Sepsis
Introduction
According to The Third International Concensus Definition of Sepsis, sepsis is life-threatening organ dysfunction caused by dysregulated host response to infection.
- Organ dysfunction can be identified as an acute change in the total SOFA score of 2 points or higher consequent to infection.
Without timely treatment, sepsis may advance to septic shock, which is defined as vasodilatory hypotension below a mean arterial pressure of 65 mm Hg and lactate level > 2 mmol/L (18 mg/dL) despite adequate fluid resuscitaiton and is associated with increased mortality (>40%).
Screening Tools
A variety of clinical variables (signs of infection, vital signs) and tools may be used for screening, e..g SIRS, NEWS2 or MEWS.
Notably, the 2021 Survival Sepsis Campaign Guidelines recommends agaisnt the use of qSOFA as a single screening tool for sepssi.
Initial Resuscitation
After recognition of sepsis and septic shock, quick action is essential. Time to treatment should be minimized and close monitoring for responses to interventions is required.
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