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.
Keywords
Abbreviation:
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)To read this article in full you will need to make a payment
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Article info
Footnotes
Emanuel P. Rivers receives research support from the National Institute of Allergy and Infectious Disease, and from Hutchinson Technologies. In the last 2 years, he has performed as a consultant, delivered lectures, or served as a panelist for Biosite, Edwards Lifesciences, Elan, and Eli Lilly and Co.
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© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
