Sepsis and Septic Shock: An Update

The new definition of sepsis is "life-threatening organ dysfunction caused by a dysregulated host response to infection" the current management of sepsis primarily involves early resuscitation (Administer intravenous fluid, mean arterial pressure > 65 mmHg, normalize lactate, use vasopressors), and infection control (The current guidelines recommend initiation ofintravenous antimicrobials within 1 hour of recognition of sepsis and septic shock). The new sepsis definitions also propose Quick SOFA (qSOFA) criteria (two or more of hypotension, tachypnea, and/or altered mental status) for efficient bedside screening to identify potentially infected patients at risk for poor outcomes in out-of-hospital, emergency department, and general hospital ward settings [3]. Epidemiology International data demonstrate that sepsis contributes to more than 5 million deaths annually and represents a significant financial burden to patients and society. Since 2005 to 2015, the sepsis incidence was 437 cases per 100,000 person-year, with an incidence of severe sepsis from 270 per 100,000 person-year. Lactate elevation reflects the pathophysiological changes of sepsis (hypotension, tissue hypoperfusion and organ dysfunction); it defines the diagnosis and prognosis of septic patients. [...]monitoring this parameter has been shown to improve the outcome of critically ill patients [18].