K Stahl1, B Seeliger2, S David3,4, J Schmidt5. 1. Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland. stahl.klaus@mh-hannover.de. 2. Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover, Deutschland. 3. Klinik für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Hannover, Deutschland. sascha.david@usz.ch. 4. Institut für Intensivmedizin, Universitätsspital Zürich, Rämistrasse 100, Zürich, Schweiz. sascha.david@usz.ch. 5. Klinik für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Hannover, Deutschland.
Abstract
BACKGROUND: The term sepsis was redefined in 2016 as a life-threatening organ dysfunction caused by an inadequate host response to an infection. The German S3 guidelines for the treatment of sepsis were published in 2018. OBJECTIVE: What is evidence-based in the treatment of patients with sepsis? MATERIAL AND METHODS: Discussion of the S3 guidelines and inclusion of study results after 2018. RESULTS: The cornerstones for the treatment of sepsis continue to consist of early hemodynamic stabilization, anti-infection treatment and organ support procedures. Supportive and extracorporeal treatments are controversially discussed and continue to be intensively investigated. CONCLUSION: Despite an improved understanding of the pathophysiology, there is still no effective causal sepsis treatment, i.e. directed against the pathological host reaction. The treatment of patients with sepsis is therefore still based on the basic principles of correction of volume deficits, anti-infective agents, source control and organ support, including the symptomatic treatment of vasoplegia with catecholamines.
BACKGROUND: The term sepsis was redefined in 2016 as a life-threatening organ dysfunction caused by an inadequate host response to an infection. The German S3 guidelines for the treatment of sepsis were published in 2018. OBJECTIVE: What is evidence-based in the treatment of patients with sepsis? MATERIAL AND METHODS: Discussion of the S3 guidelines and inclusion of study results after 2018. RESULTS: The cornerstones for the treatment of sepsis continue to consist of early hemodynamic stabilization, anti-infection treatment and organ support procedures. Supportive and extracorporeal treatments are controversially discussed and continue to be intensively investigated. CONCLUSION: Despite an improved understanding of the pathophysiology, there is still no effective causal sepsis treatment, i.e. directed against the pathological host reaction. The treatment of patients with sepsis is therefore still based on the basic principles of correction of volume deficits, anti-infective agents, source control and organ support, including the symptomatic treatment of vasoplegia with catecholamines.