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Sepsis: Treatment & Medication
Updated: Nov 13, 2009
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Treatment
Medical Care
Initial focus should be on stabilization and correction of metabolic, circulatory, and respiratory derangements.2 Appropriate antimicrobial therapy should be started as soon as possible after evaluation occurs. Ongoing re-evaluation is essential.
- Most of these infants and children require monitoring and treatment in an intensive care setting.
- Cardiac output may need to be assessed repeatedly.
- Multiple peripheral intravenous, intraosseous, and/or central venous access devices are likely necessary.
- Frequent sampling of arterial blood is often required.
- Ventilatory support with supplemental oxygen therapy, aggressive fluid resuscitation and support of cardiac output, maintenance of adequate hemoglobin concentration, correction of physiologic and metabolic derangements, and monitoring of urine output and other end-organ functioning are often vital.
- Adjunctive therapies such as inhaled nitric oxide, extracorporeal membrane oxygenation, corticosteroids, pentoxifylline, intravenous immunoglobulin, and various other mediators of the inflammatory response may be needed.
- In cases of refractory shock, newer adjunctive therapies (such as terlipressin) have shown potential benefit in initial trials.3 Further clinical studies are required, but the risks of the drug may be outweighed by its benefits in certain circumstances.
Surgical Care
Surgical intervention (eg, draining an abscess, venous access, appendectomy) is occasionally required.
Consultations
- Critical care expertise is essential for moderate-to-severe cases.
- Consultation with an infectious disease specialist may be necessary.
- Other consultations should be made based on the clinical circumstances.
Diet
Generally, patients with systemic inflammatory response syndrome (SIRS) should not be fed until gut hypoxia and hypoperfusion have been ruled out. Once feeding can safely begin, immune-enhancing nutrition may reduce the mortality rate in sepsis. Arginine, omega-3 fatty acids, and messenger RNA (mRNA) have been identified in preliminary studies to be of potential benefit.
Medication
Rapid fluid resuscitation with crystalloid or colloid parenteral solutions should be initiated immediately. If circulatory derangements do not resolve with 3 intravenous (IV) boluses of 20 mL/kg of fluids, vasopressor support should follow. Antimicrobial agents should be given as soon as possible, according to most likely pathogens.
Empiric antimicrobial therapy for the infant or child with systemic inflammatory response syndrome (SIRS) of unclear etiology should be based upon the most frequently encountered pathogens in each age group. For example, newborns and infants in the first 6-8 weeks of life should generally receive ampicillin and gentamicin, ampicillin and cefotaxime, or ampicillin and ceftriaxone for empiric therapy of sepsis without a clear etiology. Older infants and children most often receive a third-generation cephalosporin (or ampicillin/sulbactam) alone in this situation. Patients who have indwelling catheters or those who are at high risk for methicillin-resistant S aureus infection may require vancomycin as well. Patients who have fever and neutropenia should receive broad-spectrum coverage with an emphasis on gram-negative rods.
The most frequently used antibacterial, antifungal, antiviral, and inotropic agents and albumin are described below. Other antimicrobial agents that are used less frequently include caspofungin, fluconazole, foscarnet, ganciclovir, liposomal amphotericin B, itraconazole, and voriconazole. Posaconazole (Noxafil) is also used and was recently approved by the US Food and Drug Administration (FDA) in children aged 13 years or older and in adults for prophylaxis of invasive Aspergillus and Candida infections in patients at high risk due to severe immunosuppression.
Drotrecogin alfa (Xigris) is approved by the FDA for sepsis in adults but its phase III clinical trial for use in pediatric patients was discontinued. Drotrecogin alfa is a recombinant human-activated protein C indicated for reduction of mortality in adults with severe sepsis. Enrollment in the pediatric trial was halted in March 2005 after a review of interim results determined that drotrecogin alfa was unlikely to demonstrate improvement over placebo.4,5 The study also showed increased CNS bleeding when compared with placebo.
Bovine lactoferrin supplementation (alone or in combination with the probiotic Lactobacillus rhamnosus GG) for very low birth weight neonates reduces the incidence of a first episode of late-onset sepsis.6 Studies of other such interventions are underway.
Other examples of experimental agents to consider include dexamethasone, intravenous immunoglobulin, methylprednisolone, nitric oxide, and pentoxifylline.
Antibiotics
Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.
Ampicillin (Principen)
Bactericidal activity against susceptible organisms.
Adult
500 mg to 1.5 g IM q4-6h
500 mg to 3 g IV q4-6h; not to exceed 12 g/d
Pediatric
Neonates:
<7 days and <2000 g: 50 mg/kg/dose IV/IM q12h
<7 days and >2000 g: 50 mg/kg/dose IV/IM q8h
7-30 days and <1200 g: 50 mg/kg/dose IV/IM q12h
7-30 days and 1200-2000 g: 50 mg/kg/dose IV/IM q8h
7-30 days and >2000 g: 50 mg/kg/dose IV/IM q6h
Infants and children: 100-400 mg/kg/d IV/IM divided q4-6h; use higher doses for documented or suspected meningitis
Probenecid and disulfiram elevate levels; allopurinol decreases effects and has additive effects on ampicillin rash; may decrease effects of PO contraceptives
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Adjust dose in renal failure; evaluate rash and differentiate from hypersensitivity reaction
Ampicillin and sulbactam (Unasyn)
Drug combination of beta-lactamase inhibitor with ampicillin. Covers skin, enteric flora, and anaerobes. Not ideal for nosocomial pathogens.
Adult
1.5 (1 g ampicillin + 0.5 g sulbactam) to 3 g (2 g ampicillin + 1 g sulbactam) IV/IM q6-8h; not to exceed 4 g/d sulbactam or 8 g/d ampicillin
Pediatric
<3 months: Not established
3 months to 12 years: 100-200 mg ampicillin/kg/d (150-300 mg Unasyn) IV divided q6h
>12 years: Administer as in adults
Probenecid and disulfiram elevate ampicillin levels; allopurinol decreases ampicillin effects and has additive effects on ampicillin rash; may decrease effects of PO contraceptives
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Adjust dose in renal failure; evaluate rash and differentiate from hypersensitivity reaction
Cefotaxime (Claforan)
For septicemia and treatment of infections caused by susceptible organisms. Arrests bacterial cell-wall synthesis, which, in turn, inhibits bacterial growth. Third-generation cephalosporin with gram-negative spectrum but efficacious for many gram-positive organisms and most routine pediatric invasive pathogens. Generally preferred over ceftriaxone for neonates, since cefotaxime is less likely to cause or aggravate kernicterus.
Adult
Moderate-to-severe infections:
1-2 g IV/IM q6-8h
Life-threatening infections: 1-2 g IV/IM q4h
Pediatric
Neonates: 100-200 mg/kg/d IV/IM divided q6-12h
Infants and children: 50-200 mg/kg/d IV/IM divided q4-6h
>12 years: Administer as in adults
Probenecid may increase levels; coadministration with furosemide and aminoglycosides may increase nephrotoxicity
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Adjust dose in severe renal insufficiency (high doses may cause CNS toxicity); superinfections and promotion of nonsusceptible organisms may occur with prolonged use or repeated therapy; has been associated with severe colitis
Ceftriaxone (Rocephin)
For septicemia and treatment of infections caused by susceptible organisms. Arrests bacterial cell-wall synthesis, which, in turn, inhibits bacterial growth. Third-generation cephalosporin with gram-negative spectrum but efficacious for many gram-positives and most routine pediatric invasive pathogens.
Adult
Severe infections: 1-2 g IV qd, or divided bid; not to exceed 4 g/d
Pediatric
Neonates >7 days: 25-50 mg/kg/d IV/IM; not to exceed 125 mg/d
Infants and children: 50-100 mg/kg/d IV/IM divided q12h; not to exceed 4 g/d
Probenecid may increase levels; coadministration with ethacrynic acid, furosemide, and aminoglycosides may increase nephrotoxicity
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Adjust dose in severe renal insufficiency (high doses may cause CNS toxicity); superinfections and promotion of nonsusceptible organisms may occur with prolonged use or repeated therapy; caution in breastfeeding women; may displace bilirubin from protein binding sites, increasing chance of kernicterus in the newborn with elevated bilirubin levels
Gentamicin (Garamycin)
Aminoglycoside antibiotic for gram-negative coverage. Often used in combination with agent covering gram-positive organisms and/or one that covers anaerobes. Consider if penicillins or other less toxic drugs are contraindicated, when clinically indicated, and in mixed infections caused by susceptible staphylococci and gram-negative organisms. Dosing regimens are numerous; adjust dose on basis of CrCl and changes in volume of distribution. May be given IV/IM.
Adult
Serious infections and normal renal function: 3 mg/kg/dose IV q8h
Loading dose and maintenance dose: 1-2.5 mg/kg IV and 1-1.5 mg/kg IV, respectively, q8h
Extended dosing regimen for life-threatening infections: 5 mg/kg/d IV/IM q6-8h
Follow each regimen by at least a trough level drawn on third or fourth dose (0.5 h before dosing); may draw peak level 0.5 h after 30-min infusion
Pediatric
Premature neonate <1 kg: 3.5 mg/kg/dose IV q24h
Postnatal age 0-7 days: 2.5 mg/kg/dose IV q12-24h
>7 days: 2.5 mg/kg/dose IV q8-12h
Infants and children <5 years: 2.5 mg/kg/dose IV/IM q8h
Children >5 years: 1.5-2.5 mg/kg/dose IV/IM q8h or 6-7.5 mg/kg/d divided q8h; not to exceed 300 mg/d; monitor as in adults
Coadministration with other aminoglycosides, cephalosporins, penicillins, and amphotericin B may increase nephrotoxicity; because aminoglycosides enhance effects of neuromuscular blocking agents prolonged respiratory depression may occur; coadministration with loop diuretics may increase auditory toxicity of aminoglycosides; possible irreversible hearing loss of varying degrees may occur (monitor regularly)
Documented hypersensitivity; non–dialysis-dependent renal insufficiency
Pregnancy
D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus
Precautions
Narrow therapeutic index (not intended for long-term therapy); nephrotoxicity and ototoxicity may occur and are directly associated with cumulative dose and treatment duration; caution in neonates because of renal immaturity and those with renal failure (patients not on dialysis), myasthenia gravis, hypocalcemia, and conditions that depress neuromuscular transmission; adjust dose in renal impairment
Imipenem and cilastatin (Primaxin)
Bactericidal broad-spectrum carbapenem antibiotic that inhibits cell-wall synthesis. Effective against most gram-positive and gram-negative bacteria for treatment of infection by multiple organisms in which other agents do not have wide spectrum coverage or are contraindicated because of potential for toxicity. More likely to cause seizures than other carbapenems.
Adult
Base initial dose on severity of infection and administer in equally divided doses; dose may range from 250-500 mg q6h IV for a maximum of 3-4 g/d
Alternatively, 500-750 mg q12h IM or intra-abdominally
Pediatric
0-4 weeks and <1.2 kg: 20 mg/kg/dose IV q18-24h
Postnatal age <7 days: 20-25 mg/kg/dose IV q12h
Postnatal age 7-28 days: 20-25 mg/kg/dose IV q8-12h
4 weeks to 3 months: 25 mg/kg/dose IV q6h
Infants >3 months and children <12 years: 15-25 mg/kg/dose IV q6h
Infections with fully susceptible organisms: Not to exceed 2 g/d
Infections with moderately susceptible organisms: Not to exceed 4 g/d
>12 years: Administer as in adults
Coadministration with cyclosporine may increase CNS side effects of both agents; coadministration with ganciclovir may result in generalized seizures
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Adjust dose in renal insufficiency; avoid use in children <12 y; seizures may occur in children with CNS infections; avoid use in children with meningitis
Meropenem (Merrem)
Bactericidal broad-spectrum carbapenem antibiotic that inhibits cell-wall synthesis. Effective against most gram-positive and gram-negative bacteria. Has slightly increased activity against gram-negatives and slightly decreased activity against staphylococci and streptococci compared with imipenem.
Adult
1 g IV q8h
Pediatric
Neonates: 20 mg/kg/dose IV q8-12h
>3 months:
Mild-to-moderate infections: 20 mg/kg/dose IV q8h
Meningitis: 40 mg/kg/dose IV q8h
Probenecid may inhibit renal excretion of meropenem, increasing meropenem levels
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Pseudomembranous colitis and thrombocytopenia may occur, requiring immediate discontinuation of medication
Vancomycin (Vancocin)
Potent antibiotic directed against gram-positive organisms and active against Enterococcus species. Useful in the treatment of septicemia and skin structure infections. Indicated for patients who cannot receive, or have failed to respond to, penicillins and cephalosporins or have infections with resistant staphylococci. For abdominal penetrating injuries, is combined with an agent active against enteric flora and/or anaerobes.
Adult
500 mg to 2 g/d IV divided q6-8h
Pediatric
0-4 weeks: 15 mg/kg/dose IV q8-24h
Infants >1 month and children: 40 mg/kg/d IV divided q6-8h
Erythema, histaminelike flushing, and anaphylactic reactions may occur when administered with anesthetic agents; taken concurrently with aminoglycosides, risk of nephrotoxicity may increase above that with aminoglycoside monotherapy; caution with other nephrotoxic drugs (eg, loop diuretics, cisplatin); effects in neuromuscular blockade may be enhanced when coadministered with nondepolarizing muscle relaxants
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in renal failure, adjust dose according to CrCl; may cause neutropenia; red man syndrome is caused by too-rapid IV infusion (dose given over a few min) but rarely happens when dose given IV over 2 h or as PO or IP administration; red man syndrome is not an allergic reaction
Antifungal agents
These agents are indicated for treating serious fungal infections. Their mechanism of action may involve an alteration of RNA and DNA metabolism or an intracellular accumulation of peroxide that is toxic to the fungal cell.
Amphotericin B, conventional (Amphocin, Fungizone)
Polyene antibiotic produced by a strain of Streptomyces nodosus; can be fungistatic or fungicidal. Binds to sterols, such as ergosterol, in the fungal cell membrane, causing intracellular components to leak with subsequent fungal cell death.
Adult
0.25-1.5 mg/kg IV q24-48h
Pediatric
Administer as in adults
Antineoplastic agents may enhance the potential of amphotericin B for renal toxicity, bronchospasm, and hypotension; corticosteroids, digitalis, and thiazides may potentiate hypokalemia; the risk of renal toxicity is increased with cyclosporine
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Monitor renal function, levels of serum electrolytes such as magnesium and potassium, liver function, CBC count, and hemoglobin concentrations; resume therapy at the lowest level (eg, 0.25 mg/kg) when therapy is interrupted for more than 7 d; hypoxemia, acute dyspnea, and interstitial infiltrates may occur in neutropenic patients receiving leukocyte transfusions (separate time of amphotericin infusion from time of leukocyte transfusion); fever and chills are not uncommon after first few administrations of drug; rare acute reactions may include hypotension, bronchospasm, arrhythmias, and shock
Posaconazole (Noxafil)
Triazole antifungal agent. Blocks ergosterol synthesis by inhibiting the enzyme lanosterol 14-alpha-demethylase and sterol precursor accumulation. This action results in cell membrane disruption. Available as oral susp (200 mg/5 mL). Indicated for prophylaxis of invasive Aspergillus and Candida infections in patients at high risk because of severe immunosuppression.
Adult
200 mg (5 mL) PO tid with food or liquid nutritional supplement to enhance absorption
Pediatric
<13 years: Not established
>13 years: Administer as in adults
Metabolized via UDP glucuronidation; P-gp efflux substrate; CYP3A4 inhibitor UDP-G inducers (eg, rifabutin, phenytoin) and drugs that increase gastric pH (eg, cimetidine) decrease serum levels (avoid concomitant use unless benefit outweighs risk); inhibits CYP3A4 and may elevate serum levels of cyclosporine, tacrolimus, sirolimus, rifabutin, midazolam, phenytoin, calcium channel blockers (eg, nifedipine, bepridil), HMG-CoA reductase inhibitors (eg, lovastatin, pravastatin), ergot alkaloids, terfenadine, astemizole, cisapride, pimozide, halofantrine, quinidine, or vinca alkaloids (eg, vincristine, vinblastine)
Documented hypersensitivity; coadministration with ergot alkaloids; coadministration with CYP3A4 substrates likely to result in serious toxicities (eg, terfenadine, astemizole, cisapride, pimozide, halofantrine, quinidine)
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Common adverse effects include nausea, vomiting, diarrhea, rash, hypokalemia, thrombocytopenia, and elevated liver enzyme levels; closely monitor patients with severe diarrhea or vomiting for breakthrough fungal infections; rare adverse events include arrhythmias caused by QTc prolongation, bilirubinemia, or liver function impairment; caution with preexisting cardiac risk factors (eg, history of arrhythmia, hypokalemia, hypomagnesemia); food improves absorption and provides optimal serum concentration; shake well before use; administer with measuring spoon provided in package; avoid if breastfeeding
Antiviral agents
These agents are indicated for treating serious viral (particularly herpetic) infections. Nucleoside analogs are initially phosphorylated by viral thymidine kinase to eventually form a nucleoside triphosphate. These molecules inhibit herpes simplex virus (HSV) polymerase with 30-50 times the potency of human alpha-DNA polymerase.
Acyclovir (Zovirax)
Inhibits activity of both HSV-1 and HSV-2. Has affinity for viral thymidine kinase and once phosphorylated causes DNA chain termination when acted on by DNA polymerase. Patients experience less pain and faster resolution of cutaneous lesions when used within 48 h from rash onset. May prevent recurrent outbreaks. Early initiation of therapy is imperative.
Adult
5-20 mg/kg/dose IV q8h or 750-3000 mg/m2/d divided q8h
Pediatric
Administer as in adults
Concomitant use of probenecid or zidovudine prolongs half-life and increases CNS toxicity of acyclovir
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Caution in renal failure or when using nephrotoxic drugs
Vasopressor and inotropic agents
These drugs are administered to support blood pressure, cardiac output, and tissue and organ perfusion.
Dobutamine (Dobutrex)
Produces vasodilation and increases inotropic state. At higher dosages, may cause increased heart rate, exacerbating myocardial ischemia.
Adult
0.5 mcg/kg/min IV initially and titrate until desired therapeutic effect attained
Pediatric
Administer as in adults
Beta-adrenergic blockers antagonize effects of dobutamine; general anesthetics may increase toxicity
Documented hypersensitivity; idiopathic hypertrophic subaortic stenosis and atrial fibrillation or flutter
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Use with extreme caution following myocardial infarction; hypovolemic state should be corrected before using this drug
Dopamine (Intropin)
Stimulates both adrenergic and dopaminergic receptors. Hemodynamic effect is dependent on dose. Lower doses predominantly stimulate dopaminergic receptors that in turn produce renal and mesenteric vasodilation. Cardiac stimulation and renal vasodilation produced by higher doses. After initiating therapy, increase dose by 1-4 mcg/kg/min q10-30min until optimal response obtained. More than 50% of patients are satisfactorily maintained on doses <20 mcg/kg/min.
Adult
1-5 mcg/kg/min IV; not to exceed 50 mcg/kg/min
Pediatric
Administer as in adults
Alpha- and beta-adrenergic blockers may decrease dopamine effects; alpha- and beta-adrenergic agonists, general anesthesia, and MAOIs increase toxicity or prolong effects of dopamine; coadministration with phenytoin may result in seizures or severe hypotension
Documented hypersensitivity; pheochromocytoma or ventricular fibrillation
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Closely monitor urine flow, cardiac output, pulmonary wedge pressure, and blood pressure during infusion; before infusion, correct hypovolemia with whole blood or plasma, as indicated; monitoring central venous pressure or left ventricular filling pressure may be helpful in detecting and treating hypovolemia
Epinephrine (Adrenalin)
Considered the single most useful drug in cardiac arrest. Increases coronary perfusion pressure.
Adult
0.1-1 mcg/kg/min IV
Pediatric
Administer as in adults
Increases toxicity of beta- and alpha-blocking agents and that of halogenated inhalational anesthetics
Documented hypersensitivity; cardiac arrhythmias; angle-closure glaucoma; local anesthesia in areas such as fingers or toes because vasoconstriction may produce sloughing of tissue; during labor (may delay second stage of labor)
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in elderly patients, prostatic hypertrophy, hypertension, cardiovascular disease, diabetes mellitus, hyperthyroidism, and cerebrovascular insufficiency; rapid IV infusions may cause death from cerebrovascular hemorrhage or cardiac arrhythmias
Norepinephrine (Levophed)
For protracted hypotension following adequate fluid-volume replacement. Stimulates beta1- and alpha-adrenergic receptors, which, in turn, increases cardiac muscle contractility, heart rate, and vasoconstriction. As a result, systemic blood pressure and coronary blood-flow increases. After obtaining a response, the rate of flow should be adjusted and maintained at a low normal blood pressure, such as 80-100 mm Hg systolic, sufficient to perfuse vital organs.
Adult
4 mcg/min IV and titrate to desired response
Pediatric
0.05-0.1 mcg/kg/min IV initially; titrate upward if needed, not to exceed 1-2 mcg/kg/min
Effects increase when administered concurrently with tricyclic antidepressants, MAOIs, antihistamines, guanethidine, methyldopa, ergot alkaloids; atropine may block reflex tachycardia caused by norepinephrine and enhances pressor response
Documented hypersensitivity; peripheral or mesenteric vascular thrombosis because ischemia may be increased and the area of the infarct extended
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Correct blood-volume depletion, if possible, before administering therapy; should be administered into a large vein because extravasation may cause severe tissue necrosis; caution in occlusive vascular disease
Colloid solutions
These agents are used for volume expansion.
Albumin (Albuminar, Albunex, Buminate)
For certain types of shock or impending shock. Use 5% solutions for plasma volume expansion and maintenance of cardiac output. Use 25% solutions to raise oncotic pressure.
Adult
250-500 mL (12.5-25 g) of 5% solution IV over 20-30 min with reassessment of hemodynamic response: not to exceed 250 g/48h
Pediatric
Typical pediatric doses are 4-5 mL/kg (200-250 mg/kg) of 5% solution IV over 30 min with reassessment of hemodynamic response; not to exceed 6 g/kg/24h
None reported
Documented hypersensitivity; pulmonary edema; severe congestive heart failure or anemia; protein load of 5% albumin (tends to exacerbate renal insufficiency, a potential complication of septic shock)
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in renal or hepatic failure because may cause protein overload; rapid infusion may cause vascular overload or hypotension; monitor for volume overload; caution in sodium restriction; common adverse effects include congestive heart failure, hypotension, tachycardia, fever, chills, and pulmonary edema; do not dilute albumin 25% with sterile water for injection (produces hypotonic solution and if administered may result in life-threatening hemolysis and acute renal failure)
More on Sepsis |
| Overview: Sepsis |
| Differential Diagnoses & Workup: Sepsis |
 Treatment & Medication: Sepsis |
| Follow-up: Sepsis |
| Multimedia: Sepsis |
| References |
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Further Reading
Keywords
sepsis, systemic inflammatory response syndrome, SIRS, septic shock, septicemia, blood infection, bloodstream infection, neonatal sepsis, bacteremia, viremia, fungemia, parasitemia, treatment, diagnosis, symptoms
