Abstract
Sepsis and septic shock represent important infection-related medical emergencies
that result in significant morbidity and mortality. The prevalence and microbiology
of these processes are evolving. Nonetheless, timely and appropriate antibiotic therapy
continues to represent the most important determinant of survival. Recent trials have
clarified that crystalloids are preferred for initial resuscitation, and balanced
crystalloids appear superior to 0.9% saline. Controversy remains regarding not only
the rate and rapidity of fluid resuscitation but also about the timing and use of
vasopressors to maintain blood pressure. While some newer alternative vasopressors
may have a role in sepsis, more evidence supporting their use is required. Conflicting
data exist regarding the impact of corticosteroids on mortality in septic shock. However,
these reports indicate that adjunctive hydrocortisone can lead to more rapid shock
reversal.
Keywords
antibiotics - corticosteroids - fluids - sepsis - resuscitation - vasopressors
