Journal
SURGICAL CLINICS OF NORTH AMERICA
Volume 97, Issue 6, Pages 1339-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.suc.2017.07.003
Keywords
Sepsis; Septic shock; Resuscitation; Goal-directed therapy; Critical care
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Three therapeutic principles most substantially improve organ dysfunction and survival in sepsis: early, appropriate antimicrobial therapy; restoration of adequate cellular perfusion; timely source control. The new definitions of sepsis and septic shock reflect the inadequate sensitivity, specify, and lack of prognostication of systemic inflammatory response syndrome criteria. Sequential (sepsis-related) organ failure assessment more effectively prognosticates in sepsis and critical illness. Inadequate cellular perfusion accelerates injury, and reestablishing perfusion limits injury. Multiple organ systems are affected by sepsis and septic shock, and an evidence-based multipronged approach to systems-based therapy in critical illness results in improve outcomes.
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