Guideline for management of sepsis and septic shock: Surviving sepsis campaign - Page 2

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-10-07T19:45:55+05:30 | Updated On 7 Oct 2021 7:49 PM IST

De-escalation of antibiotics

For adults with sepsis or septic shock, the authors suggest daily assessment for de-escalation of antimicrobials over using fixed durations of therapy without daily reassessment for de-escalation.

Duration of antibiotics

For adults with an initial diagnosis of sepsis or septic shock and adequate source control, the authors suggest using a shorter over a longer duration of antimicrobial therapy.

Biomarkers to discontinue antibiotics

For adults with an initial diagnosis of sepsis or septic shock and adequate source control where the optimal duration of therapy is unclear, the authors suggest using procalcitonin AND clinical evaluation to decide when to discontinue antimicrobials over clinical evaluation alone.

Fluid management

For adults with sepsis or septic shock, the authors recommend using crystalloids as first-line fluid for resuscitation.
For adults with sepsis or septic shock, the authors suggest using balanced crystalloids instead of normal saline for resuscitation.
For adults with sepsis or septic shock, the authors suggest using albumin in patients who received large volumes of crystalloids over using crystalloids alone.
For adults with sepsis or septic shock, the authors recommend against using starches for resuscitation.
For adults with sepsis and septic shock, the authors suggest against using gelatin for resuscitation.

Vasoactive agents

For adults with septic shock, the authors recommend using norepinephrine as the first-line agent over other vasopressors.
For adults with septic shock on norepinephrine with inadequate MAP levels, the authors suggest adding vasopressin instead of escalating the dose of norepinephrine.
For adults with septic shock and inadequate MAP levels despite norepinephrine and vasopressin, the authors suggest adding epinephrine.
For adults with septic shock, the authors suggest against using terlipressin

Reference:

Evans, L., Rhodes, A., Alhazzani, W. et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med (2021). https://doi.org/10.1007/s00134-021-06506-y

Surviving sepsis campaignIntensive Care Medicinesepsis

Source : Intensive Care Medicine

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751