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TITLE:

MANAGEMENT OF SEPTIC SHOCK

AUTHORS:

Al-Hanuf Jamal Ahmed Al-Bokhari , Fatmah Ibrahim AlAbdullah , Hazem Faisal Alotaibi , Rohiya Emad Hejazi , Faris Matouq Almowalad , Adel Saleh Alanazi , Laila khalid alanazi , Nadiah Mohammadidris Ali Johar , Mohammed Abdullah Mohammed Asiri , Meshal Abdulrahman Hassan Ogran , Ahmad Abdulaziz M. Almehmadi

ABSTRACT:

Introduction: Sepsis is known as the systemic inflammatory response to infection. Sepsis is a very critical as it is seen in ten of thousand hospitalized patients and multiple organ dysfunction syndrome (MODS) could develop in about thirty percent ofof these patients; mortality is observed in twenty percent of patients with sepsis and eighty percent of patients with septic shock. Early diagnosis and management are crucial because of very high mortality rates. Advances in the field of molecular biology have assisted us understand most pathologic events that occur in sepsis. Understanding sepsis pathogenesis is very critical in terms of new advancements in the diagnosis, follow-up, and management plan. The sepsis triad is systemic inflammation, coagulation, and disordered fibrinolysis. There are microbial pathogens and inflammatory responses included in the sepsis physiopathology. Researchers revealed that as a result of infection in tissues and traumatic damage, the humoral system was activated in the body and several cytokines were released. The end result is the systemic inflammatory response, hemostatic changes, and organ damage. Recently, studies have been conducted and concluded that describe the treatment of sepsis patients. Most of these methods’ goals are to modulate or stop the sepsis physiopathology and prevent multiple organ failure. Many new methods have been reported to decrease mortality rates in severe sepsis. These involve the application of low tidal volume in acute respiratory distress syndrome (ARDS), plasma glucose control, goal-oriented treatment started in the early period, and corticosteroid at mean doses. Besides medications, early and proper antibiotic treatment and cardiovascular support have huge importance in the management of sepsis. Aim of work: In this review, we will discuss the management of septic shock Methodology: We did a systematic search for the management of septic shock using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles. Conclusions: Studies revealed that sepsis is a very critical disease globally. Recent studies that focused on unclarified mechanisms underlying sepsis provided new management approaches for physicians. Several management plans like balanced corticosteroid usage, antiendotoxin treatment, vasoactive agents such as levosimendan, HBO treatment, fibrates, and several antioxidant supplements are promising approaches for sepsis management. Due to the fact that there are several experimental and clinical studies, there is a need for further research to develop new treatment approaches. Key words: management, septic shock, presentation, emergency

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