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Septic shock is a result of a systemic response to infection or multiple infectious causes. The precipitating infections that may lead to septic shock if severe enough include but are not limited to appendicitis, pneumonia, bacteremia, diverticulitis, pyelonephritis, meningitis, pancreatitis, necrotizing fasciitis, MRSA and mesenteric ischemia.
Sepsis requires immediate treatment with intravenous fluids and antimicrobial medications. [1] [5] Ongoing care and stabilization often continues in an intensive care unit. [1] If an adequate trial of fluid replacement is not enough to maintain blood pressure, then the use of medications that raise blood pressure becomes necessary. [1]
Piperacillin with tazobactam is administered through an intravenous (IV) method, where it is infused into the bloodstream over a period of 30 minutes to 4 hours so that the medication is delivered slowly and steadily. [10] [11] The minimal duration of the infusion of 30 minutes is set for both adults and pediatric patients. [11]
Drotrecogin alfa has not been found to improve outcomes in people with severe sepsis. The manufacturer's aggressive strategies in marketing its use in severe sepsis have been criticized. [ 1 ] On October 25, 2011, Eli Lilly & Co. withdrew Xigris from the market after a major study showed no efficacy for the treatment of sepsis .
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Examples of total parenteral nutrition solutions [40] Substance Normal patient High stress Fluid-restricted Amino acids: 85 g: 128 g: 75 g Dextrose: 250 g: 350 g: 250 g Lipids: 100 g: 100 g: 50 g Na + 150 mEq: 155 mEq: 80 mEq K + 80 mEq: 80 mEq: 40 mEq Ca 2+ 360 mg: 360 mg: 180 mg Mg 2+ 240 mg: 240 mg: 120 mg Acetate: 72 mEq: 226 mEq: 134 mEq ...
Treatment of the underlying cause is crucial. Appropriate antibiotic therapy is started as soon as culture results are available, or if infection is suspected (whichever is earlier). Empirical therapy may be appropriate if local microbiological surveillance is efficient. Where possible the origin of the infection is removed.
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