With more than 1 million American dying from sepsis annually, providers follow a set of protocols to mitigate a patient's risk of sepsis.
JAMA delves into the updated guidelines, titled Surviving Sepsis Guidelines, which Critical Care Medicine and Intensive Care Medicine originally published in January 2017. The 2017 updates are the fourth sepsis updates to date.
Here are six key points:
1. While previous guidelines recommend early goal-directed therapy, the 2017 guidelines do not.
2. Rather, the guidelines advise providers to use hemodynamic assessment for further fluid administration following an initial fluid bolus as well as conduct a hemodynamic assessment.
3. The guideline authors recommend providers use dynamic, as opposed to static, variables when predicting fluid responsiveness. Dynamic variables include a patient's pulse or stroke volume variations.
4. Similar to past guidelines, infection source control is the main source of treatment for sepsis. Providers should obtain source control as quickly as they are able. Providers should administer antibiotics within a one-hour maximum time frame.
5. The guidelines do not recommend combination therapy to treat neutropenic sepsis. However, the guidelines make a "weak" recommendation to use empirical combination therapy in patients with septic shock.
6. JAMA states these updated guidelines should "prove helpful for clinicians to continue to improve the care of patients with sepsis and improve the outcome of these critically ill patients."