Principles of source control in the management of sepsis.

Abstract:

:This brief overview of the role of source control in sepsis emphasizes the underlying principles rather than the empiric evidence from well-performed clinical studies. The reasons for this are several. First there is a paucity of high-level published evidence, with few rigorous large clinical series, and even fewer clinical trials. Second, the decision-making process in the individual patient is complex, and often not amenable to study using the design of a randomized controlled trial, for decisions involve consideration not only of the underlying disease but of the stability of the patient, the presence of comorbidities, and the prior surgical history, all factors that can heavily influence the decision to choose one therapeutic option rather than another. The scope of the topic is large, and the space limited. Interested readers are referred to more detailed discussions such as that found in the background to the recommendations on source control in the guidelines of the Surviving Sepsis Campaign.(1) Source control is a core treatment modality in the management of the patient with severe sepsis or septic shock. Its optimal use assumes a comprehensive knowledge of biologic principles, the complexities of the septic response, and the range of surgical and nonsurgical options, and a combination of therapeutic aggressiveness and judicious caution in the clinician charged with making the decision. As every intensivist learns, appropriate source-control intervention can rapidly alter the course of sepsis to a more favorable direction, and suboptimal decision-making can change a difficult clinical challenge into a nightmare.

authors

Marshall JC,Al Naqbi A

doi

10.1016/j.ccell.2010.12.006

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

99-114

issue

1

eissn

0899-5885

issn

1558-3481

pii

S0899-5885(10)00091-2

journal_volume

23

pub_type

杂志文章,评审
  • Infectious diseases in end-stage liver disease patients.

    abstract::Patients with chronic liver diseases sustain impairment to immune systems, which worsens over time. These defects in their host defense lead to risks of bacterial infections and increased morbidity. Providers should have heightened surveillance for infectious diseases and suspect one with any acute change in status. P...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccell.2010.04.002

    authors: Mehta AK,Lyon GM 3rd

    更新日期:2010-09-01 00:00:00

  • Intravenous Smart Pumps: Usability Issues, Intravenous Medication Administration Error, and Patient Safety.

    abstract::With an estimated 90% of all hospitalized patients receiving intravenous medications via infusion pumps, intravenous infusion pump systems are among the most frequently used technologies in health care. This article reviews important issues regarding clinical usability, intravenous medication administration error, and...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.cnc.2018.02.004

    authors: Giuliano KK

    更新日期:2018-06-01 00:00:00

  • Cardiovascular risk assessment and hyperlipidemia.

    abstract::This article reviews how to identify and risk-stratify patients at risk for developing coronary artery disease (CAD) or who already have CAD (or coronary risk equivalents), and how to manage their lipids. This discussion is directed toward nurses, nurse practitioners, and physician assistants, who can and should play ...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccell.2008.03.014

    authors: Becker J

    更新日期:2008-09-01 00:00:00

  • Traumatic cerebral vasospasms and secondary head injury.

    abstract::Traumatic cerebral vasospasm is a relatively frequent occurrence after an individual suffers a severe head injury, and therefore poses a real threat for these individuals. Although vasospasm is a physiologic defense response, it can cause a decrease in CBF, ischemia, infarction, and death. A review of the literature h...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章

    doi:

    authors: Susi EA,Walls SK

    更新日期:1990-03-01 00:00:00

  • Trends in cardiac surgery: exploring the past and looking into the future.

    abstract::Today's successes would not be possible without the foundation of yesterday's practitioners and patients. This article assists in the exploration of cardiac surgery procedures, provides a brief historical review of the significant changes in cardiothoracic surgery, and provides an overview of current and future method...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccell.2007.07.009

    authors: Miga KC

    更新日期:2007-12-01 00:00:00

  • Cultural related complementary therapies: their use in critical care units.

    abstract::Complementary therapies are becoming widely used in health care in the United States. Most nurses, as are many Americans, are familiar with complementary therapies such as imagery, aromatherapy, massage, and healing touch. Many nurses, however, are not familiar with complementary therapies that are widely used in othe...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章

    doi:10.1016/s0899-5885(02)00048-5

    authors: Snyder M,Niska K

    更新日期:2003-09-01 00:00:00

  • Complications of multiple trauma.

    abstract::Patients who acquire sepsis, ARDS, ARF, or MSOF subsequent to multiple trauma have a high mortality rate. The pathophysiology of these complications is complex and is thought to involve ischemia, the generation of mediators, alterations in regional perfusion, and cellular oxygen use. Because of the critical nature of ...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Littleton MT

    更新日期:1989-03-01 00:00:00

  • The nurse's role in pediatric injury prevention.

    abstract::Nurses can play a major role in injury prevention. Nurses are, by nature, educators and role models to their families, patients, and communities. Knowing the magnitude and impact of injuries on both children and their families, nurses must become more informed about the necessity of injury prevention. They must also h...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Widner-Kolberg MR

    更新日期:1991-09-01 00:00:00

  • Patient care in a biological safety level-4 (BSL-4) environment.

    abstract::The greatest threats to America's public health include accidental importation of deadly diseases by international travelers and the release of biologic weapons by our adversaries. The greatest failure is unpreparedness because international travel and dispersion of biologic agents by our enemies are inevitable. An ef...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/s0899-5885(02)00079-5

    authors: Marklund LA

    更新日期:2003-06-01 00:00:00

  • Postpartum tobacco use: developing evidence for practice.

    abstract::Most women who quit smoking during pregnancy return to tobacco use within 6 months after delivery. Findings demonstrate that minimal intervention effectiveness exists with strategies to prevent postpartum smoking relapse. This article provides a synthesis of current research on postpartum tobacco use. Whether in the l...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccell.2005.10.004

    authors: Gaffney KF,Baghi H,Zakari NM,Sheehan SE

    更新日期:2006-03-01 00:00:00

  • Pathogenesis and prevention of chronic lung disease in the neonate.

    abstract::Often used interchangeably, chronic lung disease (CLD) or bronchopulmonary dysplasia (BPD) develops primarily in extremely low birth weight infants weighing <1000 g who receive prolonged oxygen therapy and or positive pressure ventilation. CLD, which occurs in as many as 30 percent of infants born weighing <1000 g, co...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccell.2008.09.006

    authors: Askin DF,Diehl-Jones W

    更新日期:2009-03-01 00:00:00

  • The next generation of medications for kidney transplant patients.

    abstract::Transplant pharmacotherapy evolves as new agents are investigated and approved for use. Clinical immunosuppression has been plagued with maintaining a balance between rejection of the transplanted organ and complications of over-immunosuppression, including infection and malignancy. Clinicians must understand current ...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/s0899-5885(03)00041-8

    authors: Sims TW,Good EW

    更新日期:2002-03-01 00:00:00

  • Conscious sedation in the ambulatory setting.

    abstract::Conscious sedation has become an important component of practice for many ambulatory procedures. Important factors to maintain the safety of this technique are proper patient selection, slow titration of the medication, continuous patient monitoring, proper education of the individuals administering the medication and...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Odom J

    更新日期:1997-09-01 00:00:00

  • Pediatric brain tumors.

    abstract::Pediatric brain tumors are the most common solid tumor and the second most common neoplasm in childhood. Diagnosis is made by CT scan and MR imaging. Treatment includes surgery followed by observation, chemotherapy, or radiation therapy. A multidisciplinary approach in the treatment of these children is necessary with...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Shiminski-Maher T,Wisoff JH

    更新日期:1995-03-01 00:00:00

  • Overview of the organ donation process.

    abstract::Organ transplantation has become a viable treatment option for end-stage organ disease. With the advent of immunosuppressive medication and vastly improved preservation practices and surgical techniques, it is now possible to transplant an increasing number and variety of organs. In their role as direct care givers to...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Albert PL

    更新日期:1994-09-01 00:00:00

  • Transitional care models: preventing readmissions for high-risk patient populations.

    abstract::Transition from hospital to home is a vulnerable period for older adults with multiple chronic conditions. A pilot of the Transitional Care Model at a community hospital reduced readmission rates for patients with heart failure by 48%. This article shares the experience of a large metropolitan health care system in ex...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccell.2014.08.009

    authors: Centeno MM,Kahveci KL

    更新日期:2014-12-01 00:00:00

  • Toward continuous quality improvement in trauma care.

    abstract::Trauma providers are engaged in a constant struggle to improve quality and to assure positive outcomes in an unpredictable disease process. Traditional quality assurance has been unsuccessful in achieving these goals. Continuous quality improvement methodologies hold promise as the tools to balance quality, outcomes, ...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Eastes LE

    更新日期:1994-09-01 00:00:00

  • Needs of children during the critical illness of a parent or sibling.

    abstract::The needs and significance of well children in the family typically have not been considered when addressing family-centered care. Health care providers and overstressed parents may have little awareness of or insight into the needs and concerns of these children. Without informed and sensitive interventions, however,...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章

    doi:

    authors: Lewandowski LA

    更新日期:1992-12-01 00:00:00

  • The use of nitric oxide in neonatal care.

    abstract::Knowledge of NO and its role in the human body currently is limited. Further scientific research involving this unique molecule will expand its clinical usefulness. It is an exciting era in research,involving numerous body processes and systems. The initial work on pulmonary vascular response in newborns who have PPHN...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccell.2004.02.004

    authors: Bradshaw WT

    更新日期:2004-06-01 00:00:00

  • Perioperative nursing care for congenital cardiac defects.

    abstract::Continuity of nursing care between the preoperative and postoperative phases of the patient with congenital heart disease is the goal of the perioperative nurse. Good assessment and planning are essential to efficient participation in the various stages of the operative course, from premedication to transport to the I...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章

    doi:

    authors: Foldy SM,Gorman JB

    更新日期:1989-06-01 00:00:00

  • Assessment of peripheral arterial occlusive disease.

    abstract::Many older patients in critical care settings have significant arterial disease, so the assessment of peripheral circulation may be important in their management. A great deal of information can be gained through the physical examination, which can be supplemented by the use of the Doppler velocity detector. This devi...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Baker JD

    更新日期:1991-09-01 00:00:00

  • Strategies for safe care of critical care perinatal patients.

    abstract::In most inpatient settings, the complexity of care required by individual patients coupled with the wide range of services provided within a single institution mean patients are routinely cared for in highly specialized units. Service lines, such as surgical services; intensive care; emergency services; and maternity,...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章

    doi:10.1016/j.ccell.2010.03.008

    authors: Olson BL

    更新日期:2010-06-01 00:00:00

  • Pulmonary complications from enteral nutrition.

    abstract::Complications of enteral nutrition may compromise respiratory function by direct mechanical injury by feeding tubes, aspiration of formula, or alterations in metabolism. Although much of the data reviewed in this paper were published more than 10 years ago, these studies still comprise most of the literature on pulmon...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章

    doi:

    authors: Eisenberg PG

    更新日期:1991-12-01 00:00:00

  • Ablative therapy in the treatment of tachyarrhythmias.

    abstract::Ablative therapy for treatment of tachycarrhythmias has developed rapidly in recent years due to an increased understanding of electrophysiologic mechanisms of arrhythmogenesis and improved modalities of destroying or isolating arrhythmogenic tissue. Radiofrequency catheter ablation is currently the most frequently pe...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章

    doi:

    authors: Finkelmeier BA

    更新日期:1994-03-01 00:00:00

  • Invasive Neuromonitoring.

    abstract::Advances in technology have resulted in a plethora of invasive neuromonitoring options for practitioners to manage while caring for the complex needs of the critical care patient. Although many types of invasive neuromonitoring are available to the practitioner, intraparenchymal monitors and external ventricular devic...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.cnc.2015.10.001

    authors: Heck C

    更新日期:2016-03-01 00:00:00

  • Complications of Sedation in Critical Illness: An Update.

    abstract::Sedation is a necessary component of care for the critically ill. Oversedation, however, is associated with immediate complications and long-term problems, termed post-intensive care unit syndrome. It also contributes to unnecessary costs of care. This article describes the physical, functional, psychiatric, and cogni...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.cnc.2016.02.003

    authors: Foster J

    更新日期:2016-06-01 00:00:00

  • Preparation for mass casualty incidents.

    abstract::Mass casualty incidents are events where the number of injured patients exceeds the resources of the health care institution to the degree that care may not be available or may be limited for a portion of the casualties. Mass casualty incidents are increasing in frequency throughout the United States. Managing mass ca...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.cnc.2015.02.008

    authors: VandenBerg SL,Davidson SB

    更新日期:2015-06-01 00:00:00

  • Rational diuretic management in congestive heart failure: a case-based review.

    abstract::The pharmacology and pharmacokinetics of diuretics are unique among therapeutic drugs. Knowledge of these principles can be used to great advantage in the management of heart failure, whereas ignoring them can lead to either minor or life-threatening adverse consequences. Two major categories of potential therapeutic ...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/s0899-5885(02)00092-8

    authors: Paul RV

    更新日期:2003-12-01 00:00:00

  • Escherichia coli Complications in Pediatric Critical Care.

    abstract::Escherichia coli is a bacterium that is an important part of the intestinal tract; however, it has the potential to become pathogenic. Shiga toxin-producing E coli (STEC) is a leading cause of E coli infections and has led to outbreaks in North America. Transmission is through ingestion of contaminated food sources, a...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.cnc.2017.10.013

    authors: Puentes SS,Dunstan M

    更新日期:2018-03-01 00:00:00

  • Family decision making for incompetent patients in the ICU.

    abstract::Insight into the experience of family-member decision making regarding treatment of incompetent ICU patients can be gained through an exploration of the literature regarding the ICU environment, normative bioethics, and the decision-making process (see Fig. 1). The review of these relevant bodies of literature has sug...

    journal_title:Critical care nursing clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Jacob D

    更新日期:1997-03-01 00:00:00