Highlights from Sepsis surviving Campaign 2016:
- Base on ProCESS, ProMISe and ARISE trials, all 3 trials confirmed that there was no survival benefit of EGDT compared to usual resuscitation. However, in all three studies patients had early antibiotics, >30ml/kg of IVF prior to randomization. We need therefore to keep in mind that the practice has changed.
- Source control: empiric broad-spectrum therapy Abx to cover all likely pathogens within 1hr
- Initial resuscitation: 30ml/kg of IV crystalloid fluid in first 3 hours and REASSESS fluid status & hemodynamic status with goal of MAP > 65mmHg
- Norepinephrine as 1st choice vasopressor, Vasopressin or Epinephrine are 2nd-line
- Check Lactate clearance as marker of tissue hypoperfusion