A large proportion of patients with septic shock but who present to the ED with vague symptoms not specific to infection have a significantly higher mortality rate than those with symptoms that are explicit to an infection.
Delayed lactate measurement is associated with delayed antibiotic administration and increased mortality in patients with increased lactate levels.
Although the Systemic Inflammatory Response Syndrome criteria have been used for decades to identify sepsis in patients with suspected infection, they have been re-evaluated in the Third International Consensus Definitions for Sepsis and Septic Shock.
Early antibiotic administration in treating infection has evident biological plausibility, however, time-sensitivity to outcomes appears to be most relevant in septic shock.
Study demonstrated a new approach to incorporate time (“delay”) when analyzing the effect on outcomes and provided new evidence for clinical practice and research of severe sepsis or septic shock.
Researchers evaluated the prognostic significance of the cutoff value for lactate via comparison of clinical presentation and outcome between patients with septic shock with high and low lactate levels.
In patients with insulin-treated diabetes and sepsis, increased highest glucose levels and glycemic variability have a significant illness severity-adjusted association with decreasing in-hospital mortality.
In this study involving patients with septic shock, 90-day all-cause mortality was lower in patients who received hydrocortisone plus fludrocortisone than in patients who received placebo.
Induced hypothermia (target temperature 32°C-34°C) proved harmful with regards to respiratory function and it also prolonged septic shock.
Adjunctive glucocorticoid therapy in patients with septic shock may reduce the duration of shock.
