Systematic screening is essential for early diagnosis of severe sepsis and septic shock - Critical Care Science (CCS)

Systematic screening is essential for early diagnosis of severe sepsis and septic shock |

SEPSIS, EARLY INTERVENTIONS AND MORTALITY

For over a decade, after studies showing the benefit of early goal-directed therapy⁽⁾ and the publication of the first Survival Sepsis Campaign (SSC) guidelines in 2004,⁽⁾ several other pieces of evidence have demonstrated the importance of early treatment in reducing mortality among patients with severe sepsis or septic shock.^(-) This evidence led to the analysis of the SSC impact in 2010, which involved 15,022 patients from 165 hospitals. This analysis revealed continuous and sustained improvements in compliance with early interventions, especially with antibiotic therapy (odds ratio - OR 0.70; p < 0.001), and blood culture requests (0.78; p < 0.001), along with a reduction in the mortality rate associated with severe sepsis or septic shock (from 30.8% to 27%; p < 0.01).⁽⁾

Over time, the identification of procedures associated with the reduction in mortality rate has simplified the initial interventions in patients with severe sepsis or septic shock, emphasizing the proper antibiotic therapy (blood culture before antibiotic + broad-spectrum antibiotic within 1 hour) and the control of hemodynamic instability (administration of 30mL/kg crystalloid for mean arterial pressure - < 65mmHg or lactate ≥ 4mmol/L + vasopressors for hypotension refractory to volume).⁽⁾

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