Description
"Sepsis is referred to as the ""deadliest killer you've never heard of,"" and the World Health Organization has also made an official resolution urging all of its member states to have national action plans in place to combat it. Every year, sepsis causes 1 in 5 fatalities globally. The annual death toll is estimated to be 6 million in the world, which is a burden on health equivalent to tobacco. According to the current international definition of sepsis, the condition develops when the body's defenses against an infection result in organ malfunction.
Sepsis can damage any organ and cause a wide range of symptoms depending on the infection. It may lead to confusion if the brain is involved, and breathing problems if the lungs are impacted. The aged and very young people, as well as anyone with pre-existing health complications, are particularly at danger. Sepsis is a widespread and deadly medical condition that soaks up a significant amount of resources. The mortality rate is still significant, and there are severe long-term repercussions, such as total disability."
Summary Listen
- Sepsis is a major global health concern with high incidence and mortality rates, projected to increase further in the coming decades. It is a disregulated immune response to an infection leading to life-threatening organ dysfunction, and survivors often experience long-term physical and psychological effects. Early recognition of sepsis is critical, utilizing tools like quick SOFA, NEWS, or SIRS, in conjunction with clinical suspicion.
- The speaker emphasized differentiating infection from sepsis, as well as sepsis from septic shock. Serum lactate levels are important for diagnosis, and the appropriate laboratory tests must be ordered in order to best assess a patient. Sepsis management must begin immediately upon identification, with careful attention to airway, breathing, and circulation.
- Fluid resuscitation is a cornerstone of sepsis management, but it needs to be individualized. A single 30 ml/kg fluid bolus may be harmful, and clinicians should use dynamic measures to assess fluid responsiveness, such as passive leg raising tests. The choice of intravenous fluid is not as important as the amount administered. Recent studies have provided evidence that the judicious use of normal saline or balanced crystalloid solution may be considered, and that albumin may help.
- Early vasopressor support is vital to improve tissue perfusion in sepsis and septic shock. Norepinephrine is the first-line agent, and vasopressin can be added for those not responding to norepinephrine alone, as per the latest guidelines. Early, balanced, and multimodal therapy should become a standard. Blood pressure targets should be in the 65-70 mmHg range.
- The administration of timely and appropriate antibiotics is crucial in sepsis management. Initial therapy should be broad-spectrum to combat potential multidrug-resistant organisms, but prompt reevaluation is necessary to de-escalate or discontinue antibiotics if a non-infectious etiology is identified.
- Corticosteroids can be considered for septic shock patients refractory to fluid and vasopressor therapy, but should not be routine. Hydrocortisone is the preferred agent. Addressing the underlying source of infection through definitive source control is also a critical aspect of sepsis management.
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