Management of sepsis  

Oleh:

MacKenzie, Ian ; Lever, Andrew

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: British Medical Journal (keterangan: ada di Proquest) vol. 335 no. 7626 (Nov. 2007), page 929.

Ketersediaan

Perpustakaan FK Nomor Panggil: B16.K.2007.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

This is the second of two reviews—the first discussed the definition, epidemiology, and diagnosis of sepsis, whereas this one focuses on management and outcome. Management of sepsis can conveniently be divided into general supportive measures and specific treatment. Summary points A favourable outcome depends on early, aggressive, treatment Antimicrobial treatment must take into account both patient susceptibilities and local resistance patterns; advice from infectious disease or microbiology colleagues is often helpful Volume resuscitation and cardiovascular support should be titrated to simple clinical end points Subtle signs of organ hypoperfusion should be sought in physically robust patients The role of activated protein C and low dose steroids remains to be clarified What are the general supportive measures? Circulatory compromise arises from the combination of vasodilatation, capillary leak, and reduced myocardial contractility, and needs early correction. Whether crystalloids or colloids are better for volume resuscitation remains unresolved. Few people now use human albumin after a controversial meta-analysis concluded that albumin . . .

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