Patients with sepsis should complete the sepsis bundle (fluid resuscitation, antibiotics, lactate measurement, and cultures) within three hours of presentation. Sepsis care protocols decrease sepsis-related mortality and should be implemented in all medical facilities. Validation studies and retrospective analysis of observational studies In settings other than the intensive care unit, the quick Sequential Organ Failure Assessment () can help clinicians recognize possible sepsis early in the evaluation. Future trials of sepsis management are focusing on improving long-term rates of readmission and death, physical disability, cognitive impairment, and quality of life. Vasopressor therapy is indicated if hypotension persists despite fluid administration. The latest guidelines recommend starting antimicrobials within one hour, but this is controversial. Most research indicates that antimicrobial therapy should be started within three hours of presentation.

Antimicrobial therapy should also be initiated early. Fluid resuscitation is the priority in early management, including administering an intravenous crystalloid at 30 mL per kg within the first three hours. Initial evaluation of patients with suspected sepsis includes basic laboratory tests, cultures, imaging studies as indicated, and sepsis biomarkers such as procalcitonin and lactate levels. Although many patients with sepsis have fever, the clinical manifestation can be subtle, particularly in older patients and those who are immunocompromised. Pneumonia is the most common cause of sepsis. Respiratory, gastrointestinal, genitourinary, and skin and soft tissue infections are the most common sources of sepsis. The guidelines recommend the Sequential Organ Failure Assessment (original and quick versions) as an important tool for early diagnosis. The measurement of serum lactate has been incorporated into the latest septic shock definition. The guidelines define septic shock as sepsis with circulatory, cellular, and metabolic dysfunction that is associated with a higher risk of mortality. Guidelines published in 2016 provide a revised definition of sepsis: life-threatening organ dysfunction caused by a dysregulated host response to infection.

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