Current standards of care in the management of patients with abdominal sepsis

Česká verzia

Authors: P. Ihnát ^1,2; M. Peteja ^1,2 ; P. Vávra ^1,2; L. Tulinský ^1,2 ; P. Zonča ^1,2
Authors place of work: Katedra chirurgických oborů, LF Ostravské Univerzity, Ostrava, vedoucí katedry: MUDr. P. Vávra, Ph. D. ¹; Chirurgická klinika FN Ostrava, přednosta: doc. MUDr. P. Zonča, Ph. D., FRCS ²
Published in the journal: Rozhl. Chir., 2015, roč. 94, č. 6, s. 234-237.
Category: Souhrnné sdělení

Summary

Introduction:
Abdominal sepsis patient management is an issue of high current importance, and the amount of knowledge keeps increasing and changing the approach to critically ill patients with abdominal sepsis.

Methods:
Literature search (in MEDLINE, PubMed and Google Scholar databases) was done, focused on identification of relevant studies. The aim of this paper is to provide a review of current trends in diagnosing and predicting the prognosis of, and recommended treatment standards for patients with abdominal sepsis.

Results:
Abdominal sepsis is defined as the Systemic Inflammatory Response Syndrome (SIRS) with an abdominal infection requiring a surgical intervention to control the source; or SIRS with an infection within 14 days after any major surgery. Although many different monitoring and scoring systems exist, daily careful clinical examination is the most reliable diagnostic tool in identification of septic patients. Whenever abdominal sepsis is suspected, the gold standard comprises immediate administration of broad-spectrum antibiotics, transferring the patient to the intensive care unit, with surgical intervention and supportive intensive care based on current guidelines of the Surviving Sepsis Campaign. Source control surgery is the principal therapeutic modality for patients with abdominal sepsis. The most relevant negative prognostic factors include clinical signs of septic shock and the necessity of high doses of catecholamines.

Conclusion:
Early identification of septic patients and prompt implementation of a complex, evidence-based interdisciplinary approach are the principal conditions for improving healthcare outcomes of care provided to patients with abdominal sepsis.

Key words:
abdominal sepsis – surgical source control – prognosis prediction – intensive care

Zdroje

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