Management of sepsis in the critically ill patient: key aspects

Severe sepsis is a major cause of morbidity and mortality in the critically ill patient. Management involves identification and treatment of the underlying causative infection, with antimicrobial agents and surgery where necessary, haemodynamic resuscitation with fluids and vasoactive agents, steroids (for septic shock) and immunomodulation with drotrecogin-α (activated), where not contraindicated. Every effort must be made to identify sepsis early so as to optimise the patient’s chances of a good outcome.