Review Article| Volume 29, ISSUE 4, P689-704, December 2008

Management of Sepsis: Early Resuscitation

      Key links in the chain of survival for the management of severe sepsis and septic shock are early identification and comprehensive resuscitation of high-risk patients. Multiple studies have shown that the first 6 hours of early sepsis management are especially important from a diagnostic, pathogenic, and therapeutic perspective, and that steps taken during this period can have a significant impact on outcome. The recognition of this critical time period and the robust outcome benefit realized in previous studies provides the rationale for adopting early resuscitation as a distinct intervention. Sepsis joins trauma, stroke, and acute myocardial infarction in having “golden hours,” representing a critical opportunity early on in the course of disease for actions that offer the most benefit.



      ARR (Absolute risk reduction), ALI (Acute lung injury), ARDS (Adult respiratory distress syndrome), APACHE II (Acute physiologic and chronic health evaluation score II), CVP (Central venous pressure), CQI (Continuos quality improvement), ED (Emergency department), EDM (Esophageal doppler monitoring), EGDT (Early goal-directed therapy), ESRD (End stage renal disease), GPU (Inpatient general practice unit (medical-surgical floors)), HFH (Henry Ford Hospital), ICU (Intensive care unit), IHI (Institute for Health Improvement), IL-8 (Interleukin 8), LOS (Length of stay), MB (Maintainance or 24 hour bundle), mmol/L (millimoles per liter), MODS (Multiple organ dysfunction score), NNT (Number needed to treat), OR (Odds ratio), PAC (Pulmonary artery catheter), PAOP (Pulmonary capillary occlusion pressure), PPV (Pulse pressure variation), RR (Relative risk), RRR (Relative risk reduction), SAPS II (Simplified acute physiologic score), SBP (Systolic blood pressure), ScvO2 (Central venous oxygen saturation), SvO2 (Mixed venous oxygen saturation), SD (Standard deviation), SSC (Surviving Sepsis Campaign)
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