critical care medicine
Sepsis and Septic Shock
Key Points
Sepsis and septic shock are increasingly severe clinical syndromes of life-threatening organ dysfunction caused by a dysregulated response to infection. An important component is critical reduction in tissue perfusion, which can lead to acute failure of multiple organs, including the lungs, kidneys, and liver. Early recognition and treatment is the key to improved survival. Resuscitate with intravenous fluids and sometimes vasopressors titrated to optimize central venous oxygen saturation (ScvO2) and preload, and to lower serum lactate levels. Control the source of infection by removing catheters, tubes, and infected and/or necrotic tissue and by draining abscesses. Give empiric broad-spectrum antibiotics directed at most likely organisms and switch quickly to more specific medications based on culture and sensitivity results. 