Sepsis Treatment

Introduction & Definition:
Sepsis refers to a combination of systematic inflammatory response syndrome (SIRS) and documented infection.
Systematic inflammatory response syndrome (SIRS) refers to the presence of:

Early Treatment of Sepsis

When sepsis is detected during its early stages before it affects vital organs, the condition may be treated at home using antibiotic tablets.
Those with severe sepsis and septic shock may need emergency treatment and should be admitted to ICU.
Provision of comfort, sedative agents, optimal fluid management, and vasoactive and antimicrobial drugs may be helpful in ICU

Symptomatic Treatment

Severe sepsis is accompanied by vasodilation and tissue perforation that leads to reduced cardiac function and cardiac performance.
Patients normally lose fluid from their intravascular regions to extravascular regions due to concomitant capillary leakage and systematic inflammation.
Initial treatment should consist of replenishing the under filled vascular regions with fluid through fluid resuscitation.

Fluid Resuscitation

ncreased amounts of fluid is needed to prevent kidney failure and dehydration.
Within the first 24 and 48 hours, a patient should be given fluid intravenously to replenish vascular volume.
Helps in restoring cardiac functioning by optimizing cardiac preload.
Crystalloid of between 500-100 ml and colloid of between 300-500 ml should be administered after every 3 hours.

Vasoactive Drugs

Vasoactive drugs are useful where fluid resuscitation fails to restore the required perfusion pressure in all the vital organs.
Lifesaving treatment should be aimed at specific hemodynamic objectives
Staff should titrate short-acting vasoactive drugs by the effect on metabolic and circulatory parameters.
Catecholamine such as norepinephrine, epinephrine, and dopamine should be used.

Adjunctive Drug Intervention: Activated Protein C

Activated protein C (aPC) should be administered to improve the survival terms by activating protein C Zymogen.
Through Escherichia coli injection, the administration of aPC can be used reduce mortality due to lower levels of protein C.

Corticosteroids

Low dose of steroids can be used to treat patients having vasopressor-dependent septic shock.
Should be administered to patients whose systolic blood pressure is less than 90 mmHg for more than an hour even after vasopressor therapy and fluid replenishment
Hydrocortisone 200-300 mg/day within the first 7 days.
Oral administration of Fludrocortisone to patients with septic shock at 50µg once every 24 hours

Glucose Control

Administration of intensive insulin therapy can help attaine glucose levels in the range of 4.4 and 6.1 mmoI/L.
Helps to reduce mortality rates by 10 percent.

Diagnosis of Sepsis

Attain at least 2 blood cultures: 1 percutaneous and the other  from each vascular access.
For antibiotics, intravenous antibiotics should begin within the 1st hour of recognizing a septic shock.
Assess antimicrobial regimen  in the next 48 to 76 hours.

Diagnosis of Sepsis

Attain at least 2 blood cultures: 1 percutaneous and the other  from each vascular access.
For antibiotics, intravenous antibiotics should begin within the 1st hour of recognizing a septic shock.
Assess antimicrobial regimen  in the next 48 to 76 hours.

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