title: Sepsis in Patients With Cirrhosis.
abstract: Patients with cirrhosis are at high risk for sepsis and sepsis-related mortality. Aggressive treatment aimed at avoidance of hypoperfusion and prompt identification and treatment of the causative organism can improve patients' survival. Fluid administration is the first-line treatment to improve perfusion to vital organs; however, care should be taken to assess true intravascular volume status. In patients with adequate intravascular volume, vasopressors are then added to support blood pressure. Complications of cirrhosis often worsen in the setting of sepsis. Portosystemic encephalopathy, pulmonary complications, renal complications, adrenal insufficiency, malnutrition, and insufficient glucose control all must be considered and treated to support a patient with cirrhosis through sepsis. The quality of care that these patients receive ultimately influences their survival.
authors.affiliation: Diane McLaughlin is an Acute Care Nurse Practitioner, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224 (mclaughlin.diane@mayo.edu). Lori Shellenback is a Family Nurse Practitioner, Mayo Clinic, Jacksonville, Florida.
authors.forename: Diane
authors.initials: D
authors.lastname: McLaughlin
authors.affiliation: Diane McLaughlin is an Acute Care Nurse Practitioner, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224 (mclaughlin.diane@mayo.edu). Lori Shellenback is a Family Nurse Practitioner, Mayo Clinic, Jacksonville, Florida.
authors.forename: Lori
authors.initials: L
authors.lastname: Shellenback
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003422:Critical Care / Q000592:standards*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D017410:Practice Guidelines as Topic; D018805:Sepsis / Q000188:drug therapy* / Q000209:etiology* / Q000451:nursing*
chemical_list: D000900:Anti-Bacterial Agents
keywords: cirrhosis; sepsis; shock