Severe sepsis and septic shock continue to be among of the leading causes of death in intensive care unit patients, carrying an estimated mortality rate between 30% and 50%. This article provides an evidence-based focused review of sepsis, including an update on management strategies based on the most recent guidelines published by the Surviving Sepsis Campaign.
AngusDCLinde-ZwirbleWTLidickerJClermontGCarcilloJPinskyMR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303-1310.
2.
PapadakosPJHaitsmaJJ. Cytokines: the tomb markers of the ICU. Chest. 2004;125:1980-1982.
3.
RussellJA. Management of sepsis. N Engl J Med. 2006;355:1699-1713.
4.
PapadakosPSzaladosJE. Critical Care: The Requisites in Anesthesiology. 1st ed. St Louis, MO: Mosby; 2005.
5.
VincentJLOpalSMMarshallJCTraceyKJ. Sepsis definitions: time for change. Lancet. 2013;381:774-775.
6.
MovatHZCybulskyMIColditzIGChanMKDinarelloCA. Acute inflammation in gram-negative infection: endotoxin, interleukin 1, tumor necrosis factor, and neutrophils. Fed Proc. 1987;46:97-104.
7.
BoneRCFisherCJJrClemmerTPSlotmanGJMetzCABalkRA. A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med. 1987;317:653-658.
8.
ZieglerEJFisherCJJrSprungCL. Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. A randomized, double-blind, placebo-controlled trial. The HA-1A Sepsis Study Group. N Engl J Med. 1991;324:429-436.
9.
FisherCJJrAgostiJMOpalSM. Treatment of septic shock with the tumor necrosis factor receptor:Fc fusion protein. The Soluble TNF Receptor Sepsis Study Group. N Engl J Med. 1996;334:1697-1702.
10.
BernardGRWheelerAPRussellJA. The effects of ibuprofen on the physiology and survival of patients with sepsis. The Ibuprofen in Sepsis Study Group. N Engl J Med. 1997;336:912-918.
11.
HotchkissRSKarlIE. The pathophysiology and treatment of sepsis. N Engl J Med. 2003;348:138-150.
12.
HotchkissRSOpalS. Immunotherapy for sepsis—a new approach against an ancient foe. N Engl J Med. 2010;363:87-89.
13.
SchoutenMWiersingaWJLeviMvan der PollT. Inflammation, endothelium, and coagulation in sepsis. J Leukoc Biol. 2008;83:536-545.
14.
WarrenBLEidASingerP. Caring for the critically ill patient. High-dose antithrombin III in severe sepsis: a randomized controlled trial. JAMA. 2001;286:1869-1878.
15.
AbrahamEReinhartKOpalS. Efficacy and safety of tifacogin (recombinant tissue factor pathway inhibitor) in severe sepsis: a randomized controlled trial. JAMA. 2003;290:238-247.
16.
RanieriVMThompsonBTBariePS. Drotrecogin alfa (activated) in adults with septic shock. N Engl J Med. 2012;366:2055-2064.
17.
1van der PollTLeviM. Crosstalk between inflammation and coagulation: the lessons of sepsis. Curr Vasc Pharmacol. 2012;10:632-638.
18.
LevyMMDellingerRPTownsendSR. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Intensive Care Med. 2010;36:222-231.
19.
MarshallJCDellingerRPLevyM. The Surviving Sepsis Campaign: a history and a perspective. Surg Infect (Larchmt). 2010;11:275-281.
20.
DellingerRPLevyMMRhodesA. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39:165-228.
21.
GuyattGHOxmanADVistGE. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924-926.
22.
RiversEP. Point: adherence to early goal-directed therapy: does it really matter? Yes. After a decade, the scientific proof speaks for itself. Chest. 2010;138:476-480.
23.
RiversENguyenBHavstadS. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368-1377.
24.
JonesAEShapiroNITrzeciakSArnoldRCClaremontHAKlineJA. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010;303:739-746.
25.
JansenTCvan BommelJSchoonderbeekFJ. Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial. Am J Respir Crit Care Med. 2010;182:752-761.
26.
AlamFFMustafaASKhanZU. Comparative evaluation of (1,3)-beta-D-glucan, mannan and anti-mannan antibodies, and Candida species-specific snPCR in patients with candidemia. BMC Infect Dis. 2007;7:103.
27.
SendidBDotanNNseirS. Antibodies against glucan, chitin, and Saccharomyces cerevisiae mannan as new biomarkers of Candida albicans infection that complement tests based on C. albicans mannan. Clin Vaccine Immunol. 2008;15:1868-1877.
28.
Assink-de JongEde LangeDWvan OersJANijstenMWTwiskJWBeishuizenA. Stop Antibiotics on guidance of Procalcitonin Study (SAPS): a randomised prospective multicenter investigator-initiated trial to analyse whether daily measurements of procalcitonin versus a standard-of-care approach can safely shorten antibiotic duration in intensive care unit patients—calculated sample size: 1816 patients. BMC Infect Dis. 2013;13:178.
29.
PernerAHaaseNGuttormsenAB. Hydroxyethyl starch 130/0.42 versus Ringer’s acetate in severe sepsis. N Engl J Med. 2012;367:124-134.
30.
MyburghJAFinferSBellomoR. Hydroxyethyl starch or saline for fluid resuscitation in intensive care. N Engl J Med. 2012;367:1901-1911.
31.
PerelPRobertsI. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev. 2011;(3):CD000567.
32.
MarikPECavallazziRVasuTHiraniA. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit Care Med. 2009;37:2642-2647.
33.
De BackerDBistonPDevriendtJ. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med. 2010;362:779-789.
34.
MarikPEMohedinM. The contrasting effects of dopamine and norepinephrine on systemic and splanchnic oxygen utilization in hyperdynamic sepsis. JAMA. 1994;272:1354-1357.
35.
MartinCViviandXLeoneMThirionX. Effect of norepinephrine on the outcome of septic shock. Crit Care Med. 2000;28:2758-2765.
36.
PatelGPGraheJSSperryM. Efficacy and safety of dopamine versus norepinephrine in the management of septic shock. Shock. 2010;33:375-380.
37.
RuokonenETakalaJKariASaxenHMertsolaJHansenEJ. Regional blood flow and oxygen transport in septic shock. Crit Care Med. 1993;21:1296-1303.
38.
De BackerDAldecoaCNjimiHVincentJL. Dopamine versus norepinephrine in the treatment of septic shock: a meta-analysis. Crit Care Med. 2012;40:725-730.
39.
DunserMWMayrAJTurA. Ischemic skin lesions as a complication of continuous vasopressin infusion in catecholamine-resistant vasodilatory shock: incidence and risk factors. Crit Care Med. 2003;31:1394-1398.
40.
DellingerRPLevyMMCarletJM. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med. 2008;36:296-327.
41.
ShuklaA. Updates on role of human recombinant activated protein C in patients with sepsis and severe sepsis: changed scenario after PROWESS SHOCK trial. Indian J Anaesth. 2012;56:597-598.
42.
NICE-SUGAR Study Investigators; FinferSChittockDRSuSY. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360:1283-1297.