VIDEO: Effective treatment strategies for sepsis management

Editor’s note: This is an automatically generated transcript, which has been slightly edited for clarity. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

After decades of research into various novel treatments for sepsis, as of today, it still comes down to the basics which involves early recognition and treatment with appropriate antimicrobials, fluid resuscitation when there's hypotension or signs of hypoperfusion and controlling the source of infection as applicable. So, it's important to know that the Centers for Medicare and Medicaid Services is benchmarking hospitals on compliance rates with the SEP-1 measure, which defines a bundle of actions for clinicians to do within 3 to 6 hours of sepsis or septic shock onset.
So, the 3-hour bundle includes lactate measurements, blood cultures, antibiotics and volume resuscitation for hypertension or elevated lactate levels. And the 6-hour bundle includes a repeat lactate if the initial level is elevated, a reassessment of volume and perfusion status, and starting vasopressors if the patient is still hypotensive after fluids.

Now, some elements of the bundle are quite controversial, particularly the exact fluid amount that's required and whether the urgency of antibiotics. It really is the same for patients with sepsis and septic shock.

However, the general principles behind the core bundle elements are in pretty good practice for most patients with sepsis. I'll say that another element that is not included in the bundle but is a really important part of managing sepsis is achieving source control as quickly as possible. And that might mean, you know, removing an infected central line or relieving a biliary or a urinary obstruction through an intervention or surgical management of a bowel perforation, etc. Several studies now have found associations between delays in source control and worse sepsis outcomes.