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Septic shock

MedGen UID:
11410
•Concept ID:
C0036983
•
Pathologic Function
Synonyms: Septic Shock; Shock, Septic
SNOMED CT: Septicemic shock (76571007); Sepsis-associated hypotension (76571007); Septic shock (76571007)

Definition

A state of acute circulatory failure characterized by persistent arterial hypotension despite adequate fluid resuscitation or by tissue hypoperfusion unexplained by other causes. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVSeptic shock

Professional guidelines

PubMed

International Consensus Criteria for Pediatric Sepsis and Septic Shock.
Schlapbach LJ, Watson RS, Sorce LR, Argent AC, Menon K, Hall MW, Akech S, Albers DJ, Alpern ER, Balamuth F, Bembea M, Biban P, Carrol ED, Chiotos K, Chisti MJ, DeWitt PE, Evans I, Flauzino de Oliveira C, Horvat CM, Inwald D, Ishimine P, Jaramillo-Bustamante JC, Levin M, Lodha R, Martin B, Nadel S, Nakagawa S, Peters MJ, Randolph AG, Ranjit S, Rebull MN, Russell S, Scott HF, de Souza DC, Tissieres P, Weiss SL, Wiens MO, Wynn JL, Kissoon N, Zimmerman JJ, Sanchez-Pinto LN, Bennett TD; Society of Critical Care Medicine Pediatric Sepsis Definition Task Force
JAMA 2024 Feb 27;331(8):665-674. doi: 10.1001/jama.2024.0179. PMID: 38245889Free PMC Article
Sepsis-induced immunosuppression: mechanisms, diagnosis and current treatment options.
Liu D, Huang SY, Sun JH, Zhang HC, Cai QL, Gao C, Li L, Cao J, Xu F, Zhou Y, Guan CX, Jin SW, Deng J, Fang XM, Jiang JX, Zeng L
Mil Med Res 2022 Oct 9;9(1):56. doi: 10.1186/s40779-022-00422-y. PMID: 36209190Free PMC Article
Sepsis: pathophysiology and clinical management.
Gotts JE, Matthay MA
BMJ 2016 May 23;353:i1585. doi: 10.1136/bmj.i1585. PMID: 27217054

Recent clinical studies

Etiology

What is new and different in the 2021 Surviving Sepsis Campaign guidelines.
Prescott HC, Ostermann M
Med Klin Intensivmed Notfmed 2023 Dec;118(Suppl 2):75-79. Epub 2023 Jun 7 doi: 10.1007/s00063-023-01028-5. PMID: 37286842Free PMC Article
Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial.
Ibarra-Estrada M, Kattan E, Aguilera-González P, Sandoval-Plascencia L, Rico-Jauregui U, Gómez-Partida CA, Ortiz-Macías IX, López-Pulgarín JA, Chávez-Peña Q, Mijangos-Méndez JC, Aguirre-Avalos G, Hernández G
Crit Care 2023 Mar 13;27(1):110. doi: 10.1186/s13054-023-04397-7. PMID: 36915146Free PMC Article
Neonatal septic shock, a focus on first line interventions.
Spaggiari V, Passini E, Crestani S, Roversi MF, Bedetti L, Rossi K, Lucaccioni L, Baraldi C, Della Casa Muttini E, Lugli L, Iughetti L, Berardi A
Acta Biomed 2022 Jul 1;93(3):e2022141. doi: 10.23750/abm.v93i3.12577. PMID: 35775767Free PMC Article
Hemodynamic monitoring and management of pediatric septic shock.
Lee EP, Wu HP, Chan OW, Lin JJ, Hsia SH
Biomed J 2022 Feb;45(1):63-73. Epub 2021 Oct 12 doi: 10.1016/j.bj.2021.10.004. PMID: 34653683Free PMC Article
Severe sepsis and septic shock.
Angus DC, van der Poll T
N Engl J Med 2013 Aug 29;369(9):840-51. doi: 10.1056/NEJMra1208623. PMID: 23984731

Diagnosis

SEPSIS DEFINITION: WHAT'S NEW 
IN THE TREATMENT GUIDELINES.
Srzić I, Nesek Adam V, Tunjić Pejak D
Acta Clin Croat 2022 Jun;61(Suppl 1):67-72. doi: 10.20471/acc.2022.61.s1.11. PMID: 36304809Free PMC Article
Recognition and management of sepsis: the nurse's role.
Bleakley G, Cole M
Br J Nurs 2020 Nov 26;29(21):1248-1251. doi: 10.12968/bjon.2020.29.21.1248. PMID: 33242267
Sepsis and Septic Shock - Basics of diagnosis, pathophysiology and clinical decision making.
Font MD, Thyagarajan B, Khanna AK
Med Clin North Am 2020 Jul;104(4):573-585. Epub 2020 May 12 doi: 10.1016/j.mcna.2020.02.011. PMID: 32505253
Sepsis and septic shock: New definitions, new diagnostic and therapeutic approaches.
Esposito S, De Simone G, Boccia G, De Caro F, Pagliano P
J Glob Antimicrob Resist 2017 Sep;10:204-212. Epub 2017 Jul 22 doi: 10.1016/j.jgar.2017.06.013. PMID: 28743646
Severe sepsis and septic shock.
Angus DC, van der Poll T
N Engl J Med 2013 Aug 29;369(9):840-51. doi: 10.1056/NEJMra1208623. PMID: 23984731

Therapy

Prolonged vs Intermittent Infusions of β-Lactam Antibiotics in Adults With Sepsis or Septic Shock: A Systematic Review and Meta-Analysis.
Abdul-Aziz MH, Hammond NE, Brett SJ, Cotta MO, De Waele JJ, Devaux A, Di Tanna GL, Dulhunty JM, Elkady H, Eriksson L, Hasan MS, Khan AB, Lipman J, Liu X, Monti G, Myburgh J, Novy E, Omar S, Rajbhandari D, Roger C, Sjövall F, Zaghi I, Zangrillo A, Delaney A, Roberts JA
JAMA 2024 Aug 27;332(8):638-648. doi: 10.1001/jama.2024.9803. PMID: 38864162Free PMC Article
Fluid Therapy for Critically Ill Adults With Sepsis: A Review.
Zampieri FG, Bagshaw SM, Semler MW
JAMA 2023 Jun 13;329(22):1967-1980. doi: 10.1001/jama.2023.7560. PMID: 37314271
Hemodynamic phenotype-based, capillary refill time-targeted resuscitation in early septic shock: The ANDROMEDA-SHOCK-2 Randomized Clinical Trial study protocol.
Kattan E, Bakker J, Estenssoro E, Ospina-Tascón GA, Cavalcanti AB, Backer D, Vieillard-Baron A, Teboul JL, Castro R, Hernández G
Rev Bras Ter Intensiva 2022 Jan-Mar;34(1):96-106. doi: 10.5935/0103-507X.20220004-pt. PMID: 35766659Free PMC Article
Septic Shock: Advances in Diagnosis and Treatment.
Seymour CW, Rosengart MR
JAMA 2015 Aug 18;314(7):708-17. doi: 10.1001/jama.2015.7885. PMID: 26284722Free PMC Article
International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics.
Goldstein B, Giroir B, Randolph A; International Consensus Conference on Pediatric Sepsis
Pediatr Crit Care Med 2005 Jan;6(1):2-8. doi: 10.1097/01.PCC.0000149131.72248.E6. PMID: 15636651

Prognosis

Machine-learning-derived sepsis bundle of care.
Kalimouttou A, Lerner I, Cheurfa C, Jannot AS, Pirracchio R
Intensive Care Med 2023 Jan;49(1):26-36. Epub 2022 Nov 29 doi: 10.1007/s00134-022-06928-2. PMID: 36446854
Epidemiology of sepsis and septic shock.
Chiu C, Legrand M
Curr Opin Anaesthesiol 2021 Apr 1;34(2):71-76. doi: 10.1097/ACO.0000000000000958. PMID: 33492864
Maternal sepsis.
Escobar MF, Echavarría MP, Zambrano MA, Ramos I, Kusanovic JP
Am J Obstet Gynecol MFM 2020 Aug;2(3):100149. Epub 2020 Jun 29 doi: 10.1016/j.ajogmf.2020.100149. PMID: 33345880
SIRS or not SIRS: Is that the infection? A critical review of the sepsis definition criteria.
Jaramillo-Bustamante JC, Piñeres-Olave BE, González-Dambrauskas S
Bol Med Hosp Infant Mex 2020;77(6):293-302. doi: 10.24875/BMHIM.20000202. PMID: 33186343
Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock.
Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, Suppes R, Feinstein D, Zanotti S, Taiberg L, Gurka D, Kumar A, Cheang M
Crit Care Med 2006 Jun;34(6):1589-96. doi: 10.1097/01.CCM.0000217961.75225.E9. PMID: 16625125

Clinical prediction guides

Comparison of qSOFA, SIRS, and NEWS scoring systems for diagnosis, mortality, and morbidity of sepsis in emergency department.
Oduncu AF, Kıyan GS, Yalçınlı S
Am J Emerg Med 2021 Oct;48:54-59. Epub 2021 Apr 6 doi: 10.1016/j.ajem.2021.04.006. PMID: 33839632
The Changes in Pulse Pressure Variation or Stroke Volume Variation After a "Tidal Volume Challenge" Reliably Predict Fluid Responsiveness During Low Tidal Volume Ventilation.
Myatra SN, Prabu NR, Divatia JV, Monnet X, Kulkarni AP, Teboul JL
Crit Care Med 2017 Mar;45(3):415-421. doi: 10.1097/CCM.0000000000002183. PMID: 27922879
Predictive value of SAPS II and APACHE II scoring systems for patient outcome in a medical intensive care unit.
Godinjak A, Iglica A, Rama A, Tančica I, Jusufović S, Ajanović A, Kukuljac A
Acta Med Acad 2016 Nov;45(2):97-103. doi: 10.5644/ama2006-124.165. PMID: 28000485
Mottling score predicts survival in septic shock.
Ait-Oufella H, Lemoinne S, Boelle PY, Galbois A, Baudel JL, Lemant J, Joffre J, Margetis D, Guidet B, Maury E, Offenstadt G
Intensive Care Med 2011 May;37(5):801-7. Epub 2011 Mar 4 doi: 10.1007/s00134-011-2163-y. PMID: 21373821
Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality.
Boyd JH, Forbes J, Nakada TA, Walley KR, Russell JA
Crit Care Med 2011 Feb;39(2):259-65. doi: 10.1097/CCM.0b013e3181feeb15. PMID: 20975548

Recent systematic reviews

Prolonged vs Intermittent Infusions of β-Lactam Antibiotics in Adults With Sepsis or Septic Shock: A Systematic Review and Meta-Analysis.
Abdul-Aziz MH, Hammond NE, Brett SJ, Cotta MO, De Waele JJ, Devaux A, Di Tanna GL, Dulhunty JM, Elkady H, Eriksson L, Hasan MS, Khan AB, Lipman J, Liu X, Monti G, Myburgh J, Novy E, Omar S, Rajbhandari D, Roger C, Sjövall F, Zaghi I, Zangrillo A, Delaney A, Roberts JA
JAMA 2024 Aug 27;332(8):638-648. doi: 10.1001/jama.2024.9803. PMID: 38864162Free PMC Article
Criteria for Pediatric Sepsis-A Systematic Review and Meta-Analysis by the Pediatric Sepsis Definition Taskforce.
Menon K, Schlapbach LJ, Akech S, Argent A, Biban P, Carrol ED, Chiotos K, Jobayer Chisti M, Evans IVR, Inwald DP, Ishimine P, Kissoon N, Lodha R, Nadel S, Oliveira CF, Peters M, Sadeghirad B, Scott HF, de Souza DC, Tissieres P, Watson RS, Wiens MO, Wynn JL, Zimmerman JJ, Sorce LR; Pediatric Sepsis Definition Taskforce of the Society of Critical Care Medicine
Crit Care Med 2022 Jan 1;50(1):21-36. doi: 10.1097/CCM.0000000000005294. PMID: 34612847Free PMC Article
Machine learning for the prediction of sepsis: a systematic review and meta-analysis of diagnostic test accuracy.
Fleuren LM, Klausch TLT, Zwager CL, Schoonmade LJ, Guo T, Roggeveen LF, Swart EL, Girbes ARJ, Thoral P, Ercole A, Hoogendoorn M, Elbers PWG
Intensive Care Med 2020 Mar;46(3):383-400. Epub 2020 Jan 21 doi: 10.1007/s00134-019-05872-y. PMID: 31965266Free PMC Article
Corticosteroids in septic shock: a systematic review and network meta-analysis.
Gibbison B, López-López JA, Higgins JP, Miller T, Angelini GD, Lightman SL, Annane D
Crit Care 2017 Mar 28;21(1):78. doi: 10.1186/s13054-017-1659-4. PMID: 28351429Free PMC Article
Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).
Shankar-Hari M, Phillips GS, Levy ML, Seymour CW, Liu VX, Deutschman CS, Angus DC, Rubenfeld GD, Singer M; Sepsis Definitions Task Force
JAMA 2016 Feb 23;315(8):775-87. doi: 10.1001/jama.2016.0289. PMID: 26903336Free PMC Article

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