadequate blood supply to organs. […] Apart from the timely administration of fluids and antibiotics, the management of sepsis also involves surgical drainage of infected fluid collections and appropriate support for organ dysfunction. […] Two sets of blood cultures (aerobic and anaerobic) are recommended without delaying the initiation of antibiotics.

• #1 Sepsis > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/sepsis

  Treatment includes intravenous fluids, antibiotics and other medications, and mechanical ventilation. […] While septic shock can be fatal, many patients can make a complete recovery if they are diagnosed and treated early with antibiotics, intravenous fluids, and blood pressure support. […] The earlier sepsis is detected and treated, the better odds a person with the condition has for full recovery. People who have developed sepsis and most especially those who have progressed into septic shock are usually transferred to a hospitals intensive care unit for supportive care and close monitoring. Septic shock is treated with intravenous fluids, antibiotics, medications to maintain blood pressure, and mechanical ventilation, as needed. Additional treatments such as steroids, vitamins, and surgery to control the source of infection are sometimes required. […] Yale Medicine strives to provide patients with sepsis swift access to a high quality of care. It maintains a quality assurance program focused on sepsis detection, compliance with best practice recommendations, and optimal patient experience.

• #1 Sepsis and Septic Shock: Current Treatment Strategies and New Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5389495/

  In patients with sepsis, metabolic support should be provided in order to prevent malnutrition, to recover the metabolic condition, to regulate inflammation and acute phase response, and to reduce morbidity and mortality rates. […] When needed, organ-supporting treatments (respiratory failure and kidney failure treatments) should be used in sepsis treatment. […] Several new approaches for reducing mortality rates in severe sepsis have been recently reported. These new approaches: Low tidal volume application, intense plasma glucose control in ARDS is a treatment for the target started in the earlier period, and corticosteroid treatment in mean doses. […] Studies show that sepsis is a highly important disease worldwide. Recent studies that focused on unclarified mechanisms underlying sepsis provided new treatment targets for clinicians. Several treatment strategies such as balanced corticosteroid usage, antiendotoxin treatment, vasoactive agents such as levosimendan, HBO treatment, fibrates, and several antioxidant supplements are promising approaches for sepsis treatment.

• #1 Treatment Advances in Sepsis and Septic Shock: Modulating Pro- and Anti-Inflammatory Mechanisms

  https://www.mdpi.com/2077-0383/12/8/2892

  Sepsis is currently defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection, and it affects over 25 million people every year. […] Although early sepsis mortality has greatly improved in the past few years, sepsis patients who survive the hyperinflammation and subsequent organ damage often die from long-term complications, such as secondary infection, and despite decades of clinical trials targeting this stage of the disease, currently, no sepsis-specific therapies exist. […] As new pathophysiological mechanisms have been uncovered, immunostimulatory therapy has emerged as a promising path forward. Highly investigated treatment strategies include cytokines and growth factors, immune checkpoint inhibitors, and even cellular therapies. […] No sepsis-specific therapies exist, and new approaches are urgently needed.

• #1 Sepsis Protocols – Effective Strategies to Combat Sepsis | End Sepsis

  https://www.endsepsis.org/work/sepsis-protocols/

  Sepsis protocols provide guidelines for healthcare providers that facilitate the rapid identification and effective treatment of sepsis. Early identification of sepsis is critical to preventing mortality and morbidity in sepsis cases. […] Sepsis requires urgent treatment, including administration of antibiotics, fluids and other interventions. Protocols outline the steps and time frames for initiating these interventions, helping healthcare providers act swiftly and effectively. […] The following components are typically included in sepsis protocols. […] Administering appropriate antibiotics promptly is crucial. Broad-spectrum antibiotics are typically initiated initially and then tailored based on culture results and patient response. […] Continuous monitoring of vital signs, laboratory values, and clinical parameters is important to assess the response to treatment and adjust as necessary.

• #1 Surviving Sepsis Campaign Guidelines 2021 | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/surviving-sepsis-guidelines-2021

  The hour-1 bundle encourages clinicians to act as quickly as possible to obtain blood cultures, administer broad spectrum antibiotics, start appropriate fluid resuscitation, measure lactate, and begin vasopressors if clinically indicated. […] Minimizing the time to treatment acknowledges the urgency that exists for patients with sepsis and septic shock. […] SSC Hour-1 Bundle of Care Elements: Measure lactate level, Obtain blood cultures before administering antibiotics, Administer broad-spectrum antibiotics, Begin rapid administration of 30mL/kg crystalloid for hypotension or lactate level 4 mmol/L, Apply vasopressors if hypotensive during or after fluid resuscitation to maintain MAP 65 mm Hg. […] There is insufficient evidence to make a recommendation on the use of restrictive versus liberal fluid strategies in the first 24 hours of resuscitation in patients with sepsis and septic shock who still have signs of hypoperfusion and volume depletion after the initial resuscitation.

• #2 Sepsis: Symptoms, Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/12361-sepsis

  Sepsis treatment needs to begin immediately. The most important concern in sepsis protocol is a quick diagnosis and prompt treatment. […] If your provider diagnoses you with sepsis, theyll usually place you in the intensive care unit (ICU) of the hospital for special treatment. You may receive the following treatment for sepsis: […] Youll receive antibiotics if you have a bacterial infection. […] Youll need fluids to maintain blood flow to your organs and prevent your blood pressure from dropping too low. […] In some cases, you may need them to reach an adequate blood pressure. […] If organ failures occur, youll need other sepsis treatments such as dialysis for kidney failure or mechanical ventilation for respiratory failure. […] You may need surgery to remove damaged tissue.

• #2 Diagnosis and management of sepsis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6303466/

  Sepsis is a common condition with high morbidity and mortality. […] Despite these advances, there is still no molecular signature able to diagnose sepsis. […] No specific therapy targeting the mediators of sepsis has yet proven effective. Prompt administration of appropriate antibiotics is of benefit, together with fluid resuscitation and oxygen. […] Prompt administration of empirical antibiotics is essential in suspected sepsis. […] Use of the Sepsis six bundle will ensure immediate management of patients with sepsis is optimal. […] Immediate resuscitation of a critically ill septic patient is not appreciably different from non-septic patients. […] Studies have shown a clear benefit of rapid use of antimicrobials that target the likely causative pathogens. […] Identification and management of the source of sepsis is also important.

• #2 How Is Sepsis Treated?

  https://www.rwjbh.org/treatment-care/sepsis/treatment-for-sepsis/

  Surgery may be necessary depending on the site of the infection. […] If further complications and and/or septic shock develop, treatment may be required in the intensive care unit by a team of highly skilled and specialized doctors and nurses. […] Depending on progress, additional support for breathing (ventilators) or kidneys (dialysis) may be required.

• #2 Sepsis | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/sepsis/

  ANTIBIOTICS […] The main treatment for sepsis, severe sepsis or septic shock is antibiotics. These will be given directly into a vein (intravenously). […] Ideally, antibiotic treatment should start within an hour of diagnosis. […] Intravenous antibiotics are usually replaced by tablets after 2 to 4 days. You may have to take them for 7 to 10 days or longer, depending on the severity of your condition. […] TYPES OF ANTIBIOTICS […] If sepsis is suspected, broad-spectrum antibiotics are given first. This is because there won’t be time to wait until a specific type of infection has been identified. […] Broad-spectrum antibiotics work against a wide range of known infectious bacteria. They usually cure most common infections. […] Once a specific bacterium has been identified, a more focused antibiotic can be used.

• #2 Caring for Patients with Sepsis | Sepsis | CDC

  https://www.cdc.gov/sepsis/hcp/clinical-care/index.html

  Sepsis is a medical emergency. You play a critical role. Protect your patients by acting fast. […] You should immediately evaluate and treat patients who might have sepsis. […] With your fast recognition and treatment, most patients survive. […] Sepsis is diagnosed through a medical assessment by a healthcare provider. […] Start antibiotics as soon as possible in addition to other therapies appropriate for the patient. If a specific bacterial cause of sepsis is known, therapy should be targeted to optimize treatment, and broad-spectrum antibiotics might not be needed. […] Check patient progress frequently. Treatment requires urgent medical care, usually in an intensive care unit in a hospital, and includes careful monitoring of vital signs. Reassess patients with sepsis early and frequently to determine the appropriate duration and type of therapy.

• #2 Treatment | Sepsis Alliance

  https://www.sepsis.org/sepsis-basics/treatment/

  Sepsis is a medical emergency. It needs to be treated as such. In other words, sepsis should be treated as quickly and efficiently as possible as soon as it has been identified. Treatment includes rapid administration of antibiotics and fluids. The risk of death from sepsis increases by an average of up to 7.6% with every hour that passes before treatment begins. […] Antibiotics alone wont treat sepsis; you also need fluids. The body needs extra fluids to help keep the blood pressure from dropping dangerously low, causing shock. Giving IV fluids allows the health care staff to track the amount of fluid and to control the type of fluid. […] Ensuring the body has enough fluids helps the organs to function and may reduce damage from sepsis. […] Here are treatments, medications, and types of equipment that may be used on a patient with sepsis or septic shock.

• #2 Sepsis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/sepsis/diagnosis-treatment/drc-20351219

  People who have sepsis often get supportive care that includes oxygen. Some people may need a machine help them breathe. If a person’s kidneys don’t work as well because of the infection, the person may need dialysis. […] Surgery may help to remove sources of infection, such as pus, infected tissues or dead tissues.

• #2 Navigating the Modern Landscape of Sepsis: Advances in Diagnosis and Treatment

  https://www.mdpi.com/1422-0067/25/13/7396

  Hospital mortality due to sepsis has decreased with the development of treatments, such as the introduction of SSC guidelines. However, the quality of life after survival has often decreased, and patients may not lead a long-term life due to an uncontrolled immune response and resulting organ failure. […] Accordingly, immunomodulatory therapies have begun to receive attention for improving the survival of patients with sepsis, where both excessive inflammation and immunosuppression coexist. […] This study discusses several EBPs widely used in clinical practice. […] The use of an IL-1 receptor antagonist (IL-1 RA) has shown promising results in in vitro and animal studies, randomized controlled trials (RCTs) in humans have not demonstrated a survival benefit. […] However, patients with severe organ failure or a predicted death risk greater than 24% showed improved survival.

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