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Initial Management & Resuscitation
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Draw blood cultures (aerobic + anaerobic) prior to antibiotic therapy
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Start with broad spectrum antibiotics within 1 hour of sepsis diagnosis & assess for need for source control
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Resuscitate with initial crystalloid fluid bolus of 30cc/kg with the following goals:
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MAP >65 mmHg. Apply vasopressors if MAP goal not acheived with fluids
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Use dynamic* hemodynamic variables to guide fluid resuscitation
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static variables such as CVP not recommended
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Lactate clearance
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*Dynamic variables include:
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passive leg raises
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fluid challenges against stroke volume measurements
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variations in systolic pressure, pulse pressure, or stroke volume to changes in intrathoracic pressure caused by mechanical ventilation
Adapted from Surviving Sepsis Guidelines 2016. Critical Care Medicine: March 2017 - Volume 45, Issue 3, p 486–552
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