Sepsis and Mechanical Ventilation

• Essential components of the ED management of sepsis include early identification, antibiotics ASAP, fluid resuscitation, and maintaining adequate perfusion pressure.
• If patients continue to have evidence of shock (i.e. high lactate) despite adequate fluids and/or pressors, strongly consider intubation, even in the patient without acute respiratory decompensation.
• The respiratory muscles are avid consumers of oxygen and can use up to 50% of circulating O₂.
• Intubation and paralysis not only increase available O₂ to vital organs, it can also augment cardiac output for patients with persistent septic shock.