Introduction
Sepsis and septic shock remain significant challenges in healthcare, affecting millions worldwide. The "Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021" provides comprehensive recommendations for managing these conditions. This blog explores how practitioners can leverage these guidelines to enhance their clinical skills and improve patient outcomes, particularly for children.
Key Recommendations
The guidelines emphasize early identification and management of sepsis, recommending a performance improvement program that includes sepsis screening for high-risk patients. A meta-analysis of 50 observational studies showed that such programs are associated with better adherence to sepsis bundles and reduced mortality (OR 0.66; 95% CI 0.61–0.72).
Screening and Early Treatment
Screening tools like systemic inflammatory response syndrome (SIRS) criteria and quick Sequential Organ Failure Assessment (qSOFA) are discussed, although qSOFA is not recommended as a single screening tool due to its poor sensitivity. Machine learning tools have shown promise, with higher predictive accuracy for hospital-acquired sepsis (SAUROC 0.89; 95% CI 0.86–0.92).
Standard Operating Procedures
The guidelines recommend against using qSOFA alone and suggest measuring blood lactate levels in suspected sepsis cases. Elevated lactate levels are associated with increased mortality, making it a critical component of the sepsis bundle.
Initial Resuscitation
For initial resuscitation, the guidelines recommend administering at least 30 mL/kg of intravenous crystalloid fluid within the first 3 hours. This approach is based on observational evidence and has been associated with reduced mortality.
Implementing Guidelines in Practice
Practitioners can improve their skills by integrating these guidelines into their practice. This involves staying updated with the latest evidence, utilizing recommended screening tools, and adhering to standard operating procedures for sepsis management.
Encouraging Further Research
The guidelines also highlight areas where further research is needed, such as the optimal timing for interventions and the use of advanced screening technologies. Practitioners are encouraged to contribute to research efforts to refine and improve sepsis management strategies.
Conclusion
By implementing these guidelines, practitioners can enhance their clinical practice, leading to better outcomes for patients, including children. For more detailed information, practitioners are encouraged to read the full research paper: Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.
