• Lancet · Jul 2018

    Review

    Sepsis and septic shock.

    • Maurizio Cecconi, Laura Evans, Mitchell Levy, and Andrew Rhodes.
    • Department of Anaesthesia and Intensive Care, IRCCS Istituto Clinico Humanitas, Humanitas University, Milan, Italy. Electronic address: maurizio.cecconi@hunimed.eu.
    • Lancet. 2018 Jul 7; 392 (10141): 75-87.

    AbstractSepsis is a common condition that is associated with unacceptably high mortality and, for many of those who survive, long-term morbidity. Increased awareness of the condition resulting from ongoing campaigns and the evidence arising from research in the past 10 years have increased understanding of this problem among clinicians and lay people, and have led to improved outcomes. The World Health Assembly and WHO made sepsis a global health priority in 2017 and have adopted a resolution to improve the prevention, diagnosis, and management of sepsis. In 2016, a new definition of sepsis (Sepsis-3) was developed. Sepsis is now defined as infection with organ dysfunction. This definition codifies organ dysfunction using the Sequential Organ Failure Assessment score. Ongoing research aims to improve definition of patient populations to allow for individualised management strategies matched to a patient's molecular and biochemical profile. The search continues for improved diagnostic techniques that can facilitate this aim, and for a pharmacological agent that can improve outcomes by modifying the disease process. While waiting for this goal to be achieved, improved basic care driven by education and quality-improvement programmes offers the best hope of increasing favourable outcomes.Copyright © 2018 Elsevier Ltd. All rights reserved.

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