Diagnosis, Management and Treatment of Septic Shock from Early Diagnosis to Infection Focus Control

  title={Diagnosis, Management and Treatment of Septic Shock from Early Diagnosis to Infection Focus Control},
  author={Biagio Liccardo and Tiziana Formisano and Antonello D’Andrea and Mario Giordano and Francesca Martone and Vincenzo Avitabile and Roberta Bottino and Paolo Golino},
Sepsis is a syndrome characterized by clinical signs and symptoms due to infection, with a high rate of mortality, especially if not recognized and treated promptly. In the last years, several definitions were explained about this syndrome. The aim of this review is to give a common and practical definition of septic shock, and to focus on diagnosis, early resuscitation and infection focus control. 

Tables from this paper

Innate host responses to Bovine Viral Diarrhea Virus

Results demonstrate 1373-mediated induction of, and host cell response to, both IFN-α and IFN–γ, and the potential forIFN-γ to be a predictive marker for mortality during BVDV infection.



The management of severe sepsis and septic shock.

Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock*

Effective antimicrobial administration within the first hour of documented hypotension was associated with increased survival to hospital discharge in adult patients with septic shock.

Early lactate clearance is associated with improved outcome in severe sepsis and septic shock*

Lactate clearance early in the hospital course may indicate a resolution of global tissue hypoxia and is associated with decreased mortality rate, and patients with higher lactate clearance after 6 hrs of emergency department intervention have improved outcome compared with those with lower lactate cleared.

Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department*

Elapsed times from triage and qualification for early goal-directed therapy to administration of appropriate antimicrobials are primary determinants of mortality in patients with severe sepsis and septic shock treated with early goal -directed therapy.

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

The task force concluded the term severe sepsis was redundant and updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsi or at risk of developing sepsic shock.

Prognostic Accuracy of Sepsis-3 Criteria for In-Hospital Mortality Among Patients With Suspected Infection Presenting to the Emergency Department

Among patients presenting to the emergency department with suspected infection, the use of qSOFA resulted in greater prognostic accuracy for in-hospital mortality than did either SIRS or severe sepsis, and these findings provide support for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) criteria in theEmergency department setting.

Clinical Trials for the Treatment of Sepsis

The management of Sepsis and the design and conduct of previous clinical trials in Sepsis showed clear trends in survival and morbidity, and these trends are likely to continue into the next decade.

Fluid resuscitation in human sepsis: Time to rewrite history?

The historical and physiological rationale for the introduction of fluid resuscitation as treatment for sepsis is reviewed and a number of significant concerns are highlighted based on current experimental and clinical evidence.

Corticosteroids for severe sepsis: an evidence-based guide for physicians

  • D. Annane
  • Medicine, Biology
    Annals of intensive care
  • 2011
With sepsis, via nongenomic and genomic effects, corticosteroids restore cardiovascular homeostasis, terminate systemic and tissue inflammation, restore organ function, and prevent death.

Systemic host responses in severe sepsis analyzed by causative microorganism and treatment effects of drotrecogin alfa (activated).

  • S. OpalG. Garber G. Bernard
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2003
Results demonstrate that DrotAA, administered as an adjunct to standard anti-infective therapy, can improve the rate of survival for patients who develop severe sepsis regardless of causative microorganism.