Sepsis and Septic Shock: Evolving Evidence, Evolving Paradigms.
Citation: Seminars in Respiratory & Critical Care Medicine. 43(1):39-45, 2022 02.PMID: 35172357Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Sepsis | *Shock, Septic | Crystalloid Solutions | Fluid Therapy | Humans | Resuscitation | Sepsis/dt [Drug Therapy] | Shock, Septic/dt [Drug Therapy] | Vasoconstrictor Agents/tu [Therapeutic Use]Year: 2022Abstract: Sepsis and septic shock represent important infection-related medical emergencies that result in significant morbidity and mortality. The prevalence and microbiology of these processes are evolving. Nonetheless, timely and appropriate antibiotic therapy continues to represent the most important determinant of survival. Recent trials have clarified that crystalloids are preferred for initial resuscitation, and balanced crystalloids appear superior to 0.9% saline. Controversy remains regarding not only the rate and rapidity of fluid resuscitation but also about the timing and use of vasopressors to maintain blood pressure. While some newer alternative vasopressors may have a role in sepsis, more evidence supporting their use is required. Conflicting data exist regarding the impact of corticosteroids on mortality in septic shock. However, these reports indicate that adjunctive hydrocortisone can lead to more rapid shock reversal. Copyright Thieme. All rights reserved.Originally published: Seminars in Respiratory & Critical Care Medicine. 43(1):39-45, 2022 Feb.Fiscal year: FY2022Digital Object Identifier: Date added to catalog: 2022-02-22| Item type | Current library | Collection | Call number | Status | Date due | Barcode |
|---|---|---|---|---|---|---|
| Journal Article | MedStar Authors Catalog | Article | 35172357 | Available | 35172357 |
Sepsis and septic shock represent important infection-related medical emergencies that result in significant morbidity and mortality. The prevalence and microbiology of these processes are evolving. Nonetheless, timely and appropriate antibiotic therapy continues to represent the most important determinant of survival. Recent trials have clarified that crystalloids are preferred for initial resuscitation, and balanced crystalloids appear superior to 0.9% saline. Controversy remains regarding not only the rate and rapidity of fluid resuscitation but also about the timing and use of vasopressors to maintain blood pressure. While some newer alternative vasopressors may have a role in sepsis, more evidence supporting their use is required. Conflicting data exist regarding the impact of corticosteroids on mortality in septic shock. However, these reports indicate that adjunctive hydrocortisone can lead to more rapid shock reversal. Copyright Thieme. All rights reserved.
English