Sepsis — ICU Management — Clinical Pathway: Emergency Department, Inpatient and PICU

Sepsis Clinical Pathway — Emergency Department, Inpatient and PICU

ICU Management

Guidance for Ongoing Management

Continue to Monitor

  • Continue Lung Protective Strategies
  • Consider Diuretics or Dialysis if Fluid Overload > 10-15%
  • Transfuse PRBCs if Hgb < 5 g/dL
    • If patient is hemodynamically stable, consider transfusion if Hgb 5-7 g/dL
    • If patient is hemodynamically unstable:
      1. Transfuse if Hgb < 7 g/dL and
      2. Consider transfusion if Hgb ≥ 7 g/dL with signs of impaired oxygen delivery (e.g., elevated lactate, low ScvO2) despite other resuscitative therapies
  • Wean hydrocortisone when vasoactive infusions no longer required
  • Monitor culture results and reassess antibiotic coverage
  • Consider ID consult as clinically indicated (e.g., MDRO history or current infection, culture negative sepsis, bacteremia, concern for fungal infection, and in severely immunocompromised patients with septic shock)
  • PT/OT consult, consider PM&R consult
  • Refer patient to Sepsis Survivors Follow-up Program