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Joanne, Pedro e João trazem mais uma versão do Polêmicas do Sepse, logo depois da nova publicação do Surviving Sepsis! Nesse episódio mencionamos:

1) Escolha e tempo de antibioticoterapia

2) Qual solução para expansão volêmica e a quantidade necessária

3) Qual droga vasoativa realizar e como fazer

E por último, a indicação de bicarbonato na sepse! 

Referências:

1. EVANS, Laura et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive care medicine, v. 47, n. 11, p. 1181-1247, 2021.

2. WUTRICH, Yann et al. Early increase in arterial lactate concentration under epinephrine infusion is associated with a better prognosis during shock. Shock, v. 34, n. 1, p. 4-9, 2010.

3. MAITLAND, Kathryn et al. Mortality after fluid bolus in African children with severe infection. New England Journal of Medicine, v. 364, n. 26, p. 2483-2495, 2011.

4. CHURPEK, Matthew M. et al. Quick sepsis-related organ failure assessment, systemic inflammatory response syndrome, and early warning scores for detecting clinical deterioration in infected patients outside the intensive care unit. American journal of respiratory and critical care medicine, v. 195, n. 7, p. 906-911, 2017.

5. GARCIA-ALVAREZ, Mercedes; MARIK, Paul; BELLOMO, Rinaldo. Sepsis-associated hyperlactatemia. Critical care, v. 18, n. 5, p. 1-11, 2014.

6. ZAMPIERI, Fernando G. et al. Effect of Intravenous Fluid Treatment With a Balanced Solution vs 0.9% Saline Solution on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial. Jama, v. 326, n. 9, p. 818-829, 2021.

7. ZAMPIERI, Fernando G. et al. Effect of Slower vs Faster Intravenous Fluid Bolus Rates on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial. JAMA, v. 326, n. 9, p. 830-838, 2021.

8. JABER, Samir et al. Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. The Lancet, v. 392, n. 10141, p. 31-40, 2018.

9. SEMLER, Matthew W. et al. Balanced crystalloids versus saline in critically ill adults. New England Journal of Medicine, v. 378, n. 9, p. 829-839, 2018.

10. SELF, Wesley H. et al. Balanced crystalloids versus saline in noncritically ill adults. New England Journal of Medicine, v. 378, n. 9, p. 819-828, 2018.