2025 Multiprofessional Critical Care Review: Adult Online-1: Septic Shock

Video Transcription

Video Summary

John Ceransky presents an overview of evidence-based management for sepsis and septic shock as part of the Society of Critical Care Medicine's review course. Sepsis is defined by the Sepsis-3 definition as life-threatening organ dysfunction resulting from a dysregulated host response to infection, identified by a 2-point increase in the SOFA score. Septic shock involves persistent hypotension despite fluid resuscitation, requiring vasopressors and elevated lactate levels.<br /><br />The Surviving Sepsis Campaign emphasizes immediate treatment for sepsis as a medical emergency, advocating for quick initiation of antimicrobial therapy within one hour of recognition. Fluid resuscitation is guided by the patient's hemodynamics, with crystalloid fluids recommended. Vasopressors, specifically norepinephrine, are used for persistent hypotension. Supportive care strategies include mechanical ventilation for sepsis-induced respiratory failure, with low tidal volumes and prone positioning for patients with ARDS.<br /><br />Effective management also incorporates glucose control, VTE prophylaxis, and early enteral nutrition. Dynamic variables are preferred for assessing fluid responsiveness, and adjunctive therapies like IV hydrocortisone for persistent hypotension and RBC transfusion for anemia may be considered. Prompt recognition and treatment significantly improve sepsis outcomes, particularly in low to middle-income countries where the burden is greatest.

Keywords

sepsis

septic shock

SOFA score

antimicrobial therapy

fluid resuscitation

vasopressors

Surviving Sepsis Campaign

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