Sepsis Guidelines 2008_5

http://www.pcp.onlinemindanao.com http://www.PhilippineMedics.com http://www.PhilippinesDailyPhotos.com Severe sepsis and septic shock are major healthcare problems affecting millions of individuals around the world each year. In 2004, an international group of experts in the diagnosis and management of infection and sepsis published the first internationally accepted guidelines that the clinicians could use to improve outcomes in severe sepsis and septic shock. The 2008 guideline is an update to the previous guideline. The key recommendations include: early goal-directed resuscitation of the septic patient during the first 6 hours after recognition; blood cultures prior to antibiotic therapy; imaging studies performed promply; administration of broad-spectrum antibiotic therapy within 1 hour of diagnosis; reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate; a usual 7-10 days of antibiotic therapy guided by clinical response; source control; administration of either crystalloid or colloid resuscitation; fluid challenge to restore mean circulating filling pressure; reduction in rate of fluid administration with rising filing pressures and no improvement in tissue perfussion;