Sepsis on the Basis of Suspicion of Infection SUMMARY A suspected or documented infection is required for the diagnosis of sepsis. The lack of a “gold standard” for sepsis diagnosis coupled with the delay of culture results increases the likelihood of including patients in the sepsis management pathway who do not actually
Changes in Sepsis Trends: Real or Artificial? SUMMARY Recent reports indicate a significant increase in the incidence of sepsis with a concomitant drop in mortality. Controversy exists over the true degree of change based on changing definitions and coding practices. Direct clinical indicators of infection and organ dysfunction are preferred
Use of Steroids in Sepsis SUMMARY The use of corticosteroids in sepsis has been recommended on and off for over 40 years. The Surviving Sepsis Campaign (SSC) guidelines previously (2016) did not support steroid use in patients with sepsis, however, the current (2021) recommendation the use of steroids in certain septic shock
3 Major Lactate Considerations in Sepsis SUMMARY Serum lactate measurements have been part of the sepsis bundles since the beginning. The recommendation to use and follow serum lactate concentrations are based on weak and low-quality evidence. Changes in serum lactate concentrations are not solely reflective of changes in production but also based
Should Hemodynamic Profiling be a Sepsis Best Practice? SUMMARY Surviving Sepsis Campaign (SSC) guidelines were previously developed in 2016 and published in 2017. The SSC 2021 guidelines provides an update to the SSC 2016 guidelines. New recommendations are provided for a number of areas in the management of sepsis.
Should Hemodynamic Profiling be a Sepsis Best Practice? SUMMARY Hemodynamic profiles in critically ill patients are complex and change over the sepsis course. Macro-circulatory and micro-circulatory factors contribute equally to the evolving disease state. During the later stages of hemodynamic impairment, both factors must be considered. BACKGROUNDIn addition to
Sepsis Associated Encephalopathy (SAE) SUMMARYSAE is a key manifestation of sepsis occurring in up to 70% of ICU patientsAssociated with higher ICU and hospital mortality and long term consequencesDifficult to assess, diagnose without specific treatment BACKGROUNDSAE is probably the most common type of encephalopathy in the ICUSAE may occur
Top 10 Key Perspectives for Sepsis in 2022 SUMMARY The challenge of sepsis remains for most clinicians There is no one-size fits all approach Several unresolved key areas will remain with us into the next year TOP 10 SEPSIS KEY PERSPECTIVES (in no particular order)
Is the Mortality Rate from Sepsis Improving? SUMMARY The true incidence of sepsis is difficult to define. Sepsis cases are not evenly distributed Despite global efforts on improved recognition and management, the overall sepsis mortality rate has been stable. Sub-segments of the population may be experiencing increasing mortality rates. BACKGROUND
How Should We Screen for Sepsis? SUMMARY Organ dysfunction is one of the defining characteristics in the current definition of sepsis. Many of the markers currently in use are nonspecific. Organ dysfunction and injury are separate processes that need to be differentiated. Understanding ways dysfunction can be better detected will
