The Surviving Sepsis Campaign guidelines have been updated. Some of the highlights include (abstract):
- Initial fluids with crystalloids at 30cc/kg, with goal in first 6 hours of CVP 8-12mmHg, MAP>65 mmHg, and urine output >0.5cc/kg/hr;
- Antibiotics within 1 hour
- No steroids unless refractory shock and no RBC transfusions unless Hb<7
- Vasopressor of choice is norepinephrine with epinephrine added if needed, phenylephrine only with arrhythmias, if cardiac output is high with low BP, or as salvage therapy, and dobutamine for myocardial dysfunction or continued hypoperfusion.
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.