Other bulletins in this series include:

Breast Surgery

Wednesday, 3 July 2019

Focus on sepsis

Intensive Care Medicine
Authors: Morten Hylander Møller, Waleed Alhazzani, Manu Shankar-Hari

Sepsis continues to be an important clinical and research problem within critical care, as highlighted in the most recent literature.
The Surviving Sepsis Campaign bundle was updated in 2018 [1]. It was emphasised that within 1 h of presentation with sepsis, clinicians should: measure lactate, obtain blood cultures, administer broad-spectrum antimicrobials, begin fluid resuscitation with 30 ml/kg crystalloids, and apply vasopressors in case of fluid refractory shock. It was recommended that this new sepsis 1-h bundle should be used systematically in emergency departments, wards, and ICUs to reduce the global burden of sepsis [1]. While the 1-h bundle is welcomed and reasonable from a patient perspective, the quality of evidence supporting some individual elements of the bundle is low. A group of international experts representing the European Society of Intensive Care Medicine and the Society of Critical Care Medicine recently highlighted research priorities in the recent Surviving Sepsis Campaign guideline [2]. The top-six research priorities were use of personalised medicine in sepsis, fluid resuscitation, rapid diagnostic tests, empirical antibiotic combination therapy, long-term outcomes, and predictors of organ dysfunction…

No comments: