I am getting different interpretations from different people which is my concern. They way the guidelines are written it is being interpreted as: (I am discussing severe sepsis only not septic shock)
Pt has 2 SIRS & suspected infection, begin 3 hour resuscitation. Screen with labs, lactic acid. IF the lactate is less than 4 the pt gets admitted to the floor NOT the ICU irrelevant if they have one or more acute organ dysfunction, no central line etc. This is different than prior guidelines where severe sepsis required EGDT in the ICU and was defined as hypo perfusion as indicated by one or more acute organ dysfunction OR lactate greater than 4. It now seems as if everything is riding on the lactate as the only indicator of hypoprofusion. This seems like a bad idea, you can have hypoprofusion as indicated by acute organ dysfunction and a normal lactate. Should we be relying on a single indicator of severe sepsis? Christine Sent from my iPhone _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
