Sepsis and septic shocktreatment Principles of treatment

As for other causes of MODS, outcome in sepsis improves with:

1. Prompt diagnosis and treatment of the underlying cause

2. Rapid resuscitation to prevent prolonged tissue hypoxia

3. Good glycaemic control

4. Strict infection control

5. Recognition and appropriate treatment of secondary infections

6. Adequate nutrition

7. Recognition that 'normal' physiological/biochemical levels do not necessarily need to be attained while the patient is critically ill, provided he/she is not compromised: e.g. a mean BP of 55-60mmHg is often acceptable unless evidence of poor perfusion or ischaemia suggests higher levels should be sought

8. Avoidance of preventable mishaps, e.g. prolonged hypotension, pressure sores, thromboembolism

9. Temperature control in the range 36-38.5°C.

10. Prevention of contractures, early mobilisation, etc.

11. Specific treatments (see below)

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