par Vincent, Jean Louis
Référence Evidence-Based Practice of Critical Care, Elsevier, page (274-278.e1)
Publication Publié, 2019-01
Partie d'ouvrage collectif
Résumé : Sepsis remains a common condition in critically ill patients. Evidence suggests that there has been some reduction in mortality rates from sepsis over recent years, although there have been no major breakthroughs in specific sepsis therapies. There has, however, been increased awareness of the signs and symptoms of sepsis and the importance of early diagnosis and management. There have also been improvements in the general process of care for these patients, including reduced iatrogenesis, more individualized patient management, and improved multidisciplinary teamwork. Randomized controlled clinical trials of interventions for patients with sepsis have largely been unsuccessful, primarily because patient selection was inadequate with interventions targeted at widely heterogeneous groups of patients rather than at those most likely to benefit. Improved techniques to characterize patients will help in targeting treatments more appropriately. Currently, early infection management with appropriate antibiotics and source control, combined with rapid resuscitation and hemodynamic stabilization all performed by a dedicated sepsis team remain the key aspects of treatment.