Sepsis-induced cardiac arrest

Sepsis is a life-threatening condition characterized by systemic inflammatory response syndrome (SIRS), disseminated intravascular coagulation (DIC), and hypoperfusion manifesting as hypotension. The high mortality associated with sepsis underscores the critical importance of timely and appropriate interventions. In patients presenting with concurrent sepsis and cardiac arrest, standard cardiopulmonary resuscitation (CPR) protocols are followed. Moreover, for optimal management in the context of sepsis-induced cardiac arrest, consider the following recommendations:

1. Administer 100% oxygen at the maximum flow rate. Hypoxia can precipitate cardiac arrest in septic patients; timely oxygenation can potentially prevent circulatory collapse.
2. Initiate an intravenous bolus of 500 ml crystalloid solution. Assess the esponse and repeat administration as clinically indicated.
3. Measure serum lactate levels. Elevated lactate is an indicator of tissue hypoperfusion and can guide resuscitative efforts.
4. If the patient presents with hypotension or has a lactate level exceeding 4 mmol/l, commence an intravenous fluid resuscitation using a crystalloid solution at a dose of 30 ml/kg.
5. Should fluid resuscitation fail to maintain a mean arterial pressure (MAP) above 65 mmHg, consider the initiation of vasopressor therapy. Potential vasopressor agents include:
   • Norepinephrine
   • Phenylephrine
   • Vasopressin
6. Prioritize the collection of blood cultures to identify potential pathogens and guide antimicrobial therapy.
7. Administer broad-spectrum antibiotics in accordance with local clinical guidelines, ensuring timely initiation to optimize outcomes.

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