Sepsis in Patients With Cirrhosis

Document Type

Article

Abstract

Patients with cirrhosis are at high risk for sepsis and sepsis-related mortality. Aggressive treatment aimed at avoidance of hypoperfusion and prompt identification and treatment of the causative organism can improve patients' survival. Fluid administration is the first-line treatment to improve perfusion to vital organs; however, care should be taken to assess true intravascular volume status. In patients with adequate intravascular volume, vasopressors are then added to support blood pressure. Complications of cirrhosis often worsen in the setting of sepsis. Portosystemic encephalopathy, pulmonary complications, renal complications, adrenal insufficiency, malnutrition, and insufficient glucose control all must be considered and treated to support a patient with cirrhosis through sepsis. The quality of care that these patients receive ultimately influences their survival.

Medical Subject Headings

Anti-Bacterial Agents (therapeutic use); Critical Care (standards); Humans; Liver Cirrhosis (complications); Practice Guidelines as Topic; Sepsis (drug therapy, etiology, nursing)

Publication Date

10-1-2016

Publication Title

AACN advanced critical care

E-ISSN

1559-7776

Volume

27

Issue

4

First Page

408

Last Page

419

PubMed ID

27959297

Digital Object Identifier (DOI)

10.4037/aacnacc2016716

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