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Cited by 294

The DOI matches its Crossref record; 198 of the 198 references it cites were found in a registry or an index.

2023 Update on Sepsis and Septic Shock in Adult Patients: Management in the Emergency Department

Open access
Guarino, Matteo, Perna, Benedetta, Cesaro, Alice Eleonora, Maritati, Martina, Spampinato, Michele Domenico, Contini, Carlo, De Giorgio, Roberto·2023·Journal of Clinical Medicine

Abstract

Background: Sepsis/septic shock is a life-threatening and time-dependent condition that requires timely management to reduce mortality. This review aims to update physicians with regard to the main pillars of treatment for this insidious condition. Methods: PubMed, Scopus, and EMBASE were searched from inception with special attention paid to November 2021–January 2023. Results: The management of sepsis/septic shock is challenging and involves different pathophysiological aspects, encompassing empirical antimicrobial treatment (which is promptly administered after microbial tests), fluid (crystalloids) replacement (to be established according to fluid tolerance and fluid responsiveness), and vasoactive agents (e.g., norepinephrine (NE)), which are employed to maintain mean arterial pressure above 65 mmHg and reduce the risk of fluid overload. In cases of refractory shock, vasopressin (rather than epinephrine) should be combined with NE to reach an acceptable level of pressure control. If mechanical ventilation is indicated, the tidal volume should be reduced from 10 to 6 mL/kg. Heparin is administered to prevent venous thromboembolism, and glycemic control is recommended. The efficacy of other treatments (e.g., proton-pump inhibitors, sodium bicarbonate, etc.) is largely debated, and such treatments might be used on a case-to-case basis. Conclusions: The management of sepsis/septic shock has significantly progressed in the last few years. Improving knowledge of the main therapeutic cornerstones of this challenging condition is crucial to achieve better patient outcomes.

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Research works printed but not linked: 12

  1. Belousoviene, E., Kiudulaite, I., Pilvinis, V., and Pranskunas, A. (2021). Links between Endothelial Glycocalyx Changes and Microcirculatory Parameters in Septic Patients. Life, 11. · doi:10.3390/life11080790
  2. Velissaris, 2021, Presepsin as a Diagnostic and Prognostic Biomarker in Sepsis, Cureus, 13, e15019
  3. Ternes, 2020, Guideline-based treatment of urinary tract infections, Urologe A, 59, 550, 10.1007/s00120-020-01174-0 · doi:10.1007/s00120-020-01174-0
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  5. Dyson, 2012, Microvascular and macrovascular flow are uncoupled in early polymicrobial sepsis, Br. J. Anaesth., 108, 973, 10.1093/bja/aes093 · doi:10.1093/bja/aes093
  6. Chalfin, 2022, Vasopressor Therapy Early, or Vasopressors Later? Still an Important Question in Septic Shock, Crit. Care Med., 50, 717, 10.1097/CCM.0000000000005449 · doi:10.1097/ccm.0000000000005449
  7. Howard, 2017, British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings, BMJ Open Respir. Res., 4, e000170, 10.1136/bmjresp-2016-000170 · doi:10.1136/bmjresp-2016-000170
  8. Liu, 2014, Heparin for treatment of sepsis: A systemic review, Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 26, 135
  9. Yini, 2015, Effect of unfractionated heparin on endothelial glycocalyx in a septic shock model, Acta Anaesthesiol. Scand., 59, 160, 10.1111/aas.12418 · doi:10.1111/aas.12418
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Metadata

Authors
Guarino, M., Perna, B., Cesaro, A. E., Maritati, M., Spampinato, M. D., Contini, C., & De Giorgio, R.
Venue
Journal of Clinical Medicine
Publisher
MDPI AG
Published
2023-04-28
Volume
12
Issue
9
Pages
3188
ISSN
2077-0383 (ISSN-L)
OpenAlex
W4367311192
Cited by
294
References
198
FWCI
49.00
Type
journal article
Language
en
Open access
gold
Funders
Fondi Ateneo per la Ricerca

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CoChat. (2026). Citation check: 2023 Update on Sepsis and Septic Shock in Adult Patients: Management in the Emergency Department. https://app.cochat.ai/papers/10.3390/jcm12093188
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Guarino, M., Perna, B., Cesaro, A. E., Maritati, M., Spampinato, M. D., Contini, C., & De Giorgio, R. (2023). 2023 Update on Sepsis and Septic Shock in Adult Patients: Management in the Emergency Department. Journal of Clinical Medicine. https://doi.org/10.3390/jcm12093188

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.