Prompt antibiotic administration and goal-directed hemodynamic support in patients with severe sepsis and septic shock - Nobre, V.; Sarasin, F. P.; Pugin, J. (Curr Opin Crit Care, 2007)
PURPOSE OF REVIEW: Treatment protocols targeting the rapid administration of appropriate antibiotics and hemodynamic support are now recognized as a key measure in the initial care of patients presenting with severe sepsis and septic shock. Strong evidence exists showing that time parameters, particularly in the emergency department, are as important as the nature of the treatment administered. The concept of sepsis bundles integrates evidence-based and time-sensitive issues, derived from international sepsis guidelines, to ensure that all eligible patients receive the right treatment as early as possible. RECENT FINDINGS: Several studies have demonstrated that patients resuscitated according to sepsis bundles had a significantly lower mortality. SUMMARY: It seems logical that timely and protocolized treatment for patients presenting with severe sepsis and septic shock will impact on outcome. It remains to be shown, however, whether translating evidence into clinical practice will increase adherence to the bundles and positively impact on survival.
Keywords: journalArticle; *Hemodynamics; Anti-Bacterial Agents/administration & dosage/*therapeutic use; Cardiotonic Agents/therapeutic use; Clinical Protocols; Critical Care/*methods; Dopamine/therapeutic use; Drug Administration Schedule; Erythrocyte Transfusion; Fluid Therapy; Humans; Monitoring, Physiologic; Resuscitation; Sepsis/physiopathology/*therapy; Shock, Septic/physiopathology/therapy; Time Factors