Title: Timing of Source Control in Sepsis<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
<strong><u>Optimal Timing of Source Control in Sepsis</u></strong></p>
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Sepsis is the most common critical illness encountered in the emergency department.</li>
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Much of the resuscitation of patients with sepsis is focused on early and appropriate antibiotic administration, appropriate fluid resuscitation, vasopressor support, and continued hemodynamic monitoring.</li>
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Another critical pillar in sepsis resuscitation is source control. To date, there is varying literature on the optimal timing of source control in sepsis.</li>
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In a recent cohort study of approximately 5,000 patients with community-acquired sepsis, Reitz and colleagues report a 29% reduction in risk-adjusted odds of 90-day mortality for patients who had early source control (< 6 hours) compared to those with late source control (6-36 hours).</li>
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The greatest reduction in risk-adjusted 90-day mortality with early source control occurred in patients with <u>gastrointestinal/abdominal</u> and <u>soft-tissue</u> sources of infection.</li>
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<strong>Take Home Pearl: Early source control matters in sepsis resuscitation, especially in sicker patients with a GI or soft-tissue source of infection.</strong></li>
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<fieldset><legend>References</legend>
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Reitz KM, et al. Association between time to source control in sepsis and 90-day mortality. <em>JAMA Surgery</em>. 2022; 157:817-826.</p>
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