Sepsi & shock settico

Per professionisti sanitari. Le informazioni non sostituiscono la valutazione clinica del singolo caso; fanno fede il riassunto delle caratteristiche del prodotto aggiornato e le linee guida citate.

Revisione medica: Dr. med. univ. Daniel Pehböck, DESA, 03.11.2026

Sepsi & shock settico: Definizioni (Sepsis-3), Riconoscimento e screening, Gestione preospedaliera – adulti, Fluidi, Circolo – obiettivo di PAM e vasopressore, Idrocortisone – in sintesi per i team di emergenza, anestesia e terapia intensiva, con fonti e revisione medica.

Contenuto del capitolo

1. Definizioni (Sepsis-3)
2. Riconoscimento e screening
3. Gestione preospedaliera – adulti
4. Fluidi
5. Circolo – obiettivo di PAM e vasopressore
6. Idrocortisone
7. Terapia antibiotica ed emocolture
8. Focus e controllo del focus
9. Bambini
10. Meningococco e purpura fulminans

Farmaci in questo capitolo

• Noradrenalina
• Idrocortisone

Fonti e linee guida

1. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Intensive Care Med 2026;52:863–936 / Crit Care Med 2026.
2. Society of Critical Care Medicine (SCCM) und European Society of Intensive Care Medicine (ESICM). Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026.
3. Evans L et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Intensive Care Med 2021;47:1181–1247.
4. Levy MM, Evans LE, Rhodes A. The Surviving Sepsis Campaign Bundle: 2018 update. Crit Care Med 2018;46:997–1000 / Intensive Care Med 2018;44:925–928 („Hour-1-Bundle“: Laktat messen und bei > 2 mmol/l wiederholen, Blutkulturen vor Antibiose, Breitspektrum-Antibiose, 30 ml/kg Kristalloide bei Hypotonie oder Laktat ≥ 4 mmol/l, Vasopressoren bei Hypotonie trotz Volumen mit Ziel MAP ≥ 65 mmHg)
5. Deutsche Sepsis-Gesellschaft (DSG) et al. S3-Leitlinie Sepsis.
6. Sepsis in out-of-hospital emergency medicine: What can prehospital emergency care providers derive from the S3 guideline? (Übersichtsarbeit zur präklinischen Umsetzung der S3-Leitlinie Sepsis 2018)
7. Bundesministerium (Sozialministerium), Österreich. Publikationen zu gesundheitssystem-assoziierten Infektionen.
8. Singer M, Deutschman CS, Seymour CW et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016;315:801–810.
9. Ranzani OT et al. Development and Validation of the Sequential Organ Failure Assessment (SOFA)-2 Score. JAMA 2025;334(23):2090–2103 (online 10/2025, Korrektur 29.01.2026)
10. Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS. Updated report of a working party. London: RCP, 12/2017.
11. Weiss SL, Peters MJ, Oczkowski SJW et al. Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026. Intensive Care Med 2026;52:937–983 (doi 10.1007/s00134-026-08360-2) und Pediatr Crit Care Med 2026 (doi 10.1097/PCC.0000000000003927), publiziert 23.03.2026.
12. Weiss SL, Peters MJ, Alhazzani W et al. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatr Crit Care Med 2020;21:e52–e106 / Intensive Care Med 2020;46(Suppl 1):10–67.
13. Schlapbach LJ, Watson RS, Sorce LR et al. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA 2024;331:665–674; Sanchez-Pinto LN, Bennett TD, DeWitt PE et al. Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. JAMA 2024;331:675–686.
14. Djakow J, Turner NM, Skellett S et al. European Resuscitation Council Guidelines 2025 Paediatric Life Support. Resuscitation 2025;215 Suppl 1:110767.
15. National Institute for Health and Care Excellence (NICE). Meningitis (bacterial) and meningococcal disease.
16. Landratsamt Rosenheim, Gesundheitsamt. Information zur Meningokokken-Postexpositionsprophylaxe (PEP) für Ärztinnen und Ärzte (nach RKI-Ratgeber Meningokokken)
17. Kommentar bzw. Übersicht zur Surviving Sepsis Campaign 2026 (PMC13268726)
18. ACP Journal Club 04/2026 und Guideline Central (SSC 2026 Spotlight)
19. Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026, Pediatr Crit Care Med 2026 (pcc.0000000000003927; Executive Summary pcc.0000000000003928), Zusammenfassung Guideline Central 5149074.
20. S3-Leitlinie Sepsis.
21. Riassunti delle caratteristiche dei prodotti autorizzati – prodotto e sezione per ogni dose nell'app.