Acute Management of Sepsis beyond 24 Hours.

Semin Respir Crit Care Med

Department of Intensive Care, APHP University Versailles Saint Quentin-University Paris Saclay, Raymond Poincaré Hospital, Garches, France.

Published: August 2024

AI Article Synopsis

  • * Early treatment involves controlling the source of infection, using antibiotics, and supporting organ function, while later care addresses metabolic, nutritional, and immune needs.
  • * Effective management includes moderate glucose control, careful nutritional support to prevent muscle loss, and using corticosteroids to help patients with shock and organ dysfunction, emphasizing a personalized approach for better recovery.

Article Abstract

Sepsis manifests as a dysregulated immune response to an infection, leading to tissue damage, organ failure, and potentially death or long-term health issues. Sepsis remains a major health challenge globally, causing approximately 50 million cases and 11 million deaths annually. Early management of sepsis focuses on source control, antimicrobial treatment, and supporting vital organ function. Subsequent care includes metabolic, nutritional, and immune therapies to address the complex needs of septic patients. Metabolic management is based on obtaining moderate glucose targets. Nutritional support aims to mitigate hypercatabolism and muscle wasting, but aggressive early nutrition does not improve outcomes and could even be harmful. Immune modulation is crucial due to the dual nature of sepsis-induced immune responses. Corticosteroids have shown benefits in shock and organ dysfunction reversal and in mortality reduction with current guidelines recommending them in vasopressor therapy-dependent patients. In conclusion, sepsis management beyond the initial hours requires a multifaceted approach, focusing on metabolic, nutritional, and immune system support tailored to individual patient needs to enhance survival and recovery.

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Source
http://dx.doi.org/10.1055/s-0044-1787991DOI Listing

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