Chinese expert consensus on early prevention and intervention of sepsis

• Published in: Asian Pacific Journal of Tropical Medicine
• Main Authors: Zhong Wang, Xuezhong Yu, Yuguo Chen, Chuanzhu Lv, Xiaodong Zhao
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020
• Subjects: sepsis; preventing; infection; cytokines; organ function; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.4103/1995-7645.289438; https://doaj.org/article/71f0a8b0a85b40a7a468906ffedb08d9

Sepsis is currently a major problem and challenge facing the medical community. With rapid development and progress of modern medicine, researchers have put more and more attention on sepsis; meanwhile, the morbidity and mortality of sepsis remains high despite great efforts from experts in various fields. According to updated guidelines, sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Infection is the initial step of sepsis progression, and development from infection to sepsis is a complex pathophysiological process, including pathogen invasion, cytokine release, capillary leakage, microcirculation dysfunction, etc. which finally leads to organ metabolic disorders and functional failure. According to the latest recommended international guidelines of Sepsis 3.0, the presence of infection and SOFA score ≥ 2 are considered as the diagnostic criteria for sepsis, and the “rescue” measures mainly focus on reversal of organ dysfunction. However, despite nearly two decades of efforts, the “Save Sepsis Campaign” has not achieved satisfactory results. Emergency medicine is the frontier subject of acute and severe illness which treats patients with acute infections at the earliest. If at this stage, physicians can predict the possibility of sepsis progression from demographic characteristics, localize the pathogen and infection, detect the inflammatory storms by tests of cytokines and evaluate the severity of the infection with more effective clinical scoring system, and then take effective measures to prevent infection from developing into sepsis in high-risk patients, the morbidity and mortality of sepsis in patients with acute infection will be greatly reduced. Based on this situation, Chinese emergency medicine experts proposed the concept of “preventing and blocking” sepsis, and launched the nationwide “Preventing Sepsis Campaign in China (PSCC)” nationwide. The main concept is summarized as “three early and two reduces” which includes early detection, ...