Sepsis y shock séptico: enfoque actual del diagnóstico y manejo terapéutico
Sepsis and septic shock: current approach to diagnosis and therapeutic management

Lidia Espinales-Casanova, Eduardo Milian-Hernández, Jazmín Anzules-Guerra

Resumen



La sepsis y el shock séptico siguen siendo un problema común en pacientes críticamente enfermos, siendo responsables de una alta morbilidad, mortalidad y consumo de recursos sanitarios en todo el mundo. El objetivo de la revisión fue describir el diagnóstico y manejo terapéutico de la sepsis y shock séptico basándose en la evidencia clínica publicada hasta el momento. La búsqueda bibliográfica fue de tipo no sistemática en las bases de datos PubMed, SciELO, Science Direct, EMBASE, LILACS y Redalyc. Los criterios de inclusión fueron publicaciones en inglés, portugués y español, en las que el título, palabras clave, incluyeron información relacionada con el tema, en el periodo comprendido del 2013-2022. Los resultados obtenidos mostraron que la sepsis y el shock séptico conforman cuadros en donde la detección temprana es una acción fundamental para reducir la mortalidad y falla multiorgánica relacionada. El control adecuado de la fuente, el inicio de una terapia antimicrobiana adecuada, la restauración de la perfusión tisular a través de la reanimación con líquidos y las intervenciones avanzadas para guiar la evaluación de la reanimación y la resolución de la disfunción orgánica deben ser parte del tratamiento inicial de estas entidades. Se concluye que el diagnóstico precoz y el inicio de una estrategia terapéutica multimodal, son factores decisivos al momento de su abordaje, para mejorar el pronóstico de los pacientes.

Sepsis and septic shock remain a common problem in critically ill patients, being responsible for high morbidity, mortality and consumption of health resources worldwide. The aim of the review was to describe the diagnosis and therapeutic management of sepsis and septic shock based on the clinical evidence published so far. The literature search was non-systematic in the databases PubMed, SciELO, Science Direct, EMBASE, LILACS and Redalyc. The inclusion criteria were publications in English, Portuguese and Spanish, in which the title, keywords, included information related to the topic, in the period from 2013-2022. The results obtained showed that sepsis and septic shock form pictures where early detection is a fundamental action to reduce mortality and related multi-organ failure. Adequate source control, initiation of appropriate antimicrobial therapy, restoration of tissue perfusion through fluid resuscitation, and advanced interventions to guide the evaluation of resuscitation and resolution of organ dysfunction should be part of the initial treatment of these entities. It is concluded that early diagnosis and the initiation of a multimodal therapeutic strategy are decisive factors at the time of its approach, to improve the prognosis of patients.

DOI:

https://doi.org/10.53766/GICOS/2022.07.02.05


Palabras clave


diagnóstico; sepsis; shock séptico; tratamiento. diagnosis; sepsis; septic shock; treatment.

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Referencias


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