title: Challenges in Sepsis Care: New Sepsis Definitions and Fluid Resuscitation Beyond the Central Venous Pressure.
abstract: There are two important recent changes in sepsis care. The first key change is the 2016 Sepsis-3 definitions from the recent consensus workgroup with new sepsis and septic shock definitions. Useful tools for assessing patients that have a greater risk of mortality include Sequential Organ Failure Assessment (SOFA) in intensive care units and quick SOFA outside intensive care units. The second change involves management of fluid resuscitation and measures of volume responsiveness. Measures such as blood pressure and central venous pressure are not reliable. Fluid challenges and responsiveness should be based on stroke volume change of greater than 10%.
authors.affiliation: Christiana Care Health Services, Affiliated Faculty, College of Nursing, University of Delaware, 4755 Ogletown-Stanton Road, Newark, DE 19711, USA. Electronic address: Mseckel@christianacare.org.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Seckel
authors.affiliation: Barnes-Jewish Hospital, St Louis, MO 63110, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ahrens
mesh_terms: D002496:Central Venous Pressure; D003245:Consensus Statements as Topic; D005440:Fluid Therapy / Q000451:nursing / Q000592:standards*; D006801:Humans; D007362:Intensive Care Units; D063305:Organ Dysfunction Scores; D012772:Shock, Septic / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D013318:Stroke Volume
keywords: Fluid challenge; Fluid responsiveness; Sepsis; Stroke volume