Management of Sepsis in Patients with Cirrhosis: current evidence and practical approach.
Hepatology. 2018 Dec 05;:
Authors: Simonetto DA, Piccolo Serafim L, Gallo de Moraes A, Gajic O, Kamath PS
Abstract
Sepsis in patients with cirrhosis is associated with high mortality. An impaired immune response accounts for the increased infection risk observed in these patients. Hemodynamic and systemic changes suggestive of sepsis may be seen in patients with cirrhosis in the absence of infection, therefore diagnosis and treatment of sepsis may be delayed. The optimal management of the critically-ill septic patient with cirrhosis has not been well established and is generally extrapolated from consensus guidelines and expert recommendations made for management of non-cirrhotic patients with sepsis. Despite the lack of strong evidence, we propose a contemporary pragmatic approach to sepsis management in patients with cirrhosis including the choice of fluids, vasopressors and antibiotics. This article is protected by copyright. All rights reserved.
PMID: 30516866 [PubMed - as supplied by publisher]