Treatment of Severe Sepsis-Based on Surviving Sepsis Campaign Guideline

Sepsis is a systemic, deleterious host response to infection.The term "severe sepsis" is used when sepsis is complicated by acute organ dysfunction, and "septic shock" as sepsis complicated by either hypotension that is refractory to fluid resuscitation or by hyperlactatemia.The number of cases with severe sepsis exceeds 750,000 per year in the United States and the mortality is now closer to 20 to 30% in these days.The principles of the initial management bundle are to provide sufficient hemodynamic resuscitation and early initiation of appropriate antibiotics to mitigate uncontrolled infection.Initial resuscitation requires the use of intravenous fluids and vasopressors.It is very important to achieve the target of initial resuscitation.The supportive cares in ICU are also significant such as blood component transfusion, glucose control, renal replacement therapy, deep vein thrombosis prophylaxis and stress ulcer prophylaxis.The goals of care and prognosis including end-of-life care should be discussed with patients and families as early as feasible.(Korean J Med 2014;86:557-562)