Skip to main content
SpringerLink
Log in

Septic Shock and Resuscitation Strategies

  • Chapter
  • First Online:
Acute Care Surgery Handbook

  • 1515 Accesses

Abstract

Sepsis and septic shock are a common cause of admission to the surgical intensive care unit (SICU). Moreover, it remains a significant contributor to the morbidity and mortality in the SICU. Despite the clear culpability of this affliction to cause disease, its understanding, and hence treatment, remains unclear. This discussion focuses on the current updated definitions of sepsis and its entities, explains the underlying pathophysiology, and attempts to provide a framework for its treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Martin GS, Mannino DM, Eaton S, et al. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546–54.

    Article  PubMed  Google Scholar 

  2. Heron M, Hoyert DL, Murphy SL, et al. Deaths: final data for 2006. National vital statistics report, vol. 57, no. 14. National Center for Health Statistics; 2009.

    Google Scholar 

  3. Bone RC, Balk RA, Cerra FB, et al. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med. 1992;20:864–74.

    Article  Google Scholar 

  4. Levy MM, Fink MP, Marshall JC. 2001 SCCM/ESICM/ACCP/ATS/STS/SIS International sepsis definitions conference. Crit Care Med. 2003;31:1250–6.

    Article  PubMed  Google Scholar 

  5. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315:801–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Sands KE, Bates DW, Lanken PN, et al. Epidemiology of sepsis syndrome in 8 academic medical centers. JAMA. 1997;278:234–40.

    Article  CAS  PubMed  Google Scholar 

  7. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315:762–74.

    Article  CAS  PubMed  Google Scholar 

  8. Vigushin DM, Pepys MB, Hawkins PN. Metabolic and scintigraphic studies of radioiodinated human C-reactive protein in health and disease. J Clin Invest. 1993;91:1351–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Lobo SM, Lobo FR, Bota DP, et al. C-reactive protein levels correlate with mortality and organ failure in critically ill patients. Chest. 2003;123(6):2043–9.

    Article  CAS  PubMed  Google Scholar 

  10. Schmidt X, Vincent JL. The time course of blood c-reactive protein levels in relation to the response to initial antimicrobial therapy in patients with sepsis. Infection. 2008;36:213–9.

    Article  Google Scholar 

  11. Becker KL, Snider R, Nylen ES. Procalcitonin assay in systemic inflammation, infection and sepsis: clinical utility and limitations. Crit Care Med. 2008;36:941–52.

    Article  CAS  PubMed  Google Scholar 

  12. Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet. 1993;341:515–8.

    Article  CAS  PubMed  Google Scholar 

  13. Uzzan B, Cohen R, Nicolas P, et al. Procalcitonin as a diagnostic test for sepsis in adults after surgery or trauma: a systematic review and meta-analysis. Crit Care Med. 2006;34:1996–2003.

    Article  CAS  PubMed  Google Scholar 

  14. Charles PE, Tinel C, Barbar S, et al. Procalcitonin kinetics within the first days of sepsis: relationship with the approproateeness of antubiotic therapuy and the outcomes. Crit Care. 2009;13:R38.

    Article  PubMed  PubMed Central  Google Scholar 

  15. A feasibility trial to detect sepsis in the emergency department based upon blood monocyte volume variability. In: Crouser E, Parrillo J, Angus D, et al. 45th critical care congress, Society of Critical Care Medicine, Orlando; 2016.

    Google Scholar 

  16. Dellinger RP, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock. Crit Care Med. 2008;36:296–327.

    Article  PubMed  Google Scholar 

  17. Levy MM, Dellinger RP, Townsend SR, et al. The surviving sepsis campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med. 2010;38:367–74.

    Article  PubMed  Google Scholar 

  18. Gao F, Melody T, Daniels DF, et al. The impact of compliance with 6-hour and 24-hour sepsis bundles on hospital mortality in patients with severe sepsis: a prospective observational study. Crit Care. 2005;9:R764–70.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Ferrer R, Artigas A, Suarez D, et al. Effectiveness of treatments for severe sepsis: a prospective, multicenter, observational study. Am J Respir Crit Care Med. 2009;180:861–6.

    Article  CAS  PubMed  Google Scholar 

  20. Castellanos-Ortega A, Suberviola B, Garcia-Astudillo LA, et al. Impact of the surviving sepsis campaign protocols on hospital length of stay and mortality in septic shock patients: results of a three-year follow-up quasi-experimental study. Crit Care Med. 2010;38:1036–43.

    Article  PubMed  Google Scholar 

  21. Rivers E, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368–77.

    Article  CAS  PubMed  Google Scholar 

  22. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:19.

    Article  Google Scholar 

  23. Finfer S, et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004;350:2247–56.

    Article  CAS  PubMed  Google Scholar 

  24. Choi PT, et al. Crystalloids vs. colloids in fluid resuscitation: a systematic review. Crit Care Med. 1999;27:200–10.

    Article  CAS  PubMed  Google Scholar 

  25. Schierhout G, Roberts I. Fluid resuscitation with colloid or crystalloid solutions in critically ill patients: a systematic review of randomised trials. BMJ. 1998;316:961–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Hébert PC, Wells G, Blajchman MA, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med. 1999;340:409–17.

    Article  PubMed  Google Scholar 

  27. Annane D, Bellissant E, Bollaert PE, et al. Corticosteroids in the treatment of severe sepsis and septic shock in adults. JAMA. 2009;301:2362–75.

    Article  CAS  PubMed  Google Scholar 

  28. Annane D, Bellissant E, Bollaert P, et al. Corticosteroids for treating sepsis. Cochrane database of systematic reviews. 2015;12:CD002243.doi:10.1002/14651858.CD002243.pub3.

  29. Baele R, Janes JN, Brunkhorst FM, et al. Global utilization of low-dose corticosteroids in severe sepsis and septic shock: a report from the PROGRESS registry. Crit Care. 2010;14:R102.

    Article  Google Scholar 

  30. Sprung CL, Annane D, Keh D, et al. CORTICUS Study Group. Hydrocortisone therapy for patients with septic shock. N Engl J Med. 2008;358(2):111–24.

    Google Scholar 

  31. Annane D, Sébille V, Charpentier C, et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002;288(7):862–71.

    Article  CAS  PubMed  Google Scholar 

  32. Vincent JL, et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302:2323–9.

    Article  CAS  PubMed  Google Scholar 

  33. Blot F, et al. Earlier positivity of central-venous versus peripheral-blood cultures is highly predictive of catheter-related sepsis. J Clin Microbiol. 1998;36:105–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  34. Leclair MA, et al. Clostridium difficile infection in the intensive care unit. J Intensive Care Med. 2010;25:23–30.

    Article  PubMed  Google Scholar 

  35. van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359–67.

    Article  PubMed  Google Scholar 

  36. Finfer S, Chittock DR, Su SY, et al. NICE-SUGAR Study Investigators. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360(13):1283–97.

    Google Scholar 

  37. Bernard GR, Vincent JL, Laterre PF, et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med. 2001;344:699–709.

    Article  CAS  PubMed  Google Scholar 

  38. Abraham E, Laterre PF, Garg R, et al. Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death. N Engl J Med. 2005;353:1332–41.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Trauma, Emergency Surgery, and Surgical Critical Care, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA

    Shariq S. Raza MD & Marc de Moya MD, FACS

Authors
  1. Shariq S. Raza MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marc de Moya MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marc de Moya MD, FACS .

Editor information

Editors and Affiliations

  1. Emergency and Trauma Surgery Service, C.A. Pizzardi Maggiore Hospital AUSL Bologna, Bologna, Italy

    Salomone Di Saverio

  2. Emergency and Trauma Surgery, Maggiore Hospital of Parma, Parma, Italy

    Fausto Catena

  3. General, Emergency and Trauma Surgery Papa Giovanni XXIII Hospital, Bergamo, Italy

    Luca Ansaloni

  4. General, Emergency and Trauma Surgery Papa Giovanni XXIII Hospital, Bergamo, Italy

    Federico Coccolini

  5. Trauma, Emergency Medicine Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA

    George Velmahos

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Raza, S.S., de Moya, M. (2017). Septic Shock and Resuscitation Strategies. In: Di Saverio, S., Catena, F., Ansaloni, L., Coccolini, F., Velmahos, G. (eds) Acute Care Surgery Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-15341-4_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-15341-4_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15340-7

  • Online ISBN: 978-3-319-15341-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation