Thursday, May 4, 2017

Sepsis 2.0 vs Sepsis 3.0

R.E.B.E.L.EM - May 1, 2017
"Background: Just a few months ago the surviving sepsis campaign published their international guidelines for management of sepsis and septic shock. There has been a lot of talk in the FOAM world about sepsis 3.0 and this is the first update since the introduction. This was a 67 page document that made a total of 93 statements on the early management and resuscitation of patients with sepsis or septic shock. 1/3 of the statements were strong recommendations and just over 1/3 were weak recommendations. Instead of going through every component of this document, we thought we would discuss one of the potentially biggest components of sepsis care that would affect clinical practice for those of us on the front lines.
One of the main reasons we have seen a mortality decrease in sepsis overtime is due to the proactive nature health care professionals have taken in sepsis management. The so called ABC’s of sepsis management: Early identification, Early fluids, and Early antibiotics. One of the biggest components of this is early identification of these patients...
Clinical Bottom Line: Neither score is perfect. On one hand, Sepsis 2.0 has a better sensitivy for screening but at the cost of specificity as so many other things can cause SIRS. On the other hand, Sepsis 3.0 has a better specificity for prediciton of mortality when compared to Sepsis 2.0, but there maybe other scores out there that may do a better job."