From the Guidelines
Clinical sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, as stated in the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) 1.
Definition and Diagnosis
The definition of clinical sepsis requires suspected or documented infection plus acute organ dysfunction, which is typically measured using the Sequential Organ Failure Assessment (SOFA) score with an increase of 2 or more points. Common signs include fever or hypothermia, increased heart rate, rapid breathing, confusion, and decreased urine output. Laboratory findings often show elevated white blood cell count, increased lactate levels, and markers of organ dysfunction.
Key Points
- Sepsis is a life-threatening condition that requires immediate treatment with broad-spectrum antibiotics, usually within one hour of recognition, along with intravenous fluids for hemodynamic support 1.
- Vasopressors like norepinephrine may be needed if hypotension persists despite fluid resuscitation 1.
- Source control through drainage or removal of infected material is essential when applicable.
- Sepsis is a medical emergency with high mortality rates, and outcomes improve significantly with early recognition and prompt intervention following established protocols.
Management
The management of sepsis involves early identification and prompt administration of intravenous fluids and vasopressors, as well as restoring a mean systemic arterial pressure of 65 to 70 mm Hg as a good initial goal during hemodynamic support 1. The 2016 Surviving Sepsis Campaign guidelines suggest that initial hemodynamic resuscitation should be achieved within 3 h, and fluid therapy should be used to improve microvascular blood flow through an increased cardiac output 1.
Outcome
The outcome of sepsis can be significantly improved with early recognition and prompt intervention, and it is essential to follow established protocols to reduce morbidity, mortality, and improve quality of life 1.
From the Research
Definition of Clinical Sepsis
- Sepsis is a clinical syndrome that results from the dysregulated inflammatory response to infection that leads to organ dysfunction 2.
- It is defined as a life-threatening condition caused by a dysregulated host response to infection, with severe organ dysfunction 3, 4.
- The new international criteria and definition for sepsis, The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), define sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection 4, 5.
- Organ dysfunction is determined by an increase in the Sepsis-related Organ Failure Assessment (SOFA) score 5.
Key Characteristics
- Sepsis is a heterogeneous syndrome with a high fatality rate, particularly when not diagnosed and treated early 4.
- It is a global disease burden, with enormous losses to society in terms of financial burden, morbidity, and mortality 2.
- The dysregulated host response to infection leads to immune pathophysiology, which is a key aspect of sepsis 3.
Diagnosis and Management
- Early recognition and timely management of patients with sepsis are crucial 5.
- Sepsis should be treated as quickly and efficiently as possible, with rapid administration of antibiotics and fluids 5.
- Current established treatments include appropriate antimicrobial agents, optimization of intravascular volume, vasopressors, and high-quality supportive care 2.