Current management of sepsis in critically ill adult patients

Abstract

Severe sepsis is a common occurrence in critically ill patients and a major cause of morbidity and mortality in this population. Management relies on the early identification and treatment of the underlying causative infection, adequate and rapid hemodynamic resuscitation, support of associated organ failure and modulation of the immune response with drotrecogin alfa (activated) when it is not contraindicated, and corticosteroids in severe septic shock. We will review current approaches to each of these categories.

Keywords::

• antibiotics
• corticosteroids
• drotrecogin alfa (activated)
• fluid challenge
• infection
• vasopressors

Financial & competing interests disclosure

Jean-Louis Vincent has served as a paid consultant for Astellas, Curacyte, Eli Lilly, Eisai and Ferring, participated in clinical trials sponsored by Eli Lilly, Eisai, Curacyte and Ferring, and been an invited speaker at conferences supported by Astellas, Curacyte, Eli Lilly and Eisai. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.