Features  |   November 2017
Perioperative Management of the Septic Patient
Author Affiliations
  • Talia K. Ben-Jacob, M.D., M.Sc.
    Committee on Critical Care Medicine
  • Roshni Sreedharan, M.D.
    Committee on Critical Care Medicine
  • Mark E. Nunnally, M.D.
    Committee on Critical Care Medicine
Article Information
Critical Care / Infectious Disease / Features
Features   |   November 2017
Perioperative Management of the Septic Patient
ASA Monitor 11 2017, Vol.81, 18-20.
ASA Monitor 11 2017, Vol.81, 18-20.
Sepsis strikes more than 1 million Americans annually and carries a 28-50 percent mortality rate.1  The anesthesiologist has an important role in coordinating resuscitation to optimize patient survival for source control cases as 40 percent of cardiac arrests in the perioperative period were associated with sepsis and 77 percent of those cases resulted in a mortality.2 
“Sepsis-3” defines sepsis as a life-threatening organ dys-function caused by a dysregulated host response to infection. Septic shock is a subset of sepsis in which profound circulatory, cellular and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. To help clinicians establish the diagnosis of sepsis, the Sequential Organ Failure Assessment (SOFA) score may be used in the ICU. Outside the ICU, the quick Sequential Organ Failure Assessment (qSOFA) performs better than the more complex sepsis scores. However, these severity scores do not identify all patients at risk. Providing timely and appropriate care requires the anesthesiologist to have good clinical judgement and a high level of suspicion.3  Most sepsis in the O.R. is recognized, but it can arise unexpectedly from an occult source. Often, tachycardia, hypotension or fever may be initial signs of sepsis.
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