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15 - Management of sepsis

Published online by Cambridge University Press:  03 May 2011

Mark J. Midwinter
Affiliation:
Royal Centre for Defence Medicine, Birmingham
Andrew Kingsnorth
Affiliation:
Derriford Hospital, Plymouth
Douglas Bowley
Affiliation:
Heart of England NHS Foundation Trust
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Summary

Introduction

Severe sepsis and septic shock are common and account for 3% of hospital admissions and 10% of admissions to critical care units. In critically ill patients, sepsis remains the most common cause of mortality. Mortality rates approaching 40% are seen in patients with severe sepsis and up to 80% for patients with septic shock and multi-organ dysfunction syndrome (MODS). It is estimated that approximately 1400 people worldwide die of sepsis every day and 37,000 die of sepsis every year in the UK. There is evidence to suggest that the incidence of severe sepsis is increasing, with a prediction that the number of severe sepsis cases is set to grow at a rate of 1.5% per annum, adding an additional 1 million cases per year in the USA alone by 2020. Sepsis is thought to account for 40% of total ICU expenditure.

Spearheaded by the ESICM (European Society of Intensive Care Medicine), ISF (International Sepsis Forum) and SCCM (Society of Critical Care Medicine), the Surviving Sepsis Campaign® is aimed at improving the diagnosis, survival and management of patients with sepsis by addressing the challenges associated with it.

The Surviving Sepsis® programme aims to:

  • increase awareness, understanding, and knowledge

  • change perceptions and behaviour

  • increase the pace of change in patterns of care

  • influence public policy

  • define standards of care in severe sepsis

  • reduce the mortality associated with sepsis by 25% over the next 5 years

  • working with the relevant stakeholders, the Surviving Sepsis Campaign's® mission is to improve the management of sepsis through targeted initiatives.

Type
Chapter
Information
Fundamentals of Surgical Practice
A Preparation Guide for the Intercollegiate MRCS Examination
, pp. 248 - 252
Publisher: Cambridge University Press
Print publication year: 2011

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References

Castellheim, A, Brekke, O-L, Espevik, T, Mollnes, TE. Innate immune response to danger signals in systemic inflammatory response syndrome and sepsis. Scand J Immunol 2009;69:479–491.CrossRefGoogle ScholarPubMed
Dellinger, RP, Levy, MM, Carlet, JM, Bion, Jet al. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: Intensive Care Med 2008;34:17–60.CrossRefGoogle ScholarPubMed
Gao, F, Melody, T, Daniels, DF, Giles, S, Fox, S. The impact of compliance with 6-hour and 24-hour sepsis bundles on hospital mortality in patients with severe sepsis: a prospective observational study. Crit Care 2005;9(6):R764–770.CrossRefGoogle ScholarPubMed
Levy, MM, Fink, MP, Marshall, JC, Abraham, Eet al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003;31(4):1250–1256. Survive Sepsis website: http://www.survivesepsis.org.CrossRefGoogle ScholarPubMed

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