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More specific symptoms
Young and old
Symptoms of severe sepsis
Severe sepsis, is sepsis that is causing poor organ function, or insufficient blood flow to the body. Insufficient blood flow can manifest as either low blood pressure, high blood lactate, or low urine output.
Most commonly, the infection is bacterial, but it may also be fungal, viral, or protozoan. Common locations for the primary infection include the lungs, brain, urinary tract, skin, and abdominal organs.
In 2016, SIRS was replaced with a shortened sequential organ failure assessment score (called the SOFA score). With the quick SOFA, if the patient has any two of, increased breathing rate, change in their level of consciousness, or low blood pressure, then they meet the criteria.
Fluid replacement and blood pressure
If fluid replacement is not enough to maintain blood pressure, medications that raise blood pressure may be used. Mechanical ventilation and dialysis may be needed, to support the function of the lungs and kidneys.
Monitoring blood pressure
To guide treatment, a central venous catheter, and an arterial catheter may be placed for access to the bloodstream. Other measurements such as cardiac output, and superior vena cava oxygen saturation may be used.
Risks of sepsis
People with sepsis need preventive measures for deep vein thrombosis, stress ulcers and pressure ulcers, unless other conditions prevent such interventions. Some might benefit from tight control of blood sugar levels with insulin.
Millions are affected by sepsis each year, with a rate of 0.2-3 people per thousand, per year in the developed world. But the global burden of disease is unknown since little data exists from the developing world.
Change in rate of disease
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- "Sepsis Questions and Answers". cdc.gov. Centers for Disease Control and Prevention (CDC). 22 May 2014. Archived from the original on 4 December 2014. Retrieved 28 November 2014.
- Jui, Jonathan; et al. (American College of Emergency Physicians) (2011). "Ch. 146: Septic Shock". In Tintinalli, Judith E.; Stapczynski, J. Stephan; Ma, O. John; Cline, David M.; Cydulka, Rita K.; Meckler, Garth D. (eds.). Tintinalli's Emergency Medicine: A Comprehensive Study Guide (7th ed.). New York: McGraw-Hill. pp. 1003–14. Archived from the original on 15 January 2014. Retrieved 11 December 2012 – via AccessMedicine. Unknown parameter
- Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. (February 2013). "Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012" (PDF). Critical Care Medicine. 41 (2): 580–637. doi:10.1097/CCM.0b013e31827e83af. PMID 23353941. Archived from the original (PDF) on 2 February 2015.
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- Patel GP, Balk RA (January 2012). "Systemic steroids in severe sepsis and septic shock". American Journal of Respiratory and Critical Care Medicine. 185 (2): 133–9. doi:10.1164/rccm.201011-1897CI. PMID 21680949.
- Annane D, Bellissant E, Bollaert PE, Briegel J, Keh D, Kupfer Y (December 2015). "Corticosteroids for treating sepsis". The Cochrane Database of Systematic Reviews. 12 (12): CD002243. doi:10.1002/14651858.CD002243.pub3. PMID 26633262.
- Fang, F; Zhang, Y; Tang, J; Lunsford, LD; Li, T; Tang, R; He, J; Xu, P; Faramand, A; Xu, J; You, C (21 December 2018). "Association of Corticosteroid Treatment With Outcomes in Adult Patients With Sepsis: A Systematic Review and Meta-analysis". JAMA Internal Medicine. 179 (2): 213–223. doi:10.1001/jamainternmed.2018.5849. PMID 30575845.
- Jawad I, Lukšić I, Rafnsson SB (June 2012). "Assessing available information on the burden of sepsis: global estimates of incidence, prevalence and mortality". Journal of Global Health. 2 (1): 010404. doi:10.7189/jogh.01.010404. PMC 3484761. PMID 23198133.
- Martin GS (June 2012). "Sepsis, severe sepsis and septic shock: changes in incidence, pathogens and outcomes". Expert Review of Anti-Infective Therapy. 10 (6): 701–6. doi:10.1586/eri.12.50. PMC 3488423. PMID 22734959.
- Angus DC, van der Poll T (August 2013). "Severe sepsis and septic shock". The New England Journal of Medicine. 369 (9): 840–51. doi:10.1056/NEJMra1208623. PMID 23984731. Unknown parameter
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- Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. (June 1992). "Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine". Chest. 101 (6): 1644–55. doi:10.1378/chest.101.6.1644. PMID 1303622.
Septicemia... has been used... in a variety of ways... We therefore suggest that this term be eliminated from current usage.