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3.7.4 - Sepsis and Septic Shock

from Section 3.7 - Infection and Immunity

Published online by Cambridge University Press:  27 July 2023

By
Ravi Bhatia
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.

  2. 2. A change in the Sequential Organ Failure Assessment (SOFA) score post-infection of 2 or above is taken as a diagnosis of sepsis.

  3. 3. Once the diagnosis is made, treatment should be immediate and should involve source control, blood cultures, broad-spectrum antibiotics, 30 ml/kg crystalloid and vasopressors to achieve a mean arterial pressure of >65 and a lactate level of <2.

  4. 4. A quick SOFA (qSOFA) score of 2 or more is a bedside test designed to identify those suspected infective patients with higher morbidity and mortality, and should not be used as a diagnostic test for sepsis.

  5. 5. A SOFA score change of 2 or more represents an overall mortality risk of approximately 10 per cent.

Keywords

infectionimmune responsescoring systems in critical care
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 254 - 256
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Angus, D, van der Poll, T. Severe sepsis and septic shock. N Engl J Med 2013;369:840–51.Google Scholar
Gyawali, B, Ramakrishna, K, Dhamoon, AS. Sepsis: the evolution in definition, pathophysiology, and management. SAGE Open Med 2019;7:1–13.Google Scholar
Howell, MD, Davis, AM. Management of sepsis and septic shock. JAMA 2017;317:847–8.Google Scholar
Opal, SM, Wittebole, X. Biomarkers of infection and sepsis. Crit Care Clin 2020;36:11–22.Google Scholar
Singer, M, Deutschman, CS, Seymour, CW, et al. The Third International consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 2016;315:801–10.Google Scholar

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