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Sepsis pp 207-218 | Cite as

Source Control in Sepsis

  • Michael ConnollyEmail author
  • Charles Adams
Chapter
  • 2.9k Downloads
Part of the Respiratory Medicine book series (RM)

Abstract

Source control is generally accepted to be a key component in the treatment and reversal of sepsis. It is comprised of the physical efforts to remove or contain a focus of invasive infection in order to restore normal function [1]. The principles of source control for sepsis have been known for centuries, but only recently have prioritizing and achieving source control in sepsis become more recognized due to the heightened awareness of sepsis as a result of the Surviving Sepsis Campaign [2]. The majority of research in sepsis has focused on early diagnosis, resuscitation, antibiotics, and other therapies, and despite source control being the cornerstone of therapy for sepsis for centuries, it has not been widely studied. Due to this lack of evidence, source control is often overlooked or underutilized much to the detriment of septic patients.

Keywords

Severe Sepsis Percutaneous Drainage Soft Tissue Infection Necrotizing Fasciitis Abdominal Compartment Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Marshall JC, al Naqbi A. Principles of source control in the management of sepsis. Crit Care Clin. 2009;25:753–68.CrossRefPubMedGoogle Scholar
  2. 2.
    Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580–637.CrossRefPubMedGoogle Scholar
  3. 3.
    Jimenez MF, Marshall JC. Source control in the management of sepsis. Intensive Care Med. 2001;27:S49–62.CrossRefPubMedGoogle Scholar
  4. 4.
    Gerzof SG, Robbins AH, Johnson WC, Birkett DH, Nabseth DC. Percutaneous catheter drainage of abdominal abscesses. A five-year experience. N Engl J Med. 1981;305:653–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Moulton JS, Benkert RE, Weisiger KH, Chambers JA. Treatment of complicated pleural fluid collections with image-guided drainage and intracavitary urokinase. Chest. 1995;108(5):1252–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Cinat ME, Wilson SE, Din AM. Determinants for successful percutaneous image-guided drainage of intra-abdominal abscess. Arch Surg. 2002;137(7):845–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Fernandez-del Castillo C, Rattner DW, Makary MA, Mostafavi A, McGrath D, Warshaw AL. Debridement and closed packing for the treatment of necrotizing pancreatitis. Ann Surg. 1998;228(5):676–84.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, et al. A setp-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362:1491–502.CrossRefPubMedGoogle Scholar
  9. 9.
    Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368–77.CrossRefPubMedGoogle Scholar
  10. 10.
    Gajic O, Urrutia LE, Sewani H, Schroeder DR, Cullinane DC, Peters SG. Acute abdomen in the medical intensive care unit. Crit Care Med. 2002;30(6):1187–90.CrossRefPubMedGoogle Scholar
  11. 11.
    Boyer A, Vargas F, Coste F, Saubusse E, Castaing Y, Gbikpi-Benissan G, et al. Influence of surgical treatment timing on mortality from necrotizing soft tissue infections requiring intensive care management. Intensive Care Med. 2009;35(5):847–53.CrossRefPubMedGoogle Scholar
  12. 12.
    Buck DL, Vester-Andersen M, Moller MH. Surgical delay is a critical determinant of survival in perforated peptic ulcer. Br J Surg. 2013;100(8):1045–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Wacha H, Hau T, Dittmer R, Ohmann C, The Peritonitis Study Group. Risk factors associated with intraabdominal infections: a prospective multicenter study. Langenbecks Arch Surg. 1999;384:24–32.CrossRefPubMedGoogle Scholar
  14. 14.
    Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJC, Baron EJ, et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the surgical infection society and the infectious diseases society of America. Clin Infect Dis. 2010;50:133–64.CrossRefPubMedGoogle Scholar
  15. 15.
    The United Kingdom National Surgical Research Collaborative. Safety of short, in-hospital delays before surgery for acute appendicitis. Ann Surg. 2014;259:894–903.Google Scholar
  16. 16.
    Drake FT, Mottey NE, Farrokhi ET, Florence MG, Johnson MG, Mock C, et al. Time to appendectomy and risk of perforation in acute appendicitis. JAMA Surg. 2014;149(8):837–44.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Kumar RR, Kim JT, Haukoos JS, Macias LH, Dixon MR, Stamos MJ, et al. Factors affecting the successful management of intra-abdominal abscesses with antibiotics and the need for percutaneous drainage. Dis Colon Rectum. 2005;49:183–9.CrossRefGoogle Scholar
  18. 18.
    Kassi F, Dohan A, Soyer P, Vicaut E, Boudiaf M, Valleur P, et al. Predictive factors for failure of percutaneous drainage of postoperative abscess after abdominal surgery. Am J Surg. 2014;207:915–21.CrossRefPubMedGoogle Scholar
  19. 19.
    Marin D, Ho LM, Barnhard H, Neville AM, White RR, Paulson EK. Percutaneous abscess drainage in patients with perforated acute appendicitis: effectiveness, safety, and prediction of outcome. Am J Roentgenol. 2010;194:422–9.CrossRefGoogle Scholar
  20. 20.
    Eiseman B, Beart R, Norton L. Multiple organ failure. Surg Gynecol Obstet. 1977;144(3):323–6.PubMedGoogle Scholar
  21. 21.
    Norton LW. Does drainage of intraabdominal pus reverse multiple organ failure. Am J Surg. 1985;149(3):347–50.CrossRefPubMedGoogle Scholar
  22. 22.
    Hau T, Ohmann C, Wolmerhauser A, Wacha H, Yang Q. Planned relaparotomy vs relaparotomy on demand in the treatment of intra-abdominal infections. Arch Surg. 1995;130:1193–7.CrossRefPubMedGoogle Scholar
  23. 23.
    van Ruler O, Mahler CW, Boer KR, Reuland EA, Gooszen HG, Opmeer BC, et al. Comparison of on-demand vs planned relaparotomy strategy in patients with severe peritonitis. JAMA. 2007;298(8):865–72.CrossRefPubMedGoogle Scholar
  24. 24.
    Adkins AL, Robbins J, Villalba M, Bendick P, Shanley CJ. Open abdomen management of intra-abdominal sepsis. Am Surg. 2004;70(2):137–40.PubMedGoogle Scholar
  25. 25.
    Lamme B, Boermeester MA, Reitsma JB, Mahler CW, Obertop H, Gouma DJ. Meta-analysis of relaparotomy for secondary peritonitis. Br J Surg. 2002;89:1516–24.CrossRefPubMedGoogle Scholar
  26. 26.
    Sartelli M, Catena F, Ansaloni L, Coccolini F, Corbella D, Moore EE, et al. Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW study. World J Emerg Surg. 2014;9:37.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Toorenvliet BR, Swank H, Schoones JW, Hamming JF, Bemelman WA. Laparoscopic peritoneal lavage for perforated colonic diverticulitis: a systematic review. Colorectal Dis. 2010;12(9):862–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Park WM, Glovicki P, Cherry KJ, Hallet JW, Bower TC, Panneton JM, et al. Contemporary management of acute mesenteric ischemia: factors associated with survival. J Vasc Surg. 2002;35(3):445–52.CrossRefPubMedGoogle Scholar
  29. 29.
    Jamal MM, Yamini D, Singson Z, Samarasena J, Hashemzadeh M, Vega KJ. Decreasing hospitalization and the in-hospital mortality related to cholangitis in the united states. J Clin Gastroenterol. 2001;45:e92–6.CrossRefGoogle Scholar
  30. 30.
    Lai E, Mok F, Tan E, Lo C, Fan S, You K, et al. Endoscopic biliary drainage for severe acute cholangitis. N Engl J Med. 1992;326:1582–6.CrossRefPubMedGoogle Scholar
  31. 31.
    Kashab MA, Tariq A, Tariq U, Kim K, Ponor L, Lennon A, et al. Delayed and unsuccessful endoscopic retrograde cholangiopancreatography are associated with worse outcomes in patients with acute cholangitis. Clin Gastroenterol Hepatol. 2012;10:1157–61.CrossRefGoogle Scholar
  32. 32.
    Navaneethan U, Gutierrez NG, Jegadeesan R, Venkatesh P, Butt M, Sanaka MR, et al. Delay in performing ERCP and adverse events increase the 30-day readmission risk in patients with acute cholangitis. Gastrointest Endosc. 2013;78:81–90.CrossRefPubMedGoogle Scholar
  33. 33.
    Mier J, Luque-de Leon E, Castillo A, Robledo F, Blanco R. Early versus late necrosectomy in severe necrotizing pancreatitis. Am J Surg. 1997;173:71–5.CrossRefPubMedGoogle Scholar
  34. 34.
    Hartwig W, Maksan SM, Foitzik T, Schmidt J, Herfarth C, Klar E. Reduction in mortality with delayed surgical therapy of severe pancreatitis. J Gastrointest Surg. 2002;6(3):481–7.CrossRefPubMedGoogle Scholar
  35. 35.
    Anaya DA, McMahon K, Nathens AB, Sullivan SR, Foy H, Bulger E. Predictors of mortality and limb loss in necrotizing soft tissue infections. Arch Surg. 2005;140:151–8.CrossRefPubMedGoogle Scholar
  36. 36.
    McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA. Determinants of mortality for necrotizing soft-tissue infections. Ann Surg. 1995;221:558–63.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Bilton BD, Zibari GB, McMillan RW, Aultman DF, Dunn G, McDonald JC. Aggressive surgical management of necrotizing fasciitis serves to decrease mortality: a retrospective study. Am Surg. 1998;64:397–400.PubMedGoogle Scholar
  38. 38.
    von Eiff C, Jansen B, Kohnen W, Becker K. Infections associated with medical devices. Drugs. 2005;65(2):179–214.CrossRefGoogle Scholar
  39. 39.
    Costerton JW, Stewart PS, Greenberg EP. Bacterial Biofilms: a common cause of persistent infections. Science. 1999;284:1318–22.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of SurgeryAlpert/Brown Medical SchoolProvidenceUSA

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