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Published in: Langenbeck's Archives of Surgery 6/2008

01-11-2008 | Current Concepts in Clinical Surgery

Clinical sepsis and septic shock—definition, diagnosis and management principles

Author: Jean-Louis Vincent

Published in: Langenbeck's Archives of Surgery | Issue 6/2008

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Abstract

Introduction

Sepsis remains a common problem in critically ill patients.

Discussion

Considerable advances have been made in our understanding of the pathophysiology of sepsis and recent years have seen a surge of potential new therapeutic agents for sepsis. Definitions have been rethought and strategies proposed to better characterise patients with sepsis as the importance of individually targeted treatment packages has been realised. Current management aims to control infection, to achieve haemodynamic stabilisation, to modulate the immune response and to provide metabolic and organ support. As new therapies are introduced, treatment recommendations will need to be adapted accordingly.
Literature
1.
go back to reference Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR (2001) Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 29:1303–1310PubMedCrossRef Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR (2001) Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 29:1303–1310PubMedCrossRef
2.
go back to reference Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le Gall JR, Payen D (2006) Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 34:344–353PubMedCrossRef Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le Gall JR, Payen D (2006) Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 34:344–353PubMedCrossRef
3.
go back to reference Padkin A, Goldfrad C, Brady AR, Young D, Black N, Rowan K (2003) Epidemiology of severe sepsis occurring in the first 24hrs in intensive care units in England, Wales, and Northern Ireland. Crit Care Med 31:2332–2338PubMedCrossRef Padkin A, Goldfrad C, Brady AR, Young D, Black N, Rowan K (2003) Epidemiology of severe sepsis occurring in the first 24hrs in intensive care units in England, Wales, and Northern Ireland. Crit Care Med 31:2332–2338PubMedCrossRef
4.
go back to reference Cheng B, Xie G, Yao S, Wu X, Guo Q, Gu M, Fang Q, Xu Q, Wang D, Jin Y, Yuan S, Wang J, Du Z, Sun Y, Fang X (2007) Epidemiology of severe sepsis in critically ill surgical patients in ten university hospitals in China. Crit Care Med 35:2538–2546PubMedCrossRef Cheng B, Xie G, Yao S, Wu X, Guo Q, Gu M, Fang Q, Xu Q, Wang D, Jin Y, Yuan S, Wang J, Du Z, Sun Y, Fang X (2007) Epidemiology of severe sepsis in critically ill surgical patients in ten university hospitals in China. Crit Care Med 35:2538–2546PubMedCrossRef
5.
go back to reference Zahorec R, Firment J, Strakova J, Mikula J, Malik P, Novak I, Zeman J, Chlebo P (2005) Epidemiology of severe sepsis in intensive care units in the Slovak Republic. Infection 33:122–128PubMedCrossRef Zahorec R, Firment J, Strakova J, Mikula J, Malik P, Novak I, Zeman J, Chlebo P (2005) Epidemiology of severe sepsis in intensive care units in the Slovak Republic. Infection 33:122–128PubMedCrossRef
6.
go back to reference Finfer S, Bellomo R, Lipman J, French C, Dobb G, Myburgh J (2004) Adult-population incidence of severe sepsis in Australian and New Zealand intensive care units. Intensive Care Med 30:589–596PubMedCrossRef Finfer S, Bellomo R, Lipman J, French C, Dobb G, Myburgh J (2004) Adult-population incidence of severe sepsis in Australian and New Zealand intensive care units. Intensive Care Med 30:589–596PubMedCrossRef
7.
go back to reference Brun-Buisson C, Meshaka P, Pinton P, Vallet B (2004) EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units. Intensive Care Med 30:580–588PubMedCrossRef Brun-Buisson C, Meshaka P, Pinton P, Vallet B (2004) EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units. Intensive Care Med 30:580–588PubMedCrossRef
8.
go back to reference Engel C, Brunkhorst FM, Bone HG, Brunkhorst R, Gerlach H, Grond S, Gruendling M, Huhle G, Jaschinski U, John S, Mayer K, Oppert M, Olthoff D, Quintel M, Ragaller M, Rossaint R, Stuber F, Weiler N, Welte T, Bogatsch H, Hartog C, Loeffler M, Reinhart K (2007) Epidemiology of sepsis in Germany: results from a national prospective multicenter study. Intensive Care Med 33:606–618PubMedCrossRef Engel C, Brunkhorst FM, Bone HG, Brunkhorst R, Gerlach H, Grond S, Gruendling M, Huhle G, Jaschinski U, John S, Mayer K, Oppert M, Olthoff D, Quintel M, Ragaller M, Rossaint R, Stuber F, Weiler N, Welte T, Bogatsch H, Hartog C, Loeffler M, Reinhart K (2007) Epidemiology of sepsis in Germany: results from a national prospective multicenter study. Intensive Care Med 33:606–618PubMedCrossRef
9.
go back to reference Silva E, Pedro MA, Sogayar AC, Mohovic T, Silva CL, Janiszewski M, Cal RG, de Sousa EF, Abe TP, de Andrade J, de Matos JD, Rezende E, Assuncao M, Avezum A, Rocha PC, de Matos GF, Bento AM, Correa AD, Vieira PC, Knobel E (2004) Brazilian Sepsis Epidemiological Study (BASES study). Crit Care 8:R251–R260PubMedCrossRef Silva E, Pedro MA, Sogayar AC, Mohovic T, Silva CL, Janiszewski M, Cal RG, de Sousa EF, Abe TP, de Andrade J, de Matos JD, Rezende E, Assuncao M, Avezum A, Rocha PC, de Matos GF, Bento AM, Correa AD, Vieira PC, Knobel E (2004) Brazilian Sepsis Epidemiological Study (BASES study). Crit Care 8:R251–R260PubMedCrossRef
10.
go back to reference Karlsson S, Varpula M, Ruokonen E, Pettila V, Parviainen I, Ala-Kokko TI, Kolho E, Rintala EM (2007) Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study. Intensive Care Med 33:435–443PubMedCrossRef Karlsson S, Varpula M, Ruokonen E, Pettila V, Parviainen I, Ala-Kokko TI, Kolho E, Rintala EM (2007) Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study. Intensive Care Med 33:435–443PubMedCrossRef
11.
go back to reference Martin GS, Mannino DM, Eaton S, Moss M (2003) The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 348:1546–1554PubMedCrossRef Martin GS, Mannino DM, Eaton S, Moss M (2003) The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 348:1546–1554PubMedCrossRef
12.
go back to reference Harrison DA, Welch CA, Eddleston JM (2006) The epidemiology of severe sepsis in England, Wales and Northern Ireland, 1996 to 2004: secondary analysis of a high quality clinical database, the ICNARC Case Mix Programme Database. Crit Care 10:R42PubMedCrossRef Harrison DA, Welch CA, Eddleston JM (2006) The epidemiology of severe sepsis in England, Wales and Northern Ireland, 1996 to 2004: secondary analysis of a high quality clinical database, the ICNARC Case Mix Programme Database. Crit Care 10:R42PubMedCrossRef
13.
go back to reference Schottmueller H (1914) Wesen und Behandlung der Sepsis. Inn Med 31:257–280 Schottmueller H (1914) Wesen und Behandlung der Sepsis. Inn Med 31:257–280
14.
go back to reference Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ (1992) Definition for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 101:1644–1655PubMedCrossRef Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ (1992) Definition for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 101:1644–1655PubMedCrossRef
15.
go back to reference Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G (2003) 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Intensive Care Med 29:530–538PubMed Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G (2003) 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Intensive Care Med 29:530–538PubMed
16.
go back to reference Circiumaru B, Baldock G, Cohen J (1999) A prospective study of fever in the intensive care unit. Intensive Care Med 25:668–673PubMedCrossRef Circiumaru B, Baldock G, Cohen J (1999) A prospective study of fever in the intensive care unit. Intensive Care Med 25:668–673PubMedCrossRef
17.
go back to reference Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377PubMedCrossRef Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377PubMedCrossRef
18.
go back to reference Vincent JL, Bernard GR, Beale R, Doig C, Putensen C, Dhainaut JF, Artigas A, Fumagalli R, Macias W, Wright T, Wong K, Sundin DP, Turlo MA, Janes JM (2005) Drotrecogin alfa (activated) treatment in severe sepsis from the global open-label trial ENHANCE. Crit Care Med 33:2266–2277PubMedCrossRef Vincent JL, Bernard GR, Beale R, Doig C, Putensen C, Dhainaut JF, Artigas A, Fumagalli R, Macias W, Wright T, Wong K, Sundin DP, Turlo MA, Janes JM (2005) Drotrecogin alfa (activated) treatment in severe sepsis from the global open-label trial ENHANCE. Crit Care Med 33:2266–2277PubMedCrossRef
19.
go back to reference Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, Suppes R, Feinstein D, Zanotti S, Taiberg L, Gurka D, Kumar A, Cheang M (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34:1589–1596PubMedCrossRef Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, Suppes R, Feinstein D, Zanotti S, Taiberg L, Gurka D, Kumar A, Cheang M (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34:1589–1596PubMedCrossRef
20.
go back to reference Chan YL, Tseng CP, Tsay PK, Chang SS, Chiu TF, Chen JC (2004) Procalcitonin as a marker of bacterial infection in the emergency department: an observational study. Crit Care 8:R12–R20PubMedCrossRef Chan YL, Tseng CP, Tsay PK, Chang SS, Chiu TF, Chen JC (2004) Procalcitonin as a marker of bacterial infection in the emergency department: an observational study. Crit Care 8:R12–R20PubMedCrossRef
21.
go back to reference Lobo SM, Lobo FR, Bota DP, Lopes-Ferreira F, Soliman HM, Melot C, Vincent JL (2003) C-reactive protein levels correlate with mortality and organ failure in critically ill patients. Chest 123:2043–2049PubMedCrossRef Lobo SM, Lobo FR, Bota DP, Lopes-Ferreira F, Soliman HM, Melot C, Vincent JL (2003) C-reactive protein levels correlate with mortality and organ failure in critically ill patients. Chest 123:2043–2049PubMedCrossRef
22.
go back to reference Ugarte H, Silva E, Mercan D, de Mendonça A, Vincent JL (1999) Procalcitonin as a marker of infection in the intensive care unit. Crit Care Med 27:498–504PubMedCrossRef Ugarte H, Silva E, Mercan D, de Mendonça A, Vincent JL (1999) Procalcitonin as a marker of infection in the intensive care unit. Crit Care Med 27:498–504PubMedCrossRef
23.
go back to reference Damas P, Ledoux D, Nys M, Vrindts Y, DeGroote D, Franchimont P, Lamy M (1992) Cytokines serum levels during severe sepsis in human IL6 as a marker of severity. Ann Surg 215:356–362PubMedCrossRef Damas P, Ledoux D, Nys M, Vrindts Y, DeGroote D, Franchimont P, Lamy M (1992) Cytokines serum levels during severe sepsis in human IL6 as a marker of severity. Ann Surg 215:356–362PubMedCrossRef
24.
go back to reference Casey LC, Balk RA, Bone RC (1993) Plasma cytokine and endotoxin levels correlate with survival in patients with the sepsis syndrome. Ann Intern Med 119:771–778PubMed Casey LC, Balk RA, Bone RC (1993) Plasma cytokine and endotoxin levels correlate with survival in patients with the sepsis syndrome. Ann Intern Med 119:771–778PubMed
25.
go back to reference Pinsky MR, Vincent JL, Deviere J, Alegre M, Schandene L, Kahn RJ, Vandenbussche P, Content J, Dupont E (1993) Serum cytokine levels in human septic shock: relation to multiple-systems organ failure and mortality. Chest 103:565–575PubMedCrossRef Pinsky MR, Vincent JL, Deviere J, Alegre M, Schandene L, Kahn RJ, Vandenbussche P, Content J, Dupont E (1993) Serum cytokine levels in human septic shock: relation to multiple-systems organ failure and mortality. Chest 103:565–575PubMedCrossRef
26.
go back to reference Friedman G, Jankowski S, Marchant A, Goldman M, Kahn RJ, Vincent JL (1997) Blood interleukin-10 levels parallel the severity of septic shock. J Crit Care 12:183–187PubMedCrossRef Friedman G, Jankowski S, Marchant A, Goldman M, Kahn RJ, Vincent JL (1997) Blood interleukin-10 levels parallel the severity of septic shock. J Crit Care 12:183–187PubMedCrossRef
27.
go back to reference Marshall JC, Foster D, Vincent JL, Cook DJ, Cohen J, Dellinger RP, Opal S, Abraham E, Brett SJ, Smith T, Mehta S, Derzko A, Romaschin A (2004) Diagnostic and prognostic implications of endotoxemia in critical illness: results of the MEDIC study. J Infect Dis 190:527–534PubMedCrossRef Marshall JC, Foster D, Vincent JL, Cook DJ, Cohen J, Dellinger RP, Opal S, Abraham E, Brett SJ, Smith T, Mehta S, Derzko A, Romaschin A (2004) Diagnostic and prognostic implications of endotoxemia in critical illness: results of the MEDIC study. J Infect Dis 190:527–534PubMedCrossRef
28.
go back to reference Toh CH, Ticknor LO, Downey C, Giles AR, Paton RC, Wenstone R (2003) Early identification of sepsis and mortality risks through simple, rapid clot-waveform analysis. Implications of lipoprotein-complexed C reactive protein formation. Intensive Care Med 29:55–61PubMed Toh CH, Ticknor LO, Downey C, Giles AR, Paton RC, Wenstone R (2003) Early identification of sepsis and mortality risks through simple, rapid clot-waveform analysis. Implications of lipoprotein-complexed C reactive protein formation. Intensive Care Med 29:55–61PubMed
29.
go back to reference Dempfle CE, Lorenz S, Smolinski M, Wurst M, West S, Houdijk WP, Quintel M, Borggrefe M (2004) Utility of activated partial thromboplastin time waveform analysis for identification of sepsis and overt disseminated intravascular coagulation in patients admitted to a surgical intensive care unit. Crit Care Med 32:520–524PubMedCrossRef Dempfle CE, Lorenz S, Smolinski M, Wurst M, West S, Houdijk WP, Quintel M, Borggrefe M (2004) Utility of activated partial thromboplastin time waveform analysis for identification of sepsis and overt disseminated intravascular coagulation in patients admitted to a surgical intensive care unit. Crit Care Med 32:520–524PubMedCrossRef
30.
go back to reference Zakariah AN, Cozzi SM, Van Nuffelen M, Clausi CM, Pradier O, Vincent JL (2008) Combination of biphasic transmittance waveform with blood procalcitonin levels for diagnosis of sepsis in acutely ill patients. Crit Care Med 36(5):1507–1512PubMedCrossRef Zakariah AN, Cozzi SM, Van Nuffelen M, Clausi CM, Pradier O, Vincent JL (2008) Combination of biphasic transmittance waveform with blood procalcitonin levels for diagnosis of sepsis in acutely ill patients. Crit Care Med 36(5):1507–1512PubMedCrossRef
31.
go back to reference Peres-Bota D, Melot C, Lopes Ferreira F, Vincent JL (2003) Infection probability score (IPS): a simple method to help assess the probability of infection in critically patients. Crit Care Med 31:2579–2584PubMedCrossRef Peres-Bota D, Melot C, Lopes Ferreira F, Vincent JL (2003) Infection probability score (IPS): a simple method to help assess the probability of infection in critically patients. Crit Care Med 31:2579–2584PubMedCrossRef
32.
go back to reference Martini A, Gottin L, Mélot C, Vincent JL (2008) A prospective evaluation of the infection probability score (IPS) in the intensive care unit. J Infect 56:313–318 Martini A, Gottin L, Mélot C, Vincent JL (2008) A prospective evaluation of the infection probability score (IPS) in the intensive care unit. J Infect 56:313–318
33.
go back to reference Calvano SE, Xiao W, Richards DR, Felciano RM, Baker HV, Cho RJ, Chen RO, Brownstein BH, Cobb JP, Tschoeke SK, Miller-Graziano C, Moldawer LL, Mindrinos MN, Davis RW, Tompkins RG, Lowry SF (2005) A network-based analysis of systemic inflammation in humans. Nature 437:1032–1037PubMedCrossRef Calvano SE, Xiao W, Richards DR, Felciano RM, Baker HV, Cho RJ, Chen RO, Brownstein BH, Cobb JP, Tschoeke SK, Miller-Graziano C, Moldawer LL, Mindrinos MN, Davis RW, Tompkins RG, Lowry SF (2005) A network-based analysis of systemic inflammation in humans. Nature 437:1032–1037PubMedCrossRef
34.
go back to reference Johnson SB, Lissauer M, Bochicchio GV, Moore R, Cross AS, Scalea TM (2007) Gene expression profiles differentiate between sterile SIRS and early sepsis. Ann Surg 245:611–621PubMedCrossRef Johnson SB, Lissauer M, Bochicchio GV, Moore R, Cross AS, Scalea TM (2007) Gene expression profiles differentiate between sterile SIRS and early sepsis. Ann Surg 245:611–621PubMedCrossRef
35.
go back to reference Lissauer ME, Johnson SB, Siuzdak G, Bochicchio G, Whiteford C, Nussbaumer B, Moore R, Scalea TM (2007) Coagulation and complement protein differences between septic and uninfected systemic inflammatory response syndrome patients. J Trauma 62:1082–1094PubMedCrossRef Lissauer ME, Johnson SB, Siuzdak G, Bochicchio G, Whiteford C, Nussbaumer B, Moore R, Scalea TM (2007) Coagulation and complement protein differences between septic and uninfected systemic inflammatory response syndrome patients. J Trauma 62:1082–1094PubMedCrossRef
36.
go back to reference Carrigan SD, Scott G, Tabrizian M (2004) Toward resolving the challenges of sepsis diagnosis. Clin Chem 50:1301–1314PubMedCrossRef Carrigan SD, Scott G, Tabrizian M (2004) Toward resolving the challenges of sepsis diagnosis. Clin Chem 50:1301–1314PubMedCrossRef
37.
go back to reference Abraham E (2005) Immunological monitoring, functional genomics and proteomics. In: Fink MP, Sibbald WJ, Suter PM (eds) Intensive Care Medicine in 10 Years. Springer, Heidelberg, pp 189–200 Abraham E (2005) Immunological monitoring, functional genomics and proteomics. In: Fink MP, Sibbald WJ, Suter PM (eds) Intensive Care Medicine in 10 Years. Springer, Heidelberg, pp 189–200
38.
go back to reference Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL (2008) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med 34:17–60PubMedCrossRef Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL (2008) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med 34:17–60PubMedCrossRef
39.
go back to reference Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, Steingrub JS, Garber GE, Helterbrand JD, Ely EW, Fisher CJ Jr. (2001) Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 344:699–709PubMedCrossRef Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, Steingrub JS, Garber GE, Helterbrand JD, Ely EW, Fisher CJ Jr. (2001) Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 344:699–709PubMedCrossRef
40.
go back to reference Leone M, Bourgoin A, Cambon S, Dubuc M, Albanese J, Martin C (2003) Empirical antimicrobial therapy of septic shock patients: adequacy and impact on the outcome. Crit Care Med 31:462–467PubMedCrossRef Leone M, Bourgoin A, Cambon S, Dubuc M, Albanese J, Martin C (2003) Empirical antimicrobial therapy of septic shock patients: adequacy and impact on the outcome. Crit Care Med 31:462–467PubMedCrossRef
41.
go back to reference Valles J, Rello J, Ochagavia A, Garnacho J, Alcala MA (2003) Community-acquired bloodstream infection in critically ill adult patients: impact of shock and inappropriate antibiotic therapy on survival. Chest 123:1615–1624PubMedCrossRef Valles J, Rello J, Ochagavia A, Garnacho J, Alcala MA (2003) Community-acquired bloodstream infection in critically ill adult patients: impact of shock and inappropriate antibiotic therapy on survival. Chest 123:1615–1624PubMedCrossRef
42.
go back to reference Garnacho-Montero J, Ortiz-Leyba C, Herrera-Melero I, Aldabo-Pallas T, Cayuela-Dominguez A, Marquez-Vacaro JA, Carbajal-Guerrero J, Garcia-Garmendia JL (2008) Mortality and morbidity attributable to inadequate empirical antimicrobial therapy in patients admitted to the ICU with sepsis: a matched cohort study. J Antimicrob Chemother 61:436–441PubMedCrossRef Garnacho-Montero J, Ortiz-Leyba C, Herrera-Melero I, Aldabo-Pallas T, Cayuela-Dominguez A, Marquez-Vacaro JA, Carbajal-Guerrero J, Garcia-Garmendia JL (2008) Mortality and morbidity attributable to inadequate empirical antimicrobial therapy in patients admitted to the ICU with sepsis: a matched cohort study. J Antimicrob Chemother 61:436–441PubMedCrossRef
43.
go back to reference Byl B, Clevenbergh P, Jacobs F, Struelens MJ, Zech F, Kentos A, Thys JP (1999) Impact of infectious diseases specialists and microbiological data on the appropriateness of antimicrobial therapy forbacteremia. Clin Infect Dis 29:60–66PubMedCrossRef Byl B, Clevenbergh P, Jacobs F, Struelens MJ, Zech F, Kentos A, Thys JP (1999) Impact of infectious diseases specialists and microbiological data on the appropriateness of antimicrobial therapy forbacteremia. Clin Infect Dis 29:60–66PubMedCrossRef
45.
go back to reference Vincent JL, Sakr Y, Sprung CL, Harboe S, Damas P (2008) Are blood transfusions associated with greater mortality rates. Anesthesiology 108:31–39PubMedCrossRef Vincent JL, Sakr Y, Sprung CL, Harboe S, Damas P (2008) Are blood transfusions associated with greater mortality rates. Anesthesiology 108:31–39PubMedCrossRef
46.
go back to reference Deans KJ, Minneci PC, Suffredini AF, Danner RL, Hoffman WD, Ciu X, Klein HG, Schechter AN, Banks SM, Eichacker PQ, Natanson C (2007) Randomization in clinical trials of titrated therapies: unintended consequences of using fixed treatment protocols. Crit Care Med 35:1509–1516PubMedCrossRef Deans KJ, Minneci PC, Suffredini AF, Danner RL, Hoffman WD, Ciu X, Klein HG, Schechter AN, Banks SM, Eichacker PQ, Natanson C (2007) Randomization in clinical trials of titrated therapies: unintended consequences of using fixed treatment protocols. Crit Care Med 35:1509–1516PubMedCrossRef
47.
go back to reference Hollenberg SM, Ahrens TS, Annane D, Astiz ME, Chalfin DB, Dasta JF, Heard SO, Martin C, Napolitano LM, Susla GM, Totaro R, Vincent JL, Zanotti-Cavazzoni S (2004) Practice parameters for hemodynamic support of sepsis in adult patients: 2004 update. Crit Care Med 32:1928–1948PubMedCrossRef Hollenberg SM, Ahrens TS, Annane D, Astiz ME, Chalfin DB, Dasta JF, Heard SO, Martin C, Napolitano LM, Susla GM, Totaro R, Vincent JL, Zanotti-Cavazzoni S (2004) Practice parameters for hemodynamic support of sepsis in adult patients: 2004 update. Crit Care Med 32:1928–1948PubMedCrossRef
48.
go back to reference Grollman A, Geiling EMK (1932) The cardiovascular and metabolic reactions of man to the intramuscular injection of posterior pituitary liquid (Pituitrin), Pitressin and pitochin. J Pharmacol Exp Ther 16:447–460 Grollman A, Geiling EMK (1932) The cardiovascular and metabolic reactions of man to the intramuscular injection of posterior pituitary liquid (Pituitrin), Pitressin and pitochin. J Pharmacol Exp Ther 16:447–460
49.
go back to reference Landry DW, Levin HR, Gallant EM, Ashton RC Jr., Seo S, D'Alessandro D, Oz MC, Oliver JA (1997) Vasopressin deficiency contributes to the vasodilation of septic shock. Circulation 95:1122–1125PubMed Landry DW, Levin HR, Gallant EM, Ashton RC Jr., Seo S, D'Alessandro D, Oz MC, Oliver JA (1997) Vasopressin deficiency contributes to the vasodilation of septic shock. Circulation 95:1122–1125PubMed
50.
go back to reference Landry DW, Levin HR, Gallant EM, Seo S, D'Alessandro D, Oz MC, Oliver JA (1997) Vasopressin pressor hypersensitivity in vasodilatory septic shock. Crit Care Med 25:1279–1282PubMedCrossRef Landry DW, Levin HR, Gallant EM, Seo S, D'Alessandro D, Oz MC, Oliver JA (1997) Vasopressin pressor hypersensitivity in vasodilatory septic shock. Crit Care Med 25:1279–1282PubMedCrossRef
51.
go back to reference Malay MB, Ashton RC Jr., Landry DW, Townsend RN (1999) Low-dose vasopressin in the treatment of vasodilatory septic shock. J Trauma 47:699–703PubMed Malay MB, Ashton RC Jr., Landry DW, Townsend RN (1999) Low-dose vasopressin in the treatment of vasodilatory septic shock. J Trauma 47:699–703PubMed
52.
go back to reference Tsuneyoshi I, Yamada H, Kakihana Y, Nakamura M, Nakano Y, Boyle WA III (2001) Hemodynamic and metabolic effects of low-dose vasopressin infusions in vasodilatory septic shock. Crit Care Med 29:487–493PubMedCrossRef Tsuneyoshi I, Yamada H, Kakihana Y, Nakamura M, Nakano Y, Boyle WA III (2001) Hemodynamic and metabolic effects of low-dose vasopressin infusions in vasodilatory septic shock. Crit Care Med 29:487–493PubMedCrossRef
53.
go back to reference Holmes CL, Walley KR, Chittock DR, Lehman T, Russell JA (2001) The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series. Intensive Care Med 27:1416–1421PubMedCrossRef Holmes CL, Walley KR, Chittock DR, Lehman T, Russell JA (2001) The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series. Intensive Care Med 27:1416–1421PubMedCrossRef
54.
go back to reference Rady MY, Rivers EP, Nowak RM (1996) Resuscitation of the critically ill in the ED: responses of blood pressure, heart rate, shock index, central venous oxygen saturation, and lactate. Am J Emerg Med 14:218–225PubMedCrossRef Rady MY, Rivers EP, Nowak RM (1996) Resuscitation of the critically ill in the ED: responses of blood pressure, heart rate, shock index, central venous oxygen saturation, and lactate. Am J Emerg Med 14:218–225PubMedCrossRef
55.
go back to reference Vincent JL, De Backer D (2004) Oxygen transport—the oxygen delivery controversy. Intensive Care Med 30:1990–1996PubMedCrossRef Vincent JL, De Backer D (2004) Oxygen transport—the oxygen delivery controversy. Intensive Care Med 30:1990–1996PubMedCrossRef
56.
go back to reference Abraham E, Laterre PF, Garg R, Levy H, Talwar D, Trzaskoma BL, François B, Guy JS, Brückmann M, Rea-Neto A, Rossaint R, Perrotin D, Sablotzki A, Arkins N, Utterback BG, Macias WL (2005) Drotrecogin alfa [activated] for adults with severe sepsis and a low risk of death. N Engl J Med 353:1332–1341PubMedCrossRef Abraham E, Laterre PF, Garg R, Levy H, Talwar D, Trzaskoma BL, François B, Guy JS, Brückmann M, Rea-Neto A, Rossaint R, Perrotin D, Sablotzki A, Arkins N, Utterback BG, Macias WL (2005) Drotrecogin alfa [activated] for adults with severe sepsis and a low risk of death. N Engl J Med 353:1332–1341PubMedCrossRef
57.
go back to reference Nadel S, Goldstein B, Williams MD, Dalton H, Peters M, Macias WL, Abd-Allah SA, Levy H, Angle R, Wang D, Sundin DP, Giroir B (2007) Drotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial. Lancet 369:836–843PubMedCrossRef Nadel S, Goldstein B, Williams MD, Dalton H, Peters M, Macias WL, Abd-Allah SA, Levy H, Angle R, Wang D, Sundin DP, Giroir B (2007) Drotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial. Lancet 369:836–843PubMedCrossRef
58.
go back to reference Annane D, Sebille V, Charpentier C, Bollaert PE, Francois B, Korach JM, Capellier G, Cohen Y, Azoulay E, Troché G, Chaumet-Riffaut P, Bellissant E (2002) Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288:862–871PubMedCrossRef Annane D, Sebille V, Charpentier C, Bollaert PE, Francois B, Korach JM, Capellier G, Cohen Y, Azoulay E, Troché G, Chaumet-Riffaut P, Bellissant E (2002) Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288:862–871PubMedCrossRef
59.
go back to reference Sprung CL, Annane D, Keh D, Moreno R, Singer M, Freivogel K, Weiss YG, Benbenishty J, Kalenka A, Forst H, Laterre PF, Reinhart K, Cuthbertson BH, Payen D, Briegel J (2008) Hydrocortisone therapy for patients with septic shock. N Engl J Med 358:111–124PubMedCrossRef Sprung CL, Annane D, Keh D, Moreno R, Singer M, Freivogel K, Weiss YG, Benbenishty J, Kalenka A, Forst H, Laterre PF, Reinhart K, Cuthbertson BH, Payen D, Briegel J (2008) Hydrocortisone therapy for patients with septic shock. N Engl J Med 358:111–124PubMedCrossRef
60.
go back to reference Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R (2001) Intensive insulin therapy in the critically ill patient. N Engl J Med 345:1359–1367PubMedCrossRef Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R (2001) Intensive insulin therapy in the critically ill patient. N Engl J Med 345:1359–1367PubMedCrossRef
61.
go back to reference Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, Moerer O, Gruendling M, Oppert M, Grond S, Olthoff D, Jaschinski U, John S, Rossaint R, Welte T, Schaefer M, Kern P, Kuhnt E, Kiehntopf M, Hartog C, Natanson C, Loeffler M, Reinhart K (2008) Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 358:125–139PubMedCrossRef Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, Moerer O, Gruendling M, Oppert M, Grond S, Olthoff D, Jaschinski U, John S, Rossaint R, Welte T, Schaefer M, Kern P, Kuhnt E, Kiehntopf M, Hartog C, Natanson C, Loeffler M, Reinhart K (2008) Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 358:125–139PubMedCrossRef
62.
go back to reference Galban C, Montejo JC, Mesejo A, Marco P, Celaya S, Sanchez-Segura JM, Farre M, Bryg DJ (2000) An immune-enhancing enteral diet reduces mortality rate and episodes of bacteremia in septic intensive care unit patients. Crit Care Med 28:643–648PubMedCrossRef Galban C, Montejo JC, Mesejo A, Marco P, Celaya S, Sanchez-Segura JM, Farre M, Bryg DJ (2000) An immune-enhancing enteral diet reduces mortality rate and episodes of bacteremia in septic intensive care unit patients. Crit Care Med 28:643–648PubMedCrossRef
63.
go back to reference Bertolini G, Iapichino G, Radrizzani D, Facchini R, Simini B, Bruzzone P, Zanforlin G, Tognoni G (2003) Early enteral immunonutrition in patients with severe sepsis: results of an interim analysis of a randomized multicentre clinical trial. Intensive Care Med 29:834–840PubMedCrossRef Bertolini G, Iapichino G, Radrizzani D, Facchini R, Simini B, Bruzzone P, Zanforlin G, Tognoni G (2003) Early enteral immunonutrition in patients with severe sepsis: results of an interim analysis of a randomized multicentre clinical trial. Intensive Care Med 29:834–840PubMedCrossRef
64.
go back to reference Vincent JL (2007) Metabolic support in sepsis and multiple organ failure: more questions than answers.. Crit Care Med 35:S436–S440PubMedCrossRef Vincent JL (2007) Metabolic support in sepsis and multiple organ failure: more questions than answers.. Crit Care Med 35:S436–S440PubMedCrossRef
65.
go back to reference Zambon M, Ceola M, Castro R, Gullo A, Vincent JL (2008) Implementation of the Surviving Sepsis Campaign guidelines for severe sepsis and septic shock: We could go faster. J Crit Care (in press) Zambon M, Ceola M, Castro R, Gullo A, Vincent JL (2008) Implementation of the Surviving Sepsis Campaign guidelines for severe sepsis and septic shock: We could go faster. J Crit Care (in press)
Metadata
Title
Clinical sepsis and septic shock—definition, diagnosis and management principles
Author
Jean-Louis Vincent
Publication date
01-11-2008
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 6/2008
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-008-0343-1

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