title: Severe sepsis during pregnancy.
abstract: Severe sepsis is a major cause of mortality among critically ill patients. Early recognition accompanied by early initiation of broad-spectrum antibiotics with source control and fluid resuscitation improves outcomes. Hemodynamic resuscitation starts with fluid therapy followed by vasopressors if necessary. Cases refractory to first-line vasopressors (norepinephrine) will require second-line vasopressors (epinephrine or vasopressin) and low-dose steroid therapy. Resuscitation goals should include optimization of central venous oxygenation and serum lactate.
authors.affiliation: *Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine †Department of Anesthesiology, Division of Surgical Critical Care, The University of Texas Medical Branch at Galveston, Galveston, Texas.
authors.forename: Luis D
authors.initials: LD
authors.lastname: Pacheco
authors.forename: George R
authors.initials: GR
authors.lastname: Saade
authors.forename: Gary D V
authors.initials: GD
authors.lastname: Hankins
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D009638:Norepinephrine / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy*; D018805:Sepsis / Q000628:therapy; D012772:Shock, Septic / Q000628:therapy*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014667:Vasopressins / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D009638:Norepinephrine; D004837:Epinephrine