Sepsis protocols to reduce mortality in resource-restricted settings: A systematic review

Taj, Mehrunnissa; Brenner, Michael; Sulaiman, Zeenat; Pandian, Vinciya

doi:10.1016/j.iccn.2022.103255

Cited by 14 publications

(7 citation statements)

References 31 publications

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“…This approach may be beneficial in settings lacking appropriate ventilator support. These populations-and resource-dependent findings raise many questions regarding the validity of a universal resuscitation approach in all sepsis patients [ 11 , 74 , 76 ]. In a multicenter retrospective analysis published in 2017, Seymour et al showed no association between mortality and time to completion of fluid bolus during mandated emergency care for sepsis in New York [ 38 ].…”

Section: Managementmentioning

confidence: 99%

Management of Sepsis and Septic Shock: What Have We Learned in the Last Two Decades?

Kamath,

Hammad Altaq,

Abdo

2023

Microorganisms

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Sepsis is a clinical syndrome encompassing physiologic and biological abnormalities caused by a dysregulated host response to infection. Sepsis progression into septic shock is associated with a dramatic increase in mortality, hence the importance of early identification and treatment. Over the last two decades, the definition of sepsis has evolved to improve early sepsis recognition and screening, standardize the terms used to describe sepsis and highlight its association with organ dysfunction and higher mortality. The early 2000s witnessed the birth of early goal-directed therapy (EGDT), which showed a dramatic reduction in mortality leading to its wide adoption, and the surviving sepsis campaign (SSC), which has been instrumental in developing and updating sepsis guidelines over the last 20 years. Outside of early fluid resuscitation and antibiotic therapy, sepsis management has transitioned to a less aggressive approach over the last few years, shying away from routine mixed venous oxygen saturation and central venous pressure monitoring and excessive fluids resuscitation, inotropes use, and red blood cell transfusions. Peripheral vasopressor use was deemed safe and is rising, and resuscitation with balanced crystalloids and a restrictive fluid strategy was explored. This review will address some of sepsis management’s most important yet controversial components and summarize the available evidence from the last two decades.

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Section: Managementmentioning

confidence: 99%

Management of Sepsis and Septic Shock: What Have We Learned in the Last Two Decades?

Kamath,

Hammad Altaq,

Abdo

2023

Microorganisms

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“…Siendo de esta manera la complicación más severa de un proceso infeccioso, el cual desencadena respuesta inflamatoria sistémica (temperatura corporal > 38 o < 36 o C, frecuencia cardiaca > 90 latidos/minuto, frecuencia respiratoria > 20 respiraciones/minuto) e inmunológica (leucocitos > 12, 000 o < 4,000 cel/μL) en el organismo, además de modificaciones en el equilibrio ácido-base. 7 La sepsis y el choque séptico son las patologías principalmente tratadas en la UCI debido a su a elevada morbilidad y mortalidad. A causa de esto, se han desarrollo diversos estudios con la finalidad de establecer una estandarización diagnóstica eficiente y con el propósito de normalizar el metabolismo, oxigenación y gasto cardiaco.…”

Section: Sepsis Y Choque Sépticounclassified

Aclaramiento de lactato y déficit de base estándar como pronóstico de mortalidad en choque séptico

Mora¹,

Rodríguez²,

Munguía³

et al. 2022

Medicina Crítica

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“…Notwithstanding important medical advances, sepsis even now poses a major challenge for both clinicians and trialists, with its treatment still limited to antibiotics, fluid therapy and organ supportive therapy. As for many years no new therapies have become available, it is still very difficult to deal with and continues to be a leading cause of mortality worldwide, affecting both resource-rich and resource-restricted countries [ 3 , 4 ] and taking its toll across all age groups [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. A recent study estimated that in 2017 sepsis occurred in 48.9 million people globally, and was responsible for 11 million deaths [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Sepsis Phenotypes in Critically Ill Patients

Papathanakos,

Andrianopoulos,

Xenikakis

et al. 2023

Microorganisms

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Sepsis, defined as the life-threatening dysregulated host response to an infection leading to organ dysfunction, is considered as one of the leading causes of mortality worldwide, especially in intensive care units (ICU). Moreover, sepsis remains an enigmatic clinical syndrome, with complex pathophysiology incompletely understood and a great heterogeneity both in terms of clinical expression, patient response to currently available therapeutic interventions and outcomes. This heterogeneity proves to be a major obstacle in our quest to deliver improved treatment in septic critical care patients; thus, identification of clinical phenotypes is absolutely necessary. Although this might be seen as an extremely difficult task, nowadays, artificial intelligence and machine learning techniques can be recruited to quantify similarities between individuals within sepsis population and differentiate them into distinct phenotypes regarding not only temperature, hemodynamics or type of organ dysfunction, but also fluid status/responsiveness, trajectories in ICU and outcome. Hopefully, we will eventually manage to determine both the subgroup of septic patients that will benefit from a therapeutic intervention and the correct timing of applying the intervention during the disease process.

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Sepsis protocols to reduce mortality in resource-restricted settings: A systematic review

Cited by 14 publications

References 31 publications

Management of Sepsis and Septic Shock: What Have We Learned in the Last Two Decades?

Management of Sepsis and Septic Shock: What Have We Learned in the Last Two Decades?

Aclaramiento de lactato y déficit de base estándar como pronóstico de mortalidad en choque séptico

Clinical Sepsis Phenotypes in Critically Ill Patients

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