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3.7.4 - Sepsis and Septic Shock
from Section 3.7 - Infection and Immunity
- By Ravi Bhatia
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 254-256
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Summary

Key Learning Points
1. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.
2. A change in the Sequential Organ Failure Assessment (SOFA) score post-infection of 2 or above is taken as a diagnosis of sepsis.
3. Once the diagnosis is made, treatment should be immediate and should involve source control, blood cultures, broad-spectrum antibiotics, 30 ml/kg crystalloid and vasopressors to achieve a mean arterial pressure of >65 and a lactate level of <2.
4. A quick SOFA (qSOFA) score of 2 or more is a bedside test designed to identify those suspected infective patients with higher morbidity and mortality, and should not be used as a diagnostic test for sepsis.
5. A SOFA score change of 2 or more represents an overall mortality risk of approximately 10 per cent.