Updates in Sepsis Resuscitation

Emerg Med Clin North Am. 2020 Nov;38(4):807-818. doi: 10.1016/j.emc.2020.06.006.

Abstract

Sepsis care has evolved significantly since the initial early goal-directed therapy (EGDT) trials. Early fluid resuscitation, source control, and antibiotic therapy remain cornerstones of care but overall understanding is more nuanced, particularly regarding fluid selection, vasopressors, and inotropic support. Timely nutrition therapy and ventilatory support tend to receive less attention but also are important. Recent research has explored immunomodulation, β-blockade, and vitamin supplementation. A renewed emphasis on early, aggressive resuscitation reaffirms the importance of emergency medicine providers knowledgeable and skilled in sepsis management.

Keywords: Bacteremia; Sepsis; Septic shock.

Publication types

  • Review

MeSH terms

  • Angiotensin II / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Antioxidants / therapeutic use
  • Ascorbic Acid / therapeutic use
  • Blood Glucose / analysis
  • Blood Pressure
  • Cardiomyopathies / etiology
  • Cardiomyopathies / therapy
  • Cardiotonic Agents / therapeutic use
  • Critical Illness
  • Emergency Service, Hospital
  • Enteral Nutrition
  • Fluid Therapy
  • Glucocorticoids / therapeutic use
  • Hemodynamics
  • Humans
  • Organ Dysfunction Scores
  • Randomized Controlled Trials as Topic
  • Respiration, Artificial
  • Resuscitation / methods*
  • Sepsis / therapy*
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Antioxidants
  • Blood Glucose
  • Cardiotonic Agents
  • Glucocorticoids
  • Vasoconstrictor Agents
  • Angiotensin II
  • Ascorbic Acid