Skip to main content

Source Control in Sepsis

  • Chapter
  • First Online:
Sepsis

Part of the book series: Respiratory Medicine ((RM))

  • 4968 Accesses

Abstract

Source control is generally accepted to be a key component in the treatment and reversal of sepsis. It is comprised of the physical efforts to remove or contain a focus of invasive infection in order to restore normal function [1]. The principles of source control for sepsis have been known for centuries, but only recently have prioritizing and achieving source control in sepsis become more recognized due to the heightened awareness of sepsis as a result of the Surviving Sepsis Campaign [2]. The majority of research in sepsis has focused on early diagnosis, resuscitation, antibiotics, and other therapies, and despite source control being the cornerstone of therapy for sepsis for centuries, it has not been widely studied. Due to this lack of evidence, source control is often overlooked or underutilized much to the detriment of septic patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Marshall JC, al Naqbi A. Principles of source control in the management of sepsis. Crit Care Clin. 2009;25:753–68.

    Article  PubMed  Google Scholar 

  2. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580–637.

    Article  PubMed  Google Scholar 

  3. Jimenez MF, Marshall JC. Source control in the management of sepsis. Intensive Care Med. 2001;27:S49–62.

    Article  PubMed  Google Scholar 

  4. Gerzof SG, Robbins AH, Johnson WC, Birkett DH, Nabseth DC. Percutaneous catheter drainage of abdominal abscesses. A five-year experience. N Engl J Med. 1981;305:653–7.

    Article  CAS  PubMed  Google Scholar 

  5. Moulton JS, Benkert RE, Weisiger KH, Chambers JA. Treatment of complicated pleural fluid collections with image-guided drainage and intracavitary urokinase. Chest. 1995;108(5):1252–9.

    Article  CAS  PubMed  Google Scholar 

  6. Cinat ME, Wilson SE, Din AM. Determinants for successful percutaneous image-guided drainage of intra-abdominal abscess. Arch Surg. 2002;137(7):845–9.

    Article  PubMed  Google Scholar 

  7. Fernandez-del Castillo C, Rattner DW, Makary MA, Mostafavi A, McGrath D, Warshaw AL. Debridement and closed packing for the treatment of necrotizing pancreatitis. Ann Surg. 1998;228(5):676–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, et al. A setp-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362:1491–502.

    Article  PubMed  Google Scholar 

  9. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368–77.

    Article  CAS  PubMed  Google Scholar 

  10. Gajic O, Urrutia LE, Sewani H, Schroeder DR, Cullinane DC, Peters SG. Acute abdomen in the medical intensive care unit. Crit Care Med. 2002;30(6):1187–90.

    Article  PubMed  Google Scholar 

  11. Boyer A, Vargas F, Coste F, Saubusse E, Castaing Y, Gbikpi-Benissan G, et al. Influence of surgical treatment timing on mortality from necrotizing soft tissue infections requiring intensive care management. Intensive Care Med. 2009;35(5):847–53.

    Article  PubMed  Google Scholar 

  12. Buck DL, Vester-Andersen M, Moller MH. Surgical delay is a critical determinant of survival in perforated peptic ulcer. Br J Surg. 2013;100(8):1045–9.

    Article  CAS  PubMed  Google Scholar 

  13. Wacha H, Hau T, Dittmer R, Ohmann C, The Peritonitis Study Group. Risk factors associated with intraabdominal infections: a prospective multicenter study. Langenbecks Arch Surg. 1999;384:24–32.

    Article  CAS  PubMed  Google Scholar 

  14. Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJC, Baron EJ, et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the surgical infection society and the infectious diseases society of America. Clin Infect Dis. 2010;50:133–64.

    Article  PubMed  Google Scholar 

  15. The United Kingdom National Surgical Research Collaborative. Safety of short, in-hospital delays before surgery for acute appendicitis. Ann Surg. 2014;259:894–903.

    Google Scholar 

  16. Drake FT, Mottey NE, Farrokhi ET, Florence MG, Johnson MG, Mock C, et al. Time to appendectomy and risk of perforation in acute appendicitis. JAMA Surg. 2014;149(8):837–44.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kumar RR, Kim JT, Haukoos JS, Macias LH, Dixon MR, Stamos MJ, et al. Factors affecting the successful management of intra-abdominal abscesses with antibiotics and the need for percutaneous drainage. Dis Colon Rectum. 2005;49:183–9.

    Article  Google Scholar 

  18. Kassi F, Dohan A, Soyer P, Vicaut E, Boudiaf M, Valleur P, et al. Predictive factors for failure of percutaneous drainage of postoperative abscess after abdominal surgery. Am J Surg. 2014;207:915–21.

    Article  PubMed  Google Scholar 

  19. Marin D, Ho LM, Barnhard H, Neville AM, White RR, Paulson EK. Percutaneous abscess drainage in patients with perforated acute appendicitis: effectiveness, safety, and prediction of outcome. Am J Roentgenol. 2010;194:422–9.

    Article  Google Scholar 

  20. Eiseman B, Beart R, Norton L. Multiple organ failure. Surg Gynecol Obstet. 1977;144(3):323–6.

    CAS  PubMed  Google Scholar 

  21. Norton LW. Does drainage of intraabdominal pus reverse multiple organ failure. Am J Surg. 1985;149(3):347–50.

    Article  CAS  PubMed  Google Scholar 

  22. Hau T, Ohmann C, Wolmerhauser A, Wacha H, Yang Q. Planned relaparotomy vs relaparotomy on demand in the treatment of intra-abdominal infections. Arch Surg. 1995;130:1193–7.

    Article  CAS  PubMed  Google Scholar 

  23. van Ruler O, Mahler CW, Boer KR, Reuland EA, Gooszen HG, Opmeer BC, et al. Comparison of on-demand vs planned relaparotomy strategy in patients with severe peritonitis. JAMA. 2007;298(8):865–72.

    Article  PubMed  Google Scholar 

  24. Adkins AL, Robbins J, Villalba M, Bendick P, Shanley CJ. Open abdomen management of intra-abdominal sepsis. Am Surg. 2004;70(2):137–40.

    PubMed  Google Scholar 

  25. Lamme B, Boermeester MA, Reitsma JB, Mahler CW, Obertop H, Gouma DJ. Meta-analysis of relaparotomy for secondary peritonitis. Br J Surg. 2002;89:1516–24.

    Article  CAS  PubMed  Google Scholar 

  26. Sartelli M, Catena F, Ansaloni L, Coccolini F, Corbella D, Moore EE, et al. Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW study. World J Emerg Surg. 2014;9:37.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Toorenvliet BR, Swank H, Schoones JW, Hamming JF, Bemelman WA. Laparoscopic peritoneal lavage for perforated colonic diverticulitis: a systematic review. Colorectal Dis. 2010;12(9):862–7.

    Article  CAS  PubMed  Google Scholar 

  28. Park WM, Glovicki P, Cherry KJ, Hallet JW, Bower TC, Panneton JM, et al. Contemporary management of acute mesenteric ischemia: factors associated with survival. J Vasc Surg. 2002;35(3):445–52.

    Article  PubMed  Google Scholar 

  29. Jamal MM, Yamini D, Singson Z, Samarasena J, Hashemzadeh M, Vega KJ. Decreasing hospitalization and the in-hospital mortality related to cholangitis in the united states. J Clin Gastroenterol. 2001;45:e92–6.

    Article  Google Scholar 

  30. Lai E, Mok F, Tan E, Lo C, Fan S, You K, et al. Endoscopic biliary drainage for severe acute cholangitis. N Engl J Med. 1992;326:1582–6.

    Article  CAS  PubMed  Google Scholar 

  31. Kashab MA, Tariq A, Tariq U, Kim K, Ponor L, Lennon A, et al. Delayed and unsuccessful endoscopic retrograde cholangiopancreatography are associated with worse outcomes in patients with acute cholangitis. Clin Gastroenterol Hepatol. 2012;10:1157–61.

    Article  Google Scholar 

  32. Navaneethan U, Gutierrez NG, Jegadeesan R, Venkatesh P, Butt M, Sanaka MR, et al. Delay in performing ERCP and adverse events increase the 30-day readmission risk in patients with acute cholangitis. Gastrointest Endosc. 2013;78:81–90.

    Article  PubMed  Google Scholar 

  33. Mier J, Luque-de Leon E, Castillo A, Robledo F, Blanco R. Early versus late necrosectomy in severe necrotizing pancreatitis. Am J Surg. 1997;173:71–5.

    Article  CAS  PubMed  Google Scholar 

  34. Hartwig W, Maksan SM, Foitzik T, Schmidt J, Herfarth C, Klar E. Reduction in mortality with delayed surgical therapy of severe pancreatitis. J Gastrointest Surg. 2002;6(3):481–7.

    Article  PubMed  Google Scholar 

  35. Anaya DA, McMahon K, Nathens AB, Sullivan SR, Foy H, Bulger E. Predictors of mortality and limb loss in necrotizing soft tissue infections. Arch Surg. 2005;140:151–8.

    Article  PubMed  Google Scholar 

  36. McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA. Determinants of mortality for necrotizing soft-tissue infections. Ann Surg. 1995;221:558–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Bilton BD, Zibari GB, McMillan RW, Aultman DF, Dunn G, McDonald JC. Aggressive surgical management of necrotizing fasciitis serves to decrease mortality: a retrospective study. Am Surg. 1998;64:397–400.

    CAS  PubMed  Google Scholar 

  38. von Eiff C, Jansen B, Kohnen W, Becker K. Infections associated with medical devices. Drugs. 2005;65(2):179–214.

    Article  Google Scholar 

  39. Costerton JW, Stewart PS, Greenberg EP. Bacterial Biofilms: a common cause of persistent infections. Science. 1999;284:1318–22.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael Connolly MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Connolly, M., Adams, C. (2017). Source Control in Sepsis. In: Ward, N., Levy, M. (eds) Sepsis. Respiratory Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-48470-9_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-48470-9_12

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-48468-6

  • Online ISBN: 978-3-319-48470-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics