Severe Sepsis and Septic Shock: Improving Outcomes in the Emergency Department

Emergency Medicine Clinics of North America

Volumn 26, Issue 3, 2008, Pages 603-623

  Catenacci, Michael H ^a   King, Kaira ^b  

^a UNIVERSITY OF ALABAMA AT BIRMINGHAM   (United States)

^b Trinity Medical Center   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIBIOTIC AGENT; BENZODIAZEPINE DERIVATIVE; BETA LACTAM ANTIBIOTIC; CEPHALOSPORIN DERIVATIVE; CORTICOSTEROID; COTRIMOXAZOLE; DROTRECOGIN; ETOMIDATE; FLUDROCORTISONE; HYDROCORTISONE; HYPERTENSIVE AGENT; INSULIN; MACROLIDE; MORPHINE; QUINOLINE DERIVED ANTIINFECTIVE AGENT; THIOPENTAL;

ADRENAL SUPPRESSION; ANTIBIOTIC RESISTANCE; BLEEDING; CLINICAL TRIAL; EMERGENCY WARD; HIGH RISK PATIENT; HUMAN; HYPERGLYCEMIA; INCIDENCE; LOW DRUG DOSE; MORTALITY; PRIORITY JOURNAL; REVIEW; RISK FACTOR; SEPSIS; SEPTIC SHOCK; SIDE EFFECT; SINGLE DRUG DOSE; UNITED STATES;

EID: 47649096628     PISSN: 07338627     EISSN: 07338627     Source Type: Journal    
DOI: 10.1016/j.emc.2008.05.004     Document Type: Review

References (86)

1. Dombrovskiy V.Y., Martin M., Sunderrram J., et al. Rapid Increase in hospitalization and mortality rates for severe sepsis in the United States: A trend analysis from 1993 to 2003. Crit Care Med 35 (2007) 1244-1250
2. The EPISEPSIS Study Group. EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units. Intensive Care Med 30 (2004) 580-588
3. Martin G.S., Mannino D.M., Eaton S., et al. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 348 16 (2003) 1546-1554
4. Angus D., Linde-Zwirble W.T., Lidicker M.A., et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 29 (2001) 1303-1310
5. Rangel-Frausto M.S., Pittet D., Costigan M., et al. The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. JAMA 273 (1995) 117-123
6. Dellinger R.P. Cardiovascular management of septic shock. Crit Care Med 31 (2003) 946-955
7. Osborn T.M., Tracy J.K., Dunne J.R., et al. Epidemiology of sepsis in patients with traumatic injury. Crit Care Med 32 (2004) 2234-2240
8. McCaig L.F., and Burt C.W. National Hospital Ambulatory Medical Care Survey: 2002 emergency department summary. Adv Data 340 (2004) 1-34
9. Lambe S., Washington D.L., Fink A., et al. Trends in the use and capacity of California's emergency departments, 1990-1999. Ann Emerg Med 39 (2002) 389
10. Steele R., and Kiss A. EMDOC (emergency department overcrowding) internet-based safety net research. J Emerg Med (2007) DOI: 10.1016/j.jemermed.2007.03.022
11. Wang H., Shapiro N., Angus D., et al. National estimates of severe sepsis in United States emergency departments. Crit Care Med 35 (2007) 1928-1936
12. Merriam-Webster's Collegiate Dictionary. 11th edition. Merriam-Webster Incorporated; 2003.
13. Anonymous. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20 (1992) 864-874
14. Poze M.R.G., Ramsay G., Gerlach H., et al. An international sepsis survey: a study of doctors' knowledge and perception about sepsis. Crit Care 8 (2004) R409-R413
15. Levy M.M., Fink M.P., Marshall J.C., et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International sepsis definitions conference. Crit Care Med 31 (2003) 1250-1256
16. Osborn T.M., Nguyen H.B., and Rivers E.P. Emergency medicine and the surviving sepsis campaign: an international approach to managing severe sepsis and septic shock. Ann Emerg Med 46 (2005) 228-231
17. The Surviving Sepsis Campaign. Available at:. http://www.survivingsepsis.org/background/barcelona_declaration Accessed April 1, 2008
18. Dellinger R.P., Levy M.M., Carlet J.M., et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 36 (2008) 296-327
19. Dellinger R.P., Carlet J.M., Masur H., et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 32 (2004) 858-873
20. Kumar A., Roberts D., Wood K.E., et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34 (2006) 1589-1596
21. Larche J., Azoulay E., Fieux F., et al. Improved survival of critically ill cancer patients with septic shock. Intensive Care Med 29 (2003) 1688-1695
22. Proulx N., Frechette D., Toye B., et al. Delays in the administration of antibiotics are associated with mortality from adult acute bacterial meningitis. QJM 98 (2005) 291-298
23. Harbarth S., Garbino J., Pugin J., et al. Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. Am J Med 115 7 (2003) 529-535
24. Leibovici L., Shraga I., et al. The benefit of appropriate empirical antibiotic treatment in patients with bloodstream infection. J Intern Med 244 (1998) 379-386
25. Ibrahim E.H., Sherman G., Ward S., et al. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest 118 1 (2000) 146-155
26. Valles J., Rello J., Ochagavia A., et al. Community-acquired bloodstream infection in critically ill adult patients: impact of shock and inappropriate antibiotic therapy on survival. Chest 123 (2003) 1615-1624
27. Kanamaru A., and Tasumi Y. Microbiological data for patients with febrile neutropenia. Clin Infect Dis 39 (2004) S7-S10
28. Zinner S.H. Changing epidemiology of infections in patients with neutropenia and cancer: emphasis on gram-positive and resistant bacteria. Clin Infect Dis 29 3 (1999) 490-494
29. Doern G.V., Pfaller M., Kugler K., et al. Prevalence of antimicrobial resistance among respiratory tract isolates of streptococcus pneumonia in north america: 1997 results from the SENTRY antimicrobial surveillance program. Clin Infect Dis 27 (1998) 764-770
30. Thornsberry C., Sahm D.F., Kelly L.J., et al. Regional trends in antimicrobial resistance among clinical isolates of Streptococcus pneumonia, Haemophilus influenza, and Moraxella catarrhalis in the United States: results from the TRUST Surveillance Program, 1999-2000. Clin Infect Dis 34 (2002) S4-S16
31. Doern G.V., and Brown S.D. Antimicrobial susceptibility among community-acquired respiratory tract pathogens in the USA: data from PROTEKT US 2000-01. J Infect 48 (2004) 56-65
32. Centers for Disease Control and Prevention. Effect of new susceptibility breakpoints on reporting of resistance in Streptococcus pneumonia: United States, 2003. MMWR Morb Mortal Wkly Rep 53 7 (2004) 152-154
33. Crum N.F., Lee R.U., Thornton S., et al. Fifteen-year study of the changing epidemiology of methicillin-resistant Staphylococcus aureus. Am J Med 119 11 (2006) 943-951
34. Moran G.J., Krishnadasan A., Gorwitz R.J., et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med 355 (2006) 666-674
35. Frazee B.W., Lynn J.L., Charlebois E.D., et al. High prevalence of methicillin-resistant staphylococcus aureus in emergency department skin and soft tissue infections. Ann Emerg Med 45 3 (2005) 311-320
36. Klevens M.K., Morrison M.A., Nadle J., et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 298 15 (2007) 1763-1771
37. Centers for Disease Control and Prevention. Severe methicillin-resistant Staphylococcus aureus community-acquired pneumonia associated with influenza-Louisiana and Georgia, December 2006-January 2007. MMWR Morb Mortal Wkly Rep 56 14 (2007) 325-329
38. Costerton J.W., Stewart P.S., and Greenberg E.P. Bacterial biofilms: a common cause of persistent infections. Science 284 (1999) 1318-1321
39. Sahn S.A., and Light R.W. The sun should never set on a parapneumonic effusion. Chest 95 5 (1989) 945-947
40. Light R.W. A new classification of parapneumonic effusions and empyema. Chest 108 2 (1995) 299-301
41. Elliott D.C., Kufera J.A., Myers R.A., et al. The microbiology of necrotizing soft tissue infections. Am J Surg 179 (2000) 361-366
42. Elliott D.C., Kufera J.A., and Myers R.A. Necrotizing soft tissue infections: risk factors for mortality and strategies for management. Ann Surg 224 (1996) 672-683
43. Betsch A., Wiskirchen J., Trubenbach J., et al. CT guided percutaneous drainage of intra-abdominalabscesses: APACHE III score stratification of 1-year results. Eur Radiol 12 (2002) 2883-2889
44. Hatzidakis A.A., Prassopoulos P., Petinarakis I., et al. Acute cholecystitis in high-risk patients: percutaneous cholecystomy vs conservative treatment. Eur Radiol 12 (2002) 1778-1784
45. Rivers E., Nguyen B., Havstad S., et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345 (2001) 1368-1377
46. Rivers E., Coba V., and Whitmill M. Early goal-directed therapy in severe sepsis and septic shock: a contemporary review of the literature. Curr Opin Anaesthesiol 21 (2008) 128-140
47. Hickling K.G., Henderson S.J., and Jackson R. Low mortality associated with low volume pressure limited ventilation with permissive hypercapnea in severe adult respiratory distress syndrome. Intensive Care Med 16 (1990) 372-377
48. Hickling K.G., Walsh J., Henderson S., et al. Low mortality rate in adult respiratory distress syndrome using low-volume, pressure-limited ventilation with permissive hypercapnea: a prospective study. Crit Care Med 22 (1994) 1568-1578
49. Rouby J.-J., Puybasset L., Nieszkowska A., et al. Acute respiratory distress syndrome: lessons from computed tomorgraphy of the whole lung. Crit Care Med 31 Suppl (2003) S285-S295
50. Dreyfuss D., Soler P., Basset G., et al. High inflation pressure pulmonary edema: respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure. Am Rev Respir Dis 137 (1988) 1159-1164
51. Ricard J.D., Dreyfuss D., and Saumon G. Production of inflammatory cytokines in ventilator-induced lung injury: a reappraisal. Am J Respir Crit Care Med 163 (2001) 1176-1180
52. Rouby J.J., Lherm T., Martin De Lassale E., et al. Histologic aspects of pulmonary barotraumas in critically ill patients with acute respiratory failure. Intensive Care Med 19 (1993) 383-389
53. Petersen G.W., and Baier H. Incidence of pulmonary barotraumas in a medical ICU. Crit Care Med 11 (1983) 67-69
54. The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as copmpared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342 (2000) 1301-1308
55. Oelkers W. Adrenal insufficiency. N Engl J Med 335 (1996) 1206-1212
56. Bennett I.L., Finland M., Hamburger M., et al. The effectiveness of hydrocortisone in the management of severe infections. JAMA 183 (1963) 462-465
57. The Veterans Administration Systemic Sepsis Cooperative Study Group: Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of sepsis. N Engl J Med 317 (1987) 659-665
58. Sprung C.L., Caralis P.V., Marcial E.H., et al. The effect of high-dose corticosteroids in patients with septic shock. N Engl J Med 311 (1984) 1137-1143
59. Bone R.C., Fisher C.J., Clemmer T.P., et al. A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 317 (1987) 653-658
60. Lefering R., and Neugebauer E. Steroid controversy in sepsis and septic shock: a metanalysis. Crit Care Med 23 (1995) 1294-1303
61. Annane D., Sebille V., Charpentier C., et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288 (2002) 862-871
62. Sprung C.L., Annane D., Keh D., et al. Hydrocortisone therapy for patients with septic shock. N Engl J Med 358 (2008) 111-124
63. Finfer S. Cotricosteroids in septic shock. N Engl J Med 358 (2008) 188-189
64. Evans R.H., and Hill R.G. The GABA-mimetic action of etomidate. [proceedings]. Br J Pharmacol 61 (1977) 484P
65. Sakles J.C., et al. Airway management in the emergency department: A one-year study of 610 tracheal intubations. Ann Emerg Med 31 (1998) 325-332
66. Weiss-Bloom L.J., and Reich D.L. Haemodynamic responses to tracheal intubation following etomidate and fentanyl for anaesthetic induction. Can J Anaesth 39 8 (1992) 780-785
67. Gooding J.M., Weng J.T., Smith R.A., et al. Cardiovascular and pulmonary responses following etomidate induction of anesthesia in patients with demonstrated cardiac disease. Anesth Analg 58 (1979) 4-10
68. Modica P.A., and Tempelhoff R. Intracranial pressure during induction of anaesthesia and tracheal intubation with etomidate-induced EEG burst suppression. Can J Anaesth 39 (1992) 236-241
69. Wagner R.L., White P.F., Kan P.B., et al. Inhibition of adrenal steroidogenesis by the anesthetic etomidate. N Engl J Med 310 (1984) 1415-1421
70. Watt I., and Ledingham I.M. Mortality amongst multiple trauma patients admitted to an intensive therapy unit. Anaesthesia 39 (1984) 973-981
71. Annane D. ICU physicians should abandon the use of etomidate!. Intensive Care Med 31 (2005) 325-326
72. Dmello D., Taylor S., O'Brien J., et al. ICU physicians should not abandon the use of etomidate!. Crit Care Med 34 (2006) A110
73. Jackson Jr. W.L. Should we use etomidate as an induction agent for endotracheal intubation in patients with septic shock? A critical appraisal. Chest 127 (2005) 1031-1038
74. Lundy J.B., Slane M.L., and Frizzi J.D. Acute adrenal insufficiency after a single dose of etomidate. J Intensive Care Med 22 (2007) 111-117
75. Absalom A., Pledger D., and Kong A. Adrenocortical function in critically ill patients 24 h after a single dose of etomidate. Anaesthesia 54 (1999) 861-867
76. Ray D.C., and McKeown D.W. Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock. Crit Care 11 (2007) R56. http://ccforum.com/content/11/3/R56 Available at:
77. Bernard G.R., Vincent J.L., Laterre P.F., et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 344 (2001) 699-709
78. Fourrier F. Recombinant human activated protein C in the treatment of severe sepsis: an evidence based review. Crit Care Med 32 S (2004) S534-S541
79. Joyce D.E. Recombinant human activated protein C attenuates the inflammatory response in endothelium and monocytes by modulating nuclear factor-kappaB. Crit Care Med 30 5 Suppl (2002) S288-S293
80. Fisher C.J., and Yan S.B. Protein C levels as a prognostic indicator of outcome in sepsis and related diseases. Crit Care Med 28 S (2000) S49-S56
81. Yan S.B., Helterbrand J.D., Hartman D.L., et al. Low levels of protein C are associated with poor outcome in severe sepsis. Chest 120 (2001) 915-922
82. Abraham E., Laterre P.F., Garg R., et al. Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death. N Engl J Med 353 (2005) 1332-1341
83. Vincent J.L., Bernard G.R., Beale R., et al. Drotrecogin alfa(activated) treatment in severe sepsis from the global open-label trial ENHANCE: further evidence for survival and safety and implications for early treatment. Crit Care Med 33 (2005) 2266-2277
84. Nguuyen H.B., Corbett S.W., Menes K., et al. Early goal-directed therapy, corticosteroid, and recombinant human activated protein C for the treatment of severe sepsis and septic shock in the emergency department. Acad Emerg Med 13 (2006) 109-113
85. Van den Berghe G., Wouters P., Weekers F., et al. Intensive insulin therapy in critically ill patients. N Engl J Med 345 (2001) 1359-1367
86. van den Berghe G., Wilmer A., Hermans G., et al. Intensive insulin therapy in the medical ICU. N Engl J Med 354 (2006) 449-461