Biomarkers and newer laboratory investigations in the diagnosis of sepsis

Sepsis is a major cause of death in hospitalised patients accounting for mortality rates as high as 60% and, hence, is called ‘a hidden public health disaster’. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis is not a disease but is a clinical syndrome, where the initial features are nonspecific resulting in delayed diagnosis. Lack of specific laboratory tests to diagnose the syndrome adds to the diagnostic confusion.

Current clinical controversies in the management of sepsis

Sepsis remains a challenging clinical problem requiring prompt diagnosis and optimal clinical management if the continuing high mortality is to be contained. In this brief review I consider four specific questions that are the subject of ongoing controversy. First, whether the new ‘Sepsis-3’ definitions will be helpful, in particular in improving diagnosis, or whether the rapid move towards precision medicine will make the definition redundant. Second, should we routinely use combinations of antibiotics for the empiric treatment of sepsis.

Implementing Surviving Sepsis guidelines in a district general hospital

We describe efforts made at Blackpool Victoria Hospital to implement the well-established international Surviving Sepsis guidelines. These included posters, pocket guides and stickers inserted in patient notes. All doctors and nurses in acute areas received specific information and education. Sepsis teams comprising both doctors and nurses were formed to encourage implementation and to audit and disseminate data. Data collection occurred from February to November 2009. Cases were considered prospectively at the time of initial

Implementing Surviving Sepsis guidelines in a district general hospital

We describe efforts made at Blackpool Victoria Hospital to implement the well-established international Surviving Sepsis guidelines. These included posters, pocket guides and stickers inserted in patient notes. All doctors and nurses in acute areas received specific information and education. Sepsis teams comprising both doctors and nurses were formed to encourage implementation and to audit and disseminate data. Data collection occurred from February to November 2009.