Management of severe sepsis in the surgical patient.
Sepsis and septic shock are not uncommon conditions in the surgical intensive care unit. Sepsis is a generalized activation of the immune system in the presence of clinically suspected or culture-proven infection. Severe sepsis is sepsis with organ system dysfunction. Septic shock is sepsis with hypotension (systolic blood pressure <90 mm Hg) without other causes. Although the incidence of sepsis is increasing, the case fatality rate is falling. This improvement in outcome is in part due to bold initiatives like the Surviving Sepsis Campaign from the Institute for Health Care Improvement. In this article the authors present the epidemiology of severe sepsis and evidence-based campaigns for its treatment, with a focus on the surgical patient.
Sihler
Kristen C
KC
Section of General Surgery, TC-2924D, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0331, USA.
Nathens
Avery B
AB
D058186:Acute Kidney Injury / Q000503:physiopathology; D000698:Analgesia; D001803:Blood Transfusion; D002985:Clinical Protocols; D016292:Procedural Sedation; D003422:Critical Care; D005440:Fluid Therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D010437:Peptic Ulcer / Q000517:prevention & control; D011486:Protein C / Q000502:physiology; D012151:Resuscitation; D018805:Sepsis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D005938:Glucocorticoids; D011486:Protein C; D014662:Vasoconstrictor Agents