Surviving Sepsis
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Surviving Sepsis
Dr Ron Daniels
NHS Institute Safer Care Faculty
Chair: United Kingdom Sepsis Trust & Pre-hospital Working Group
A U.K. Perspective
ICNARC data 6 months to 01/06 Admissions
Severe Sepsis or Septic shock
Total 21,025 Total 6,534 (31.1%) Total 8,372 (39.8%)
ICU mortality n (%)
Hospital mortality n (%)
© Ron Daniels 20
A U.K. Perspective
40 30
Annual UK mortality (2003), thousands
20 10
0
Lung1
Colon2
cancers
Breast3
4
Sepsis4
1,2,3
www.statistics.gov.u
Intensive Care National Audit Research Centre (200
© Ron Daniels 20
Sepsis Resuscitation Bundle
Serum lactate measured Blood cultures obtained prior to antibiotic administration From the time of presentation, broad-spectrum antibiotics to be given within 1 hour Control infective source In the event of hypotension and/or lactate >4mmol/L (36mg/dl):
Deliver an initial minimum of 20 ml/kg of crystalloid (or colloid equivalent) Give vasopressors for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure (MAP) > 65 mm Hg.
To be started immediately and completed within 6 hours)
In the event of persistent arterial hypotension despite volume resuscitation (septic shock) and/or initial lactate >4 mmol/l (36 mg/dl):
Achieve central venous pressure (CVP) of >8 mm Hg Achieve central venous oxygen saturation (ScvO2) >70%
© Ron Daniels 20
Sepsis Resuscitation Bundle
Serum lactate measured Blood cultures obtained prior to antibiotic administration From the time of presentation, broad-spectrum antibiotics to be given within 1 hour Control infective source In the event of hypotension and/or lactate >4mmol/L (36mg/dl):
Deliver an initial minimum of 20 ml/kg of crystalloid (or colloid equivalent) Give vasopressors for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure (MAP) > 65 mm Hg.
To be started immediately and completed within 6 hours)
In the event...
Dr Ron Daniels
NHS Institute Safer Care Faculty
Chair: United Kingdom Sepsis Trust & Pre-hospital Working Group
A U.K. Perspective
ICNARC data 6 months to 01/06 Admissions
Severe Sepsis or Septic shock
Total 21,025 Total 6,534 (31.1%) Total 8,372 (39.8%)
ICU mortality n (%)
Hospital mortality n (%)
© Ron Daniels 20
A U.K. Perspective
40 30
Annual UK mortality (2003), thousands
20 10
0
Lung1
Colon2
cancers
Breast3
4
Sepsis4
1,2,3
www.statistics.gov.u
Intensive Care National Audit Research Centre (200
© Ron Daniels 20
Sepsis Resuscitation Bundle
Serum lactate measured Blood cultures obtained prior to antibiotic administration From the time of presentation, broad-spectrum antibiotics to be given within 1 hour Control infective source In the event of hypotension and/or lactate >4mmol/L (36mg/dl):
Deliver an initial minimum of 20 ml/kg of crystalloid (or colloid equivalent) Give vasopressors for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure (MAP) > 65 mm Hg.
To be started immediately and completed within 6 hours)
In the event of persistent arterial hypotension despite volume resuscitation (septic shock) and/or initial lactate >4 mmol/l (36 mg/dl):
Achieve central venous pressure (CVP) of >8 mm Hg Achieve central venous oxygen saturation (ScvO2) >70%
© Ron Daniels 20
Sepsis Resuscitation Bundle
Serum lactate measured Blood cultures obtained prior to antibiotic administration From the time of presentation, broad-spectrum antibiotics to be given within 1 hour Control infective source In the event of hypotension and/or lactate >4mmol/L (36mg/dl):
Deliver an initial minimum of 20 ml/kg of crystalloid (or colloid equivalent) Give vasopressors for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure (MAP) > 65 mm Hg.
To be started immediately and completed within 6 hours)
In the event...