?Blood product infusion
?Stress ulcer prophylaxis
?Neuromuscular blocking agents
?Venous thromboembolism prophylaxis
?Intensive insulin therapy
?External cooling or antipyretics
?Mechanical ventilation, sedation, weaning
?Investigational therapies for sepsis and acute respiratory distress syndrome (eg, IVIG, antithrombin, thrombomodulin, heparin, cytokine and toxin inactivators, as well as hemofiltration, statins, beta-2 agonists, beta blockade, and vitamin C/thiamine/hydrocortisone combination)
In-hospital morbidity and mortality
Sepsis has a high mortality rate. Several studies have reported decreasing mortality rates over time. During hospital admission, sepsis may increase the risk of acquiring a subsequent hospital-related infection, hinting at possible immune suppression. In patients with a diagnosis of sepsis at admission, secondary infections were mostly catheter-related blood stream infections (26 percent), pneumonia (25 percent), or abdominal infections (16 percent), compared with patients with non-sepsis admission where pneumonia was the most common ICU-acquired infection (48 percent). In both groups, patients who developed ICU-acquired infection were more severely ill on admission (eg, higher Acute Physiologic and Chronic Health Evaluation APACHE IV and Sequential Organ Failure Assessment scores and more shock on admission) and had higher mortality at day 60. However, the contribution of developing a secondary infection was small.
Following discharge from the hospital, sepsis carries an increased risk of death (up to 20 percent) as well as an increased risk of further sepsis and recurrent hospital admissions (up to 10 percent are readmitted). Most deaths occur within the first six months but the risk remains elevated at two years. Patients who survive sepsis are more likely to be admitted to acute care and/or long term care facilities in the first year after the initial hospitalization, and also appear to have a persistent decrement in their quality of life.