Sepsis Treatment

Student’s Name
Date of Presentation

Objectives of Treatment

Early therapeutic intervention such as antibiotic treatment (apposite prescription and spectrum)
Revivify the patient through supportive measures to correct hypoperfusion, hypoxia, and hypotension
Maintain proper organ system function through cardiovascular monitoring
Identify the source of infection and practice source control through surgery or antimicrobial therapy

Sepsis is clinical syndrome characterized by systematic inflammatory response to reaction causing organ failure with a high percentage of patients (15%) experiencing renal failures (Ventetuolo and Levy 2015; Hasday and Garrison 2000)
It is a combination of systemic inflammatory response syndrome (SIRS) and documented infection (Girbes, Beishuizen, Strack an Schijndel, 2008) with a high mortality rate of 30-50 percent despite the current medical intervention (Hasday and Garrison 2000)
Early recognition, diagnosis, and management of the disease is the greatest challenge in the contemporary critical care medicine (Wheeler et al., (2009)

Most microorganisms, mostly gram-positive organisms bacteria such as Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae (Simmons, Durham, and Carter, 2012)
Respiratory infections are the common cause of sepsis, severe sepsis, and septic shock, followed by genitourinary and abdominal sources of infection (Martin, 2013)
Fever, fast heartbeat and breathing, chills and shivering, muscle pain, nausea and vomiting
Procalcitonin (PCT) is the best biomarker for sepsis
Diagnosis processes include Blood culture, Chest X-ray and CT scan, and Body fluid analysis (spinal fluid, mucus, and urine)

Sepsis Treatment

Sepsis: SIRS in the presence of or because of alleged or confirmed infection
Antibiotic therapy: broad-spectrum antibiotics such as Fluoroquinolones, β-Lactams, Aminoglycosides, and Vancomycin (Simmons, Durham, and Carter, 2012)
Source control: abscess or surgery
Fluid Resuscitation: crystalloids such as 0.9% sodium chloride and colloids such as hydroxyethylstarch solutions (Simmons, Durham, and Carter, 2012)

Severe Sepsis Treatment

Severe Sepsis: Sepsis and either Acute respiratory distress syndrome, cardiovascular organ dysfunction, or two or more organ dysfunctions including neurological, hematologic, hepatic, respiratory, and renal (Simmons, Durham, and Carter, 2012)
Activated protein C: promotes fibrinolysis and limit the production of thrombin using drotrecogin alfa (activated) (DAA) (Rice, 2006)
Corticosteroids: low-dosage corticosteroids such as hydrocortisone 200 to 300 mg/d for seven days
Heparin inhibits thrombin by forming a complex inhibitor with antithrombin III
Tissue factor inhibitors (TF): a transmembrane glycoprotein mediator for coagulation and inflammatory cascades that use TF pathway inhibitor (TFPI) (Rice, 2006)

Septic Shock Treatment

Septic Shock: cardiovascular failure and sepsis
Resuscitation supports respiratory and cardiac functions
Fluid Resuscitation uses crystalloid or colloid (albumin, dextran, and gelatins) solutions to achieve volume resuscitation (Simmons, Durham, and Carter, 2012)
Vasopressor Therapy stimulates the cardiovascular system when resuscitation is ineffective. It uses Inotropic agents and vasopressors to improve oxygen delivery and preserve cardiac output (Ventetuolo & Levy 2015)
Examples of vasopressors include dopamine, norepinephrine, Epinephrine, Phenylephrine, and antidiuretic hormone (ADH)
Other approaches include
Empiric Antimicrobial Therapy

Summary and Conclusion

Sepsis is clinical syndrome characterized by systematic inflammatory response to reaction causing organ failure with a high percentage of patients (15%) experiencing renal failures
The disorder has three stages: sepsis, severe sepsis, and septic shock
Primary cause: bacterial infection
The main treatment approaches include
Fluid Resuscitation
Vasopressor Therapy
Source control
Corticosteroid Therapy
Glucose control


Girbes, A. R., Beishuizen, A., & Schijndel, R. J. (2008). Pharmacological treatment of sepsis. Fundamental & Clinical Pharmacology, 22(2008), 355-361. doi:10.1111/j.1472-8206.2008.00606.x
Hasday, J. D., & Garrison, A. (2000). Antipyretic Therapy in Patients with Sepsis. Clinical Infectious Diseases, 2000(31), 234-241. doi:10.1086/317514
Martin, G. S. (2012). Sepsis, severe sepsis and septic shock: changes in incidence, pathogens and outcomes. Expert Review of Anti-Infective Therapy,10(6), 701–706.
Rice, T. W. (2006). Treatment of Severe Sepsis: Where Next? Current and Future Treatment Approaches After the Introduction of Drotrecogin Alfa.Vascular Health and Risk Management, 2(1), 3–18.

References cont.

Simmons, M. L., Durham, S., & Carter, C. W. (2012). Pharmacological Management of the Pediatric Patients With Sepsis. AACN Advanced Critical Care, 23(4), 437-448.
Ventetuolo, C. E., & Levy, M. M. (2008). Sepsis: A Clinical Update. Clinical Journal of the American Society of Nephrology, 3(2), 571-577.
Wheeler, D. S., Zingarelli, B., Wheeler, W. J., & Wong, H. R. (2009). Novel Pharmacologic Approaches to the Management of Sepsis: Targeting the Host Inflammatory Response. Recent Patents on Inflammation & Allergy Drug Discovery, 3(2), 96–112.

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