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Lee and Moon: Treatment Guidelines of Sepsis and Septic Shock
Review
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 67(6): 491-498.

Published online: 31 December 2009

DOI: https://doi.org/10.4046/trd.2009.67.6.491

Treatment Guidelines of Sepsis and Septic Shock

Heung Bum Lee, M.D., Hee Moon, M.D.

Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.

Address for correspondence: Heung Bum Lee, M.D. Department of Internal Medicine, Chonbuk National University Medical School, San 2-20, Geumam-dong, Deokjin-gu, Jeonju 561-180, Korea. Phone: 82-63-250-1685, Fax: 82-63-254-1609, lhbmd@jbnu.ac.kr

Received 12 June 2009       Accepted 15 June 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.

Keywords: Sepsis, Shock, Septic, Practice Guideline

Figures and Tables

Figure 1
Algorithm of early goal-directed therapy19. SBP: systolic blood pressure; CVP: central venous pressure; MAP: mean arterial pressure; SCVO2: mixed venous oxygen saturation in central vein; PRC: packed red blood cell; Hct: hematocrit; HR: heart rate.
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Figure 2
Use of spontaneous breathing trial in weaning ARDS patients20-23. PEEP: positive end-expiratory pressure; VE: minute ventilation; SBT: spontaneous breathing trial; RR: respiration rate; SaO2: arterial oxygen saturation; SBP: systolic blood pressure; F: frequency; VT: tidal volume; MV: mechanical ventilation; CPAP: continuous positive airway pressure; ET: endotracheal.
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Table 1
Examples of source control
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