This book is open access under a CC BY 4.0 license. It constitutes a unique source of knowledge and guidance for all healthcare workers who care for patients with sepsis and septic shock in resource-limited settings. More than eighty percent of the worldwide deaths related to sepsis occur in resource-limited settings in low and middle-income countries. Current international sepsis guidelines cannot be implemented without adaptations towards these settings, mainly because of the difference in local resources and a different spectrum of infectious diseases causing sepsis. This prompted members of the Global Intensive Care working group of the European Society of Intensive Care Medicine (ESICM) and the Mahidol-Oxford Tropical Medicine Research Unit (MORU, Bangkok, Thailand) - among which the Editors – to develop with an international group of experts a comprehensive set of recommendations for the management of sepsis in resource-limited settings. Recommendations are based on both current scientific evidence and clinical experience of clinicians working in resource-limited settings. The book includes an overview chapter outlining the current challenges and future directions of sepsis management as well as general recommendations on the structure and organization of intensive care services in resource-limited settings. Specific recommendations on the recognition and management of patients with sepsis and septic shock in these settings are grouped into seven chapters. The book provides evidence-based practical guidance for doctors in low and middle income countries treating patients with sepsis, and highlights areas for further research and discussion.

In Collaboration with Consulting Editor, Dr. Jan Foster, Drs. Martin and Badeaux have created an issue where top authors in critical care nursing provide current updates on sepsis care and management. Authors have written clinical reviews on the following topics: International Sepsis Guidelines 2016; Pros and Cons of Early Administration of Intravenous Fluids; PTSD After ICU Stay; Role of Vitamin C and Carbon Monoxide in Sepsis; Neonatal Sepsis; Use of Etomidate in the Septic Patient; Simulation to Manage the Septic Patient in the ICU; Cardiogenic Shock Complicating Sepsis management; Hospital Costs associated with Sepsis Compared to other Medical Conditions; Special Considerations for the Septic Patient Going to the Operating Room; Management of the Septic Patient in the Emergency Room; and Management of Sepsis in the Obstetrical Patient. Reader will come away with the information they need to improve patient outcomes.

The importance of early prevention and treatment of sepsis hasnever been greater. In the UK alone sepsis contributes to moredeaths than lung cancer, from bowel cancer and breast cancercombined, and approximately one third of patients who suffer fromsevere sepsis die. The ABC of Sepsis provides a much neededintroduction and an invaluable aid in the increasing efforts toreduce hospital infection and improve patient safety. As growing numbers of junior medical staff experience emergencymedicine, critical care and acute medicine as part of theFoundation Programme, there is an increasing need to develop theskills required to treat severe sepsis. The editors are involvedwith the Survive Sepsis campaign - developed to improve therecognition, diagnosis and treatment of sepsis - and are perfectlyplaced to guide junior medics, GPs, specialist nurses, criticalcare nurses and primary care staff through this core aspect ofacute medicine.

Offering a global, multidisciplinary perspective on this life-threatening medical emergency, The Sepsis Codex provides a concise yet comprehensive look at a complex topic. Nearly 20% of global deaths are attributed to sepsis annually, nearly half of which are in children under the age of five, with low-resource settings being disproportionately affected. A “one size fits all approach is not sufficient to meet individual patients’ needs, instead requiring a therapeutic approach that considers different ages, predisposing factors, genetic traits, and more. This cutting-edge resource brings you up to date with recent medical advances in this challenging area. Covers pathophysiology, early detection, biomarkers and diagnosis, therapies, controversies, future research, the use of AI, professional organizations and public health in sepsis. Includes chapters on sepsis in special populations such as in pregnant women, transplanted patients, and children. Consolidates today's available information on this timely topic into a single, convenient resource.

Paper Presented at 42nd annual Conference of Maharashtra State Chapter of ASI ( MASICON 2020) in Amravati on 24 January 2020. ) Abstract: Background: Septic shock remains a leading cause of mortality despite advances in critical care. Recent updates and guidelines have shifted clinical approaches to improve recognition and management. This review highlights the role of various clinical tools, interventions, and therapeutic strategies in managing septic shock. Objective: To examine the current clinical strategies and guidelines in recognizing and treating septic shock, with emphasis on occult septic shock, fluid resuscitation, vasopressor usage, and the role of steroids, lactate monitoring, and procalcitonin in prognosis. Methods: A comprehensive review of the literature, including the latest guidelines from the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), the Surviving Sepsis Campaign, and retrospective studies comparing clinical tools such as SIRS, qSOFA, and NEWS for early identification of septic shock. Results: 1. Recognition of Septic Shock: - SIRS, qSOFA, and NEWS were evaluated, with NEWS emerging as a more accurate tool for early recognition. - Lactate and procalcitonin are valuable markers but have limitations in predicting patient outcomes.2. Resuscitation Strategies: - Ringer's Lactate is preferred over saline for initial resuscitation due to the latter’s association with hyperchloremic acidosis. - The recommended fluid resuscitation strategy includes rapid administration of 30mL/kg crystalloid for hypotension or lactate > 4 mmol/L.3. Vasopressor and Steroid Use: - Early norepinephrine administration is recommended to maintain a MAP > 65 mmHg. - Vasopressin is the second-line vasopressor, though its benefits in reducing mortality are uncertain. - Steroids, particularly in conjunction with vitamin C and thiamine, may improve outcomes in vasopressor-refractory septic shock.4. Antibiotic Timing and Administration: - Early antibiotic administration, ideally within one hour of sepsis diagnosis, significantly improves survival rates. Conclusion: Effective management of septic shock involves early recognition using appropriate clinical tools like NEWS, aggressive fluid resuscitation with balanced crystalloids, timely initiation of vasopressors, and careful consideration of steroids and antibiotics. Further large-scale randomized controlled trials are needed to refine these approaches, particularly in vasopressor and steroid administration.