Early recognition and treatment of severe sepsis and septic shock in CAP

Anja Kathrin Jaehne, Namita Jayaprakash, Gina Hurst, Steven Moore, Michael F. Harrison, Emanuel P. Rivers

Research output: Contribution to journalArticle

Abstract

Community-acquired pneumonia is one of the most common causes of severe sepsis and septic shock, accounting for up to 45% of cases admitted to hospitals. Early identification and illness severity stratification followed by early intervention using a bundled treatment approach have been shown to improve outcomes. This includes blood cultures before antibiotics, fluid resuscitation with 30 mL kg-1 body weight to target a mean arterial blood pressure of at least 65 mmHg, central venous pressure between 8 and 12 mmHg, and a central venous oxygen saturation of 70% within 6 h of diagnosis. In addition, early and appropriate introduction of ventilator assistance not only improves gas exchange, it further reduces the imbalance between oxygen delivery and utilisation. The mortality reduction is also accompanied by a decrease in duration of mechanical ventilation, vasopressor use, and intensive care unit and hospital length of stay.

Original languageEnglish (US)
Pages (from-to)184-204
Number of pages21
JournalEuropean Respiratory Monograph
Volume63
DOIs
StatePublished - Jan 1 2014

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Septic Shock
Length of Stay
Sepsis
Arterial Pressure
Oxygen
Central Venous Pressure
Mechanical Ventilators
Artificial Respiration
Resuscitation
Intensive Care Units
Pneumonia
Gases
Body Weight
Anti-Bacterial Agents
Mortality
Therapeutics
Blood Culture

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Jaehne, Anja Kathrin ; Jayaprakash, Namita ; Hurst, Gina ; Moore, Steven ; Harrison, Michael F. ; Rivers, Emanuel P. / Early recognition and treatment of severe sepsis and septic shock in CAP. In: European Respiratory Monograph. 2014 ; Vol. 63. pp. 184-204.
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Early recognition and treatment of severe sepsis and septic shock in CAP. / Jaehne, Anja Kathrin; Jayaprakash, Namita; Hurst, Gina; Moore, Steven; Harrison, Michael F.; Rivers, Emanuel P.

In: European Respiratory Monograph, Vol. 63, 01.01.2014, p. 184-204.

Research output: Contribution to journalArticle

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AB - Community-acquired pneumonia is one of the most common causes of severe sepsis and septic shock, accounting for up to 45% of cases admitted to hospitals. Early identification and illness severity stratification followed by early intervention using a bundled treatment approach have been shown to improve outcomes. This includes blood cultures before antibiotics, fluid resuscitation with 30 mL kg-1 body weight to target a mean arterial blood pressure of at least 65 mmHg, central venous pressure between 8 and 12 mmHg, and a central venous oxygen saturation of 70% within 6 h of diagnosis. In addition, early and appropriate introduction of ventilator assistance not only improves gas exchange, it further reduces the imbalance between oxygen delivery and utilisation. The mortality reduction is also accompanied by a decrease in duration of mechanical ventilation, vasopressor use, and intensive care unit and hospital length of stay.

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