J Med Life Sci > Volume 17(3); 2020 > Article
Journal of Medicine and Life Science 2020;17(3):80-85.
DOI: https://doi.org/10.22730/jmls.2020.17.3.80    Published online December 31, 2020.
요로감염과 관련된 중증 패혈증 및 패혈성 쇼크의 치료
황규빈1, 허정식2, 김영주2, 박경기2, 김성대2, 유현욱3
1제주대학교 의학전문대학원
2의학전문대학원 비뇨의학과교실
3유쾌한비뇨의학과의원
Treatment of severe sepsis and septic shock associated with urogenital tract infection
Kyu Bin Hwang1, Jung-Sik Huh2, Young-Joo Kim2, Kyung Kgi Park2, Sung Dae Kim2, Hyun Wook You3
1Graduate School of Medicine, Jeju National University, Jeju, Republic of Korea
2Department of Urology, Jeju National University, Graduate School of Medicine, Jeju, Republic of Korea
3Happey Urology Clinic, Jeju, Republic of Korea
Correspondence:  Hyun Wook You, Tel: 82-64-805-1151, Fax: 82-64-717-1131,  Email: mecksd@naver.com
Received: 9 November 2020   • Revised: 18 November 2020   • Accepted: 24 November 2020
Abstract
Urinary tract infections are among the most common infectious diseases and are the major causes of mortality and morbidity. These diseases result in many severe hospitalizations each year. Severe sepsis and septic shock are common and life-threatening medical conditions, and large cases are associated with urinary tract infection. The medical term “severe sepsis” is defined as sepsis complicated by hypotension, organ dysfunction, and tissue hypoperfusion, whereas “septic shock” is defined as sepsis complicated either by hypotension that is refractory to fluid resuscitation or by hyperlacteremia. A recent multicenter-study in Korea reported that the rate of in-hospital mortality associated with severe sepsis and septic shock was >34%. Among the causative diseases, urogenital tract infection showed a high correlation. Moreover, it is very important that clinicians detect severe sepsis and septic shock early and treat them properly. The principles of initial treatment include provision of sufficient hemodynamic resuscitation and early administration of appropriate antibiotic therapy to mitigate uncontrolled infection. Initial resuscitation includes the use of vasopressors and intravenous fluids, and it is a key to achieve the target of initial resuscitation. Supportive care in the intensive care unit, such as glucose control, stress ulcer prophylaxis, blood transfusion, deep vein thrombosis prophylaxis, and renal replacement therapy, is also significant. We have summarized the key components in the treatment of severe sepsis and septic shock in patients with urinary tract infection. Urologists should be aware that appropriate early treatment is necessary to prevent fatal outcomes in these patients.
Key Words: Sepsis, infection, Urinary tract, Treatment
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