Initial Management & Resuscitation 

 

  • Draw blood cultures (aerobic + anaerobic) prior to antibiotic therapy 

  • Start with broad spectrum antibiotics within 1 hour of sepsis diagnosis & assess for need for source control 

  • Resuscitate with initial crystalloid fluid bolus of 30cc/kg with the following goals: 

    • ​MAP >65 mmHg.  Apply vasopressors if MAP goal not acheived with fluids 

    • Use dynamic* hemodynamic variables to guide fluid resuscitation 

      • ​static variables such as CVP not recommended 

    • Lactate clearance 

 

*Dynamic variables include: 

  • passive leg raises

  • fluid challenges against stroke volume measurements

  • 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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