Sepsis in Patients With Cirrhosis.

Patients with cirrhosis are at high risk for sepsis and sepsis-related mortality. Aggressive treatment aimed at avoidance of hypo-perfusion and prompt identification and treatment of the causative organism can improve patients' survival. Fluid administration is the first-line treatment to improve pe...

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Detalles Bibliográficos
Publicado en:AACN Advanced Critical Care Vol. 27; no. 4; pp. 408 - 420
Autores principales: McLaughlin, Diane, Shellenback, Lori
Formato: pictorial tables/charts Journal Article
Publicado: American Association of Critical-Care Nurses Oct-Dec2016
Acceso en línea:Ver este registro en EBSCOhost
Descripción
Sumario:Patients with cirrhosis are at high risk for sepsis and sepsis-related mortality. Aggressive treatment aimed at avoidance of hypo-perfusion and prompt identification and treatment of the causative organism can improve patients' survival. Fluid administration is the first-line treatment to improve perfusion to vital organs; however, care should be taken to assess true intravascular volume status. In patients with adequate intravascular volume, vasopressors are then added to support blood pressure. Complications of cirrhosis often worsen in the setting of sepsis. Portosystemic encephalopathy, pulmonary complications, renal complications, adrenal insufficiency, malnutrition, and insufficient glucose control all must be considered and treated to support a patient with cirrhosis through sepsis. The quality of care that these patients receive ultimately influences their survival.