AUTHOR=Carsetti Andrea , Vitali Eva , Pesaresi Lucia , Antolini Riccardo , Casarotta Erika , Damiani Elisa , Adrario Erica , Donati Abele 

TITLE=Anesthetic management of patients with sepsis/septic shock

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1150124

DOI=10.3389/fmed.2023.1150124

ISSN=2296-858X

ABSTRACT=Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection while septic shock is a subset of sepsis with persisting hypotension requiring vasopressors to maintain mean arterial pressure (MAP) ≥65mmHg and having a serum lactate level >2 mmol/L despite adequate volume resuscitation. Sepsis and septic shock are medical emergencies and time-dependent diseases with a high mortality rate for which early identification, early antibiotic therapy, and early source control are paramount for the patient's outcome. The patient may require surgical intervention or invasive procedure aiming to control the source of infection and the anesthesiologist has a pivotal role in all phases of patient management. During the preoperative assessment, she/he should be aware of all possible organ dysfunctions and the severity of the disease combined with the patient's physiological reserve should be carefully assessed. All efforts should be made to opti-mize conditions before surgery, especially from a hemodynamic point of view. All anesthetic agents may worsen the hemodynamics of shock patients and anesthesiologist must know the properties of each one. All efforts should be made to maintain organ perfusion supporting hemodynamics with fluids, vasoactive agents, and inotropes if required.