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Overview
Sepsis is the systemic, dysregulated
expression of a number of critical pathways activated as part
of the innate immune response to infection. While these pathways
generally serve beneficial roles in fighting infection, they
become overactive and dysregulated in sepsis, leading to 'collateral'
damage to the host. Clinically, this manifests as multiple
organ dysfunction and often leads to death. The goals of care
are therefore to eradicate the underlying infection, prevent
further decrement in organ function, and promote rapid resolution
of any newly-developed organ dysfunction. Currently, initial
treatment entails urgent stabilization of organ dysfunction,
such as cardiovascular collapse or respiratory insufficiency,
and control of the infection using broad-spectrum, empiric
antibiotic therapy, with surgical drainage if appropriate.
Cardiovascular collapse is managed with volume resuscitation,
vasopressors, and inotropes while respiratory insufficiency
is managed with supplemental oxygen and, if necessary, mechanical
ventilation. Other organ systems may also require support,
such as dialysis for acute renal failure. Until recently,
therapies aimed specifically at modulating the various pathways
activated in sepsis, such as inflammation and coagulation,
have not proven successful. However, recent trials suggest
we can now influence these pathways as part of routine care
with the hope of improved outcome.
This course will highlight current treatment
recommendations and will assess the rationale, efficacy, safety,
and dosing of both the traditional and newer therapeutic options
for treating sepsis.
Learning Objectives
Upon completion of this course,
you will be able to:
Target Audience
This CME activity is beneficial
for physicians specializing in cardiopulmonary and critical
care medicine and other healthcare providers who manage patients
with severe sepsis.
Learner Participation to Earn Credit
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Review the course material
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Complete the online post-test with a score
of 70% or higher
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Complete online program evaluation
Faculty Disclosures
Derek C. Angus, MD, MPH, FCCP [BioSketch]
Associate Professor, Critical Care Medicine, Medicine and
Health Services Administration; Vice Chair of Research, Department
of Critical Care Medicine; Director, CRISMA Laboratory University
of Pittsburgh School of Medicine,
Pittsburgh, PA
Disclosure: Research funding: Eli Lilly and Company.
 Richard
I. Hall, MD, FCCP, FRCP [BioSketch]
Anesthesiologist and Critical Care Physician; Professor of
Anesthesiology and Pharmacology; Associate Professor of Surgery,
Dalhousie University and Queen Elizabeth II Health Sciences
Centre,
Halifax, Nova Scotia
Disclosure: Consultant: Eli Lilly and Company.
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Accreditation Statement
The American College of Chest Physicians
(ACCP) is accredited by the Accreditation Council for Continuing
Medical Education (ACCME) to provide continuing medical education
for physicians. The ACCP takes responsibility for the content,
quality, and scientific integrity of this CME activity.
CME Credit
The ACCP designates this educational activity
for a maximum of 1 category 1 credit toward the AMA Physician's
Recognition Award. Each physician should claim only those
credits that he/she actually spent in the activity.
Only US licensed physicians will be awarded
AMA PRA category 1 credit. All others, including international
licensed physicians, will receive a certificate of course
completion.
Accreditation Period
This program was initially published on April
28, 2003 and is eligible for credit through December 31, 2004.
Disclaimer
As a sponsor accredited by ACCME, the ACCP must ensure balance,
independence, objectivity, and scientific rigor in all its
individually sponsored and jointly sponsored educational activities.
All faculty participating in this activity are expected to
disclose to the activity audience any or no significant financial
interest or other relationship (1) with the manufacturer(s)
of any commercial product(s) and/or provider(s) of commercial
services discussed in an educational presentation, and/or
(2) with any commercial supporters of the activity. It remains
for the audience to determine whether the speaker's interests
or relationships may influence the presentation with regard
to exposition or conclusion. Disclosure of any or no relationships
will be made available during this activity.
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