ABSTRACT
This chapter summarises progressive pathology, prognosis, and issues specific to sepsis. Sepsis remains the most common reason for intensive care unit admission, and the leading cause of death in critically ill patients. Extent of inflammatory responses determines the severity of sepsis. Sepsis is caused by infection, usually but not always bacterial. So, urgent antimicrobial agents, usually antibiotics, are fundamental to treatment. Human and financial cost of from sepsis remain high, so much research has been invested to find solutions. This creates the temptation to promote and use expensive therapies which may have limited benefits. Mortality reflects the number of major organs failing; multidisciplinary teams should consider whether prognosis justifies continued treatment; nurses should be actively involved in team decisions. Steroids should theoretically reduce inflammatory responses, but evidence is weak to support its use in sepsis, so intravenous hydrocortisone should only be given if septic shock fails to respond to fluid resuscitation and vasopressors.
