Reducing Mortality in Severe Sepsis and Septic Shock

Andrew T. Levinson, M.D., M.P.H.; Brian P. Casserly, M.D.; Mitchell M. Levy, M.D.

Disclosures

Semin Respir Crit Care Med. 2011;32(2):195-205. 

In This Article

Source Control

The objective of source control, according to a recent review, is "the physical control of foci of infection and the restoration of optimal function and quality of life." Depending on the source of infection and the premorbid and current condition of the septic patient, options for source control may include drainage, debridement, device removal, or more definitive measures such as laparotomy. There is a paucity of randomized clinical studies to support the various options for source control to reduce mortality; such studies would be very difficult to conduct. Factors such as the current condition of the patient and past medical and surgical history should be taken into account when tailoring therapeutic options for source control to the individual patient.[60] The current SSC guidelines recommend making a diagnosis in a septic patient requiring source control as soon as possible, at least in the first 6 hours of presentation.

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