SCCM Resource Library-Septic Shock 2021 Guidelines Reference Sheet

Pdf Summary

The document is a reference sheet for the guidelines on septic shock in 2021. It highlights the APACHE II score for predicting mortality and the association between lactate level and mortality rate. Timely administration of antibiotics is emphasized, as well as the use of steroids, fluids, and pressors. The importance of balanced crystalloids for fluid management and the use of NICOM Fluid Responsiveness are mentioned. The document outlines the Surviving Sepsis Campaign's 1-hour bundle, including lactate measurement, obtaining cultures, initiating antibiotics and fluids, and administering vasopressors and hydrocortisone. It provides guidance on choosing appropriate antibiotics, highlights high-risk patients for MRSA infection, and discusses additional recommendations such as using thiamine and ascorbic acid, initiating nutrition, and providing DVT and GI prophylaxis. The document includes abbreviations, calculations, and a disclaimer that it should not replace clinical judgment or guideline-based therapies.<br /><br />The document references several studies and articles on fluid resuscitation in critically ill patients with hypovolemic shock or septic shock. The studies cover comparisons between colloids and crystalloids, the use of hydrocortisone plus fludrocortisone, high versus low blood-pressure targets, and the effectiveness of fludrocortisone and hydrocortisone. Other articles discuss the Surviving Sepsis Campaign guidelines, the effect of vitamin C, hydrocortisone, and thiamine, and the duration of hypotension before antimicrobial therapy initiation. Studies on inotropes and vasopressors, protocol-based care, and balanced crystalloids versus saline are also mentioned.<br /><br />Overall, the document provides a comprehensive overview of fluid resuscitation and therapy in critically ill patients with hypovolemic shock and septic shock, supported by current research and evidence.

Asset Subtitle

Sepsis, Quality and Patient Safety, 2024, 0:10:00

Keywords

septic shock

APACHE II score

lactate level

antibiotics

fluid management

Surviving Sepsis Campaign

MRSA infection

thiamine

ascorbic acid

balanced crystalloids

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