{"id":25,"date":"2025-03-17T11:40:19","date_gmt":"2025-03-17T10:40:19","guid":{"rendered":"https:\/\/sepsit.site.transip.me\/?page_id=25"},"modified":"2026-11-14T21:43:40","modified_gmt":"2026-11-14T20:43:40","slug":"over-sepsis","status":"publish","type":"page","link":"https:\/\/www.sepsisnet.nl\/en\/over-sepsis\/","title":{"rendered":"About sepsis"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"25\" class=\"elementor elementor-25\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8c05727 e-con-full e-flex e-con e-parent\" data-id=\"8c05727\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element- elementor-widget elementor-widget-shortcode\" data-id=\"\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"snl-kb\" data-no-translation><section class=\"snl-kb-sec hero\" id=\"intro\"><div class=\"snl-kb-in\"><p class=\"lbl\">About sepsis<\/p><h1>What is sepsis?<\/h1><p class=\"lead\">Sepsis is a life-threatening response of the body to an infection. The immune system becomes dysregulated and damages the body's own organs. Sepsis is a medical emergency: the sooner treatment starts, the better the chance of recovery.<\/p><p>On this page you can read how to recognise sepsis, who is at risk, how treatment works and what recovery may involve. Where possible, we show what the Dutch guideline and the international Surviving Sepsis Campaign recommend.<\/p><div class=\"snl-toc\"><a href=\"#alarm\">Warning signs<\/a><a href=\"#wat\">What happens in the body<\/a><a href=\"#cijfers\">Figures<\/a><a href=\"#risico\">Who is at risk<\/a><a href=\"#herkenning\">Recognition in care<\/a><a href=\"#behandeling\">Treatment<\/a><a href=\"#kinderen\">Children<\/a><a href=\"#herstel\">Recovery<\/a><a href=\"#woorden\">Glossary<\/a><\/div><figure class=\"snl-fig snl-photo\"><img decoding=\"async\" src=\"https:\/\/www.sepsisnet.nl\/wp-content\/uploads\/2025\/03\/maxim-potkin-N6eAaNLO3FA-unsplash-1536x882.jpg\" alt=\"Microscopic image of cells\" loading=\"lazy\" style=\"width:100%;height:340px;object-fit:cover;border-radius:14px;display:block\"><figcaption>Illustration: Maxim Potkin via Unsplash<\/figcaption><\/figure><\/div><\/section><section class=\"snl-kb-sec alt\" id=\"alarm\"><div class=\"snl-kb-in\"><p class=\"lbl\">Recognise<\/p><h2>Warning signs of sepsis<\/h2><p>Sepsis has no single typical symptom. Think of sepsis when someone with an infection (or fever) gets worse quickly and has one or more of these signs:<\/p><div class=\"snl-alarm\"><h3>Could this be sepsis?<\/h3><ul><li>Confused, drowsy or hard to wake<\/li><li>Fast or laboured breathing<\/li><li>Fast heart rate or low blood pressure<\/li><li>Cold, grey, pale or mottled skin<\/li><li>Passing little or no urine<\/li><li>Severe shivering, or a low temperature<\/li><li>A feeling of \"I have never felt this ill\"<\/li><li>In children also: floppy, drowsy, not drinking, or parents worried that the child is not their usual self<\/li><\/ul><p class=\"call\">In doubt? Call your GP or out-of-hours GP service straight away and use the word sepsis. If someone is severely short of breath, unconscious or confused: call 112.<\/p><\/div><p><strong>After seeing a doctor:<\/strong> if you get worse, new signs appear or you do not improve as expected, get back in touch. Older people and people with a weakened immune system may have no fever; confusion can then be the first sign.<\/p><\/div><\/section><section class=\"snl-kb-sec\" id=\"wat\"><div class=\"snl-kb-in\"><p class=\"lbl\">What it is<\/p><h2>What happens in the body?<\/h2><p>In an infection, bacteria, viruses, fungi or parasites enter the body. Usually the immune system clears them. In sepsis this immune response goes awry: blood vessels leak and dilate, blood pressure falls, blood clotting is disturbed and cells use oxygen less well. As a result, organs such as the kidneys, lungs, brain and heart work less well.<\/p><div class=\"snl-ev\"><p class=\"src\">International definition <span class=\"pill\">Sepsis-3, 2016<\/span><\/p><p>Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. <strong>Septic shock<\/strong> is the most severe form: blood pressure stays too low despite adequate intravenous fluids, drugs (vasopressors) are needed and blood lactate is raised.<\/p><p class=\"ref\"><a class=\"snl-cite\" href=\"https:\/\/doi.org\/10.1001\/jama.2016.0287\" target=\"_blank\" rel=\"noopener\" data-ref=\"Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016;315:801-10.\" data-pmid=\"26903338\">Singer, JAMA 2016<\/a>. For children, the Phoenix criteria apply since 2024 <a class=\"snl-cite\" href=\"https:\/\/doi.org\/10.1001\/jama.2024.0179\" target=\"_blank\" rel=\"noopener\" data-ref=\"Schlapbach LJ, Watson RS, Sorce LR, et al. International consensus criteria for pediatric sepsis and septic shock. JAMA 2024;331:665-74 (PMID 38245889); Sanchez-Pinto LN, et al. Development and validation of the Phoenix criteria. JAMA 2024;331:675-86 (PMID 38245897).\" data-pmid=\"38245889\">Phoenix, JAMA 2024<\/a>.<\/p><\/div><p><strong>Sepsis or blood poisoning?<\/strong> In everyday Dutch, sepsis is often called blood poisoning. That is confusing: not every patient with sepsis has the pathogen in the bloodstream, and an inflamed lymph vessel is also called blood poisoning. Sepsis is the correct term. The infection can start anywhere, for example in the lungs, urinary tract, abdomen or skin. Viruses such as influenza and the coronavirus can also cause sepsis.<\/p><figure class=\"snl-fig\"><svg viewbox=\"0 0 900 250\" role=\"img\" aria-label=\"Sepsis: life-threatening organ dysfunction caused by a dysregulated host response to infection\" font-family=\"Helvetica,Arial,sans-serif\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n<defs><marker id=\"ar\" viewbox=\"0 0 10 10\" refx=\"8\" refy=\"5\" markerwidth=\"8\" markerheight=\"8\" orient=\"auto\"><path d=\"M0 0L10 5L0 10z\" fill=\"#31575F\"\/><\/marker><\/defs>\n<rect x=\"10\" y=\"20\" width=\"250\" height=\"150\" rx=\"16\" fill=\"#E3EDEE\"\/>\n<g fill=\"#2E7668\"><circle cx=\"70\" cy=\"70\" r=\"20\" opacity=\".9\"\/><circle cx=\"108\" cy=\"58\" r=\"9\" opacity=\".6\"\/><circle cx=\"98\" cy=\"96\" r=\"12\" opacity=\".75\"\/><circle cx=\"50\" cy=\"108\" r=\"7\" opacity=\".5\"\/><\/g>\n<text x=\"135\" y=\"80\" font-size=\"22\" font-weight=\"700\" fill=\"#2E7668\">Infection<\/text><text x=\"40\" y=\"150\" font-size=\"14\" fill=\"#31575F\">bacterial, viral or fungal<\/text>\n<line x1=\"268\" y1=\"95\" x2=\"318\" y2=\"95\" stroke=\"#31575F\" stroke-width=\"3\" marker-end=\"url(#ar)\"\/>\n<rect x=\"326\" y=\"20\" width=\"250\" height=\"150\" rx=\"16\" fill=\"#f6e9ea\"\/>\n<path d=\"M350 95 q18 -40 36 0 t36 0 t36 0 t36 0 t36 0\" fill=\"none\" stroke=\"#C1282D\" stroke-width=\"4\" stroke-linecap=\"round\"\/>\n<path d=\"M350 118 q18 18 36 0 t36 0 t36 0 t36 0 t36 0\" fill=\"none\" stroke=\"#69191E\" stroke-width=\"2.5\" stroke-dasharray=\"5 5\" opacity=\".7\"\/>\n<text x=\"451\" y=\"50\" text-anchor=\"middle\" font-size=\"19\" font-weight=\"700\" fill=\"#69191E\">Dysregulated host response<\/text><text x=\"451\" y=\"152\" text-anchor=\"middle\" font-size=\"14\" fill=\"#31575F\">inflammation and suppression<\/text>\n<line x1=\"584\" y1=\"95\" x2=\"618\" y2=\"95\" stroke=\"#31575F\" stroke-width=\"3\" marker-end=\"url(#ar)\"\/>\n<rect x=\"622\" y=\"20\" width=\"268\" height=\"150\" rx=\"16\" fill=\"#fff\" stroke=\"#69191E\" stroke-width=\"2\"\/>\n<text x=\"756\" y=\"54\" text-anchor=\"middle\" font-size=\"19\" font-weight=\"700\" fill=\"#69191E\">Organ dysfunction<\/text><rect x=\"632\" y=\"74\" width=\"118\" height=\"30\" rx=\"15\" fill=\"#fff\" stroke=\"#69191E\" stroke-width=\"1.5\"\/><text x=\"691\" y=\"94\" text-anchor=\"middle\" font-size=\"13\" fill=\"#69191E\">Brain<\/text><rect x=\"756\" y=\"74\" width=\"118\" height=\"30\" rx=\"15\" fill=\"#fff\" stroke=\"#69191E\" stroke-width=\"1.5\"\/><text x=\"815\" y=\"94\" text-anchor=\"middle\" font-size=\"13\" fill=\"#69191E\">Lungs<\/text><rect x=\"632\" y=\"112\" width=\"118\" height=\"30\" rx=\"15\" fill=\"#fff\" stroke=\"#69191E\" stroke-width=\"1.5\"\/><text x=\"691\" y=\"132\" text-anchor=\"middle\" font-size=\"13\" fill=\"#69191E\">Heart and vessels<\/text><rect x=\"756\" y=\"112\" width=\"118\" height=\"30\" rx=\"15\" fill=\"#fff\" stroke=\"#69191E\" stroke-width=\"1.5\"\/><text x=\"815\" y=\"132\" text-anchor=\"middle\" font-size=\"13\" fill=\"#69191E\">Kidneys<\/text>\n<rect x=\"10\" y=\"190\" width=\"880\" height=\"48\" rx=\"12\" fill=\"#31575F\"\/><text x=\"450\" y=\"220\" text-anchor=\"middle\" font-size=\"15\" fill=\"#fff\">Sepsis: life-threatening organ dysfunction caused by a dysregulated host response to infection<\/text>\n<\/svg><\/figure><\/div><\/section><section class=\"snl-kb-sec alt\" id=\"cijfers\"><div class=\"snl-kb-in\"><p class=\"lbl\">Figures<\/p><h2>How common is sepsis?<\/h2><div class=\"snl-stats\"><div class=\"snl-stat\"><b>166 million<\/b><span>people developed sepsis worldwide in 2021; 21.4 million deaths were sepsis-related.<\/span><small><a class=\"snl-cite\" href=\"https:\/\/doi.org\/10.1016\/S2214-109X(25)00356-0\" target=\"_blank\" rel=\"noopener\" data-ref=\"GBD 2021 Global Sepsis Collaborators. Global, regional, and national sepsis incidence and mortality, 1990-2021: a systematic analysis. Lancet Glob Health 2025;13:e2013-26. doi. PMID 41135560.\">GBD 2021, Lancet Glob Health 2025<\/a><\/small><\/div><div class=\"snl-stat\"><b>31.5%<\/b><span>of all deaths worldwide in 2021 were sepsis-related. After decades of decline, this rose again during the COVID-19 pandemic.<\/span><small><a class=\"snl-cite\" href=\"https:\/\/doi.org\/10.1016\/S2214-109X(25)00356-0\" target=\"_blank\" rel=\"noopener\" data-ref=\"GBD 2021 Global Sepsis Collaborators. Global, regional, and national sepsis incidence and mortality, 1990-2021: a systematic analysis. Lancet Glob Health 2025;13:e2013-26. doi. PMID 41135560.\">GBD 2021<\/a><\/small><\/div><div class=\"snl-stat\"><b>57,304<\/b><span>quality-adjusted life years (QALYs) are lost to sepsis in the Netherlands each year, more than half due to impairments in survivors.<\/span><small><a class=\"snl-cite\" href=\"https:\/\/doi.org\/10.1186\/s13054-024-04816-3\" target=\"_blank\" rel=\"noopener\" data-ref=\"Luijks ECN, van der Slikke EC, van Zanten ARH, et al. Societal costs of sepsis in the Netherlands. Crit Care 2024;28:29. doi. PMID 38254226.\">Luijks et al., Crit Care 2024<\/a><\/small><\/div><div class=\"snl-stat\"><b>\u20ac3.8 to 6.5 bn<\/b><span>is the annual disease and indirect economic burden of sepsis in the Netherlands.<\/span><small><a class=\"snl-cite\" href=\"https:\/\/doi.org\/10.1186\/s13054-024-04816-3\" target=\"_blank\" rel=\"noopener\" data-ref=\"Luijks ECN, van der Slikke EC, van Zanten ARH, et al. Societal costs of sepsis in the Netherlands. Crit Care 2024;28:29. doi. PMID 38254226.\">Luijks et al., Crit Care 2024<\/a><\/small><\/div><div class=\"snl-stat\"><b>48%<\/b><span>of ICU patients with community-acquired sepsis had first contacted the out-of-hours GP service; in 43% of patients assessed by a GP, infection was not suspected.<\/span><small><a class=\"snl-cite\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30224394\/\" target=\"_blank\" rel=\"noopener\" data-ref=\"Loots FJ, Smits M, van Steensel C, et al. Management of sepsis in out-of-hours primary care: a retrospective study of patients admitted to the intensive care unit. BMJ Open 2018;8:e022832. PMID 30224394.\" data-pmid=\"30224394\">Loots et al., BMJ Open 2018<\/a><\/small><\/div><div class=\"snl-stat\"><b>17%<\/b><span>of Dutch people without a medical background knew the word sepsis (2020 survey).<\/span><small><a class=\"snl-cite\" href=\"https:\/\/nos.nl\/artikel\/2380903-vier-op-de-vijf-kennen-dodelijke-aandoening-sepsis-niet\" target=\"_blank\" rel=\"noopener\" data-ref=\"SepsisNet. Landelijke enqu\u00eate bekendheid sepsis, maart 2020 (n = 916); zie ook NOS, 2021.\">SepsisNet survey, n = 916<\/a><\/small><\/div><\/div><\/div><\/section><section class=\"snl-kb-sec\" id=\"risico\"><div class=\"snl-kb-in\"><p class=\"lbl\">Risk<\/p><h2>Who is at higher risk?<\/h2><p>Anyone can get sepsis, including healthy young people. The risk of sepsis and of a severe course is higher in:<\/p><div class=\"snl-grid\"><div class=\"snl-card\"><h3>Age<\/h3><ul><li>People aged 70 and over<\/li><li>Newborns, especially preterm babies<\/li><\/ul><\/div><div class=\"snl-card\"><h3>Weakened immunity<\/h3><ul><li>Chemotherapy or immunosuppressive drugs such as prednisone<\/li><li>After an organ transplant<\/li><li>No (functioning) spleen<\/li><\/ul><\/div><div class=\"snl-card\"><h3>Illness and care<\/h3><ul><li>Chronic heart, lung or kidney disease, diabetes or liver cirrhosis<\/li><li>Recent hospital admission or surgery<\/li><li>Urinary catheter, intravenous line or other foreign material<\/li><li>Heavy alcohol use<\/li><\/ul><\/div><\/div><p>Sepsis increasingly occurs as a complication of chronic diseases such as stroke, COPD and cirrhosis <a class=\"snl-cite\" href=\"https:\/\/doi.org\/10.1016\/S2214-109X(25)00356-0\" target=\"_blank\" rel=\"noopener\" data-ref=\"GBD 2021 Global Sepsis Collaborators. Global, regional, and national sepsis incidence and mortality, 1990-2021: a systematic analysis. Lancet Glob Health 2025;13:e2013-26. doi. PMID 41135560.\">GBD, Lancet Glob Health 2025<\/a>. Vaccination, good wound care and prompt treatment of infections help prevent sepsis.<\/p><\/div><\/section><section class=\"snl-kb-sec alt\" id=\"herkenning\"><div class=\"snl-kb-in\"><p class=\"lbl\">In healthcare<\/p><h2>How do healthcare professionals recognise sepsis?<\/h2><p>No single test proves sepsis. Clinicians combine the story of the patient and relatives with physical examination and measurement of vital signs: breathing, oxygen saturation, blood pressure, heart rate, temperature and consciousness. From these they calculate an early warning score. Blood tests, cultures and imaging show how severe the illness is and where the infection is located.<\/p><div class=\"snl-ev\"><p class=\"src\">Dutch sepsis guideline <span class=\"pill\">module Early recognition<\/span><\/p><p>Combine two questions. When infection is suspected: screen for vital threat with the MEWS or NEWS. When a patient is vitally threatened: consider whether an infection may be the cause. Always ask the signal question \"Could this be sepsis?\" Do not use the qSOFA score for early recognition.<\/p><p class=\"ref\">Summarised from the <a class=\"snl-cite\" href=\"https:\/\/richtlijnendatabase.nl\/richtlijn\/sepsis\/startpagina_-_sepsis.html\" target=\"_blank\" rel=\"noopener\" data-ref=\"Nederlandse Internisten Vereniging. Richtlijn Sepsis. Richtlijnendatabase, modules 2020 tot 2024.\">Dutch sepsis guideline, module Early recognition<\/a><\/p><\/div><div class=\"snl-ev ssc\"><p class=\"src\">Surviving Sepsis Campaign 2026 <span class=\"pill\">strong recommendation<\/span><\/p><p>In acutely ill hospitalised patients, use NEWS, NEWS2, MEWS or SIRS rather than qSOFA as a single screening tool.<\/p><p class=\"ref\">Summarised from the <a class=\"snl-cite ssc\" href=\"https:\/\/doi.org\/10.1097\/CCM.0000000000007075\" target=\"_blank\" rel=\"noopener\" data-ref=\"Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026. Crit Care Med 2026. doi.\">SSC adult guidelines 2026<\/a><\/p><\/div><div class=\"snl-ev\"><p class=\"src\">Dutch sepsis guideline <span class=\"pill\">module Biomarkers<\/span><\/p><p>Use CRP to make infection more or less likely. Presepsin, IL-6 and procalcitonin add little to the diagnosis and are more expensive.<\/p><p class=\"ref\">Summarised from the <a class=\"snl-cite\" href=\"https:\/\/richtlijnendatabase.nl\/richtlijn\/sepsis\/startpagina_-_sepsis.html\" target=\"_blank\" rel=\"noopener\" data-ref=\"Nederlandse Internisten Vereniging. Richtlijn Sepsis. Richtlijnendatabase, modules 2020 tot 2024.\">Dutch sepsis guideline, module Biomarkers<\/a><\/p><\/div><\/div><\/section><section class=\"snl-kb-sec\" id=\"behandeling\"><div class=\"snl-kb-in\"><p class=\"lbl\">Treatment<\/p><h2>How is sepsis treated?<\/h2><p>Sepsis is treated as an emergency. Treatment has three tracks that run in parallel: fighting the infection, supporting circulation and oxygen delivery, and supporting the organs until they recover.<\/p><div class=\"snl-grid\"><div class=\"snl-card\"><h3>1. Fight the infection<\/h3><p>Blood cultures are taken and intravenous antibiotics are started as soon as possible. At the same time, the source of infection is tackled: an abscess or inflamed gallbladder is drained or operated on, an infected line is removed. After a few days, antibiotics are adjusted based on the culture results.<\/p><\/div><div class=\"snl-card\"><h3>2. Restore circulation<\/h3><p>Intravenous fluids and, if blood pressure stays low, drugs that tighten the blood vessels (vasopressors). Lactate levels help guide treatment.<\/p><\/div><div class=\"snl-card\"><h3>3. Support the organs<\/h3><p>Oxygen or mechanical ventilation, sometimes dialysis, close monitoring and early mobilisation. In septic shock this takes place in intensive care.<\/p><\/div><\/div><h3>What do the guidelines say?<\/h3><div class=\"snl-ev ssc\"><p class=\"src\">Surviving Sepsis Campaign 2026 <span class=\"pill\">recommendation<\/span><\/p><p>For probable or definite sepsis, and for (possible) septic shock, give antimicrobials immediately, ideally within 1 hour of recognition. For possible sepsis without shock: a short course of rapid investigation first and, if concern persists, antimicrobials within 3 hours. Take blood cultures before the first dose.<\/p><p class=\"ref\">Summarised from the <a class=\"snl-cite ssc\" href=\"https:\/\/doi.org\/10.1097\/CCM.0000000000007075\" target=\"_blank\" rel=\"noopener\" data-ref=\"Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026. Crit Care Med 2026. doi.\">SSC adult guidelines 2026<\/a><\/p><\/div><div class=\"snl-ev\"><p class=\"src\">Dutch sepsis guideline <span class=\"pill\">module Fluid therapy<\/span><\/p><p>Start with at least 30 mL\/kg (ideal body weight) of crystalloid in the first three hours and evaluate the effect within an hour. Measure lactate as soon as possible and repeat until it normalises (below 2.0 mmol\/L). Use crystalloids, not albumin or other colloids; consider balanced solutions.<\/p><p class=\"ref\">Summarised from the modules <a href=\"https:\/\/richtlijnendatabase.nl\/richtlijn\/sepsis\/parameters_om_vochttoediening_te_sturen_bij_sepsis.html\" target=\"_blank\" rel=\"noopener\">Guiding fluid therapy<\/a> and <a class=\"snl-cite\" href=\"https:\/\/richtlijnendatabase.nl\/richtlijn\/sepsis\/startpagina_-_sepsis.html\" target=\"_blank\" rel=\"noopener\" data-ref=\"Nederlandse Internisten Vereniging. Richtlijn Sepsis. Richtlijnendatabase, modules 2020 tot 2024.\">Type of resuscitation fluid<\/a><\/p><\/div><div class=\"snl-ev\"><p class=\"src\">Dutch sepsis guideline <span class=\"pill\">module Vasopressors<\/span><\/p><p>If blood pressure stays low after fluids, start norepinephrine as first choice. Add vasopressin only for hypotension that responds insufficiently.<\/p><p class=\"ref\">Summarised from the <a class=\"snl-cite\" href=\"https:\/\/richtlijnendatabase.nl\/richtlijn\/sepsis\/startpagina_-_sepsis.html\" target=\"_blank\" rel=\"noopener\" data-ref=\"Nederlandse Internisten Vereniging. Richtlijn Sepsis. Richtlijnendatabase, modules 2020 tot 2024.\">Dutch sepsis guideline, module Vasopressors<\/a><\/p><\/div><div class=\"snl-ev ssc\"><p class=\"src\">Surviving Sepsis Campaign 2026 <span class=\"pill\">recommendation<\/span><\/p><p>In septic shock, target an initial mean arterial pressure of 65 mmHg; in patients aged 65 and over, 60 to 65 mmHg is sufficient. After a loading dose, give beta-lactam antibiotics as a prolonged infusion rather than a short bolus.<\/p><p class=\"ref\">Summarised from the <a class=\"snl-cite ssc\" href=\"https:\/\/doi.org\/10.1097\/CCM.0000000000007075\" target=\"_blank\" rel=\"noopener\" data-ref=\"Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026. Crit Care Med 2026. doi.\">SSC adult guidelines 2026<\/a><\/p><\/div><p class=\"snl-note\">Antibiotic choice follows the <a class=\"snl-cite\" href=\"https:\/\/swab.nl\/nl\/sepsis\" target=\"_blank\" rel=\"noopener\" data-ref=\"Stichting Werkgroep Antibioticabeleid. Richtlijn empirische antibiotische therapie bij sepsis.\">SWAB guideline on empirical therapy for sepsis<\/a>. This information is background only and does not replace medical advice.<\/p><figure class=\"snl-fig\"><svg viewbox=\"0 0 900 175\" role=\"img\" aria-label=\"Every hour of delay matters\" font-family=\"Helvetica,Arial,sans-serif\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n<rect x=\"60\" y=\"64\" width=\"780\" height=\"12\" rx=\"6\" fill=\"#E3EDEE\"><\/rect><rect x=\"60\" y=\"64\" width=\"400\" height=\"12\" rx=\"6\" fill=\"#f3c9cb\"><\/rect>\n<text x=\"450\" y=\"20\" text-anchor=\"middle\" font-size=\"13\" font-weight=\"700\" fill=\"#C1282D\" letter-spacing=\"1\">EVERY HOUR OF DELAY MATTERS<\/text><circle cx=\"100\" cy=\"70\" r=\"30\" fill=\"#2E7668\"><\/circle><text x=\"100\" y=\"78\" text-anchor=\"middle\" font-size=\"22\" font-weight=\"700\" fill=\"#fff\">1<\/text><text x=\"100\" y=\"128\" text-anchor=\"middle\" font-size=\"16\" font-weight=\"700\" fill=\"#31575F\">Recognise<\/text><text x=\"100\" y=\"150\" text-anchor=\"middle\" font-size=\"13\" fill=\"#5b6b70\">warning signs, NEWS2 or PEWS<\/text><circle cx=\"275\" cy=\"70\" r=\"30\" fill=\"#2E7668\"><\/circle><text x=\"275\" y=\"78\" text-anchor=\"middle\" font-size=\"22\" font-weight=\"700\" fill=\"#fff\">2<\/text><text x=\"275\" y=\"128\" text-anchor=\"middle\" font-size=\"16\" font-weight=\"700\" fill=\"#31575F\">Escalate<\/text><text x=\"275\" y=\"150\" text-anchor=\"middle\" font-size=\"13\" fill=\"#5b6b70\">GP, 112 or ED<\/text><circle cx=\"450\" cy=\"70\" r=\"30\" fill=\"#C1282D\"><\/circle><text x=\"450\" y=\"78\" text-anchor=\"middle\" font-size=\"22\" font-weight=\"700\" fill=\"#fff\">3<\/text><text x=\"450\" y=\"128\" text-anchor=\"middle\" font-size=\"16\" font-weight=\"700\" fill=\"#31575F\">Within 1 hour<\/text><text x=\"450\" y=\"150\" text-anchor=\"middle\" font-size=\"13\" fill=\"#5b6b70\">cultures and antibiotics<\/text><circle cx=\"625\" cy=\"70\" r=\"30\" fill=\"#69191E\"><\/circle><text x=\"625\" y=\"78\" text-anchor=\"middle\" font-size=\"22\" font-weight=\"700\" fill=\"#fff\">4<\/text><text x=\"625\" y=\"128\" text-anchor=\"middle\" font-size=\"16\" font-weight=\"700\" fill=\"#31575F\">Stabilise<\/text><text x=\"625\" y=\"150\" text-anchor=\"middle\" font-size=\"13\" fill=\"#5b6b70\">fluids, vasopressors, source<\/text><circle cx=\"800\" cy=\"70\" r=\"30\" fill=\"#31575F\"><\/circle><text x=\"800\" y=\"78\" text-anchor=\"middle\" font-size=\"22\" font-weight=\"700\" fill=\"#fff\">5<\/text><text x=\"800\" y=\"128\" text-anchor=\"middle\" font-size=\"16\" font-weight=\"700\" fill=\"#31575F\">Recovery<\/text><text x=\"800\" y=\"150\" text-anchor=\"middle\" font-size=\"13\" fill=\"#5b6b70\">review and aftercare<\/text><\/svg><\/figure><\/div><\/section><section class=\"snl-kb-sec alt\" id=\"kinderen\"><div class=\"snl-kb-in\"><p class=\"lbl\">Children<\/p><h2>Sepsis in children<\/h2><p>Sepsis in children is often recognised later: children compensate for a long time, and signs such as drowsiness, poor drinking or fast breathing resemble an ordinary infection. Parents noticing that their child is not their usual self is therefore an important warning sign.<\/p><div class=\"snl-ev lit\"><p class=\"src\">New definition <span class=\"pill\">Phoenix criteria, 2024<\/span><\/p><p>Since 2024, children have an international definition aligned with that for adults: sepsis is infection with life-threatening dysfunction of breathing, circulation, coagulation or the nervous system. Children meeting these criteria had in-hospital mortality of 7.1% in higher-resource settings and 28.5% in lower-resource settings.<\/p><p class=\"ref\"><a class=\"snl-cite\" href=\"https:\/\/doi.org\/10.1001\/jama.2024.0179\" target=\"_blank\" rel=\"noopener\" data-ref=\"Schlapbach LJ, Watson RS, Sorce LR, et al. International consensus criteria for pediatric sepsis and septic shock. JAMA 2024;331:665-74 (PMID 38245889); Sanchez-Pinto LN, et al. Development and validation of the Phoenix criteria. JAMA 2024;331:675-86 (PMID 38245897).\" data-pmid=\"38245889\">Phoenix, JAMA 2024<\/a><\/p><\/div><div class=\"snl-ev\"><p class=\"src\">Dutch guideline Sepsis in children <span class=\"pill\">2021<\/span><\/p><p>Consider a paediatric early warning score (Dutch PEWS) for hospitalised children that includes parental concern (the \"worried sign\"). In septic shock give fluid boluses of 10 mL\/kg guided by circulation, and in consultation with the paediatric ICU consider early dilute norepinephrine through a peripheral line.<\/p><p class=\"ref\">Summarised from the <a class=\"snl-cite\" href=\"https:\/\/richtlijnendatabase.nl\/richtlijn\/sepsis_bij_kinderen\/startpagina_-_sepsis_bij_kinderen.html\" target=\"_blank\" rel=\"noopener\" data-ref=\"Richtlijn Sepsis bij kinderen. Richtlijnendatabase, 2021.\">Dutch guideline Sepsis in children<\/a><\/p><\/div><div class=\"snl-ev ssc\"><p class=\"src\">Surviving Sepsis Campaign children 2026<\/p><p>Measure lactate in probable sepsis. In (suspected) septic shock start antimicrobials as soon as possible, ideally within 1 hour; in probable sepsis without shock after brief targeted investigation, ideally within 3 hours. Use balanced crystalloids rather than normal saline, and after stabilisation titrate oxygen to a conservative target.<\/p><p class=\"ref\">Summarised from the <a class=\"snl-cite ssc\" href=\"https:\/\/doi.org\/10.1007\/s00134-026-08360-2\" target=\"_blank\" rel=\"noopener\" data-ref=\"Weiss SL, Peters MJ, et al. Surviving Sepsis Campaign international guidelines for the management of sepsis and septic shock in children 2026. Intensive Care Med 2026. doi.\">SSC children's guidelines 2026<\/a><\/p><\/div><\/div><\/section><section class=\"snl-kb-sec\" id=\"herstel\"><div class=\"snl-kb-in\"><p class=\"lbl\">Recovery<\/p><h2>After sepsis<\/h2><p>Sepsis does not end at discharge. Of people admitted to hospital with sepsis, roughly half recover within the first year; about one in six still has severe physical or cognitive impairment after a year, and many are readmitted <a class=\"snl-cite\" href=\"https:\/\/doi.org\/10.1001\/jama.2017.17687\" target=\"_blank\" rel=\"noopener\" data-ref=\"Prescott HC, Angus DC. Enhancing recovery from sepsis: a review. JAMA 2018;319:62-75. PMID 29318278.\" data-pmid=\"29297082\">Prescott, JAMA 2018<\/a>. Fatigue, muscle weakness, problems with concentration and memory, anxiety and low mood are common. This is also known as post-sepsis syndrome.<\/p><p><a class=\"snl-btn\" href=\"\/en\/?page_id=977\">Read more about recovery and aftercare<\/a><\/p><\/div><\/section><section class=\"snl-kb-sec alt\" id=\"faq\"><div class=\"snl-kb-in\"><p class=\"lbl\">Frequently asked questions<\/p><h2>Questions about sepsis<\/h2><details><summary>Is sepsis the same as blood poisoning?<\/summary><div><p>No. Blood poisoning is a popular name, but it is misleading. In sepsis the body reacts so strongly to an infection that organs are damaged. Bacteria do not have to be present in the blood.<\/p><\/div><\/details><details><summary>Is sepsis contagious?<\/summary><div><p>Sepsis itself is not contagious. The infection that leads to sepsis, such as influenza, pneumonia or gastroenteritis, can be.<\/p><\/div><\/details><details><summary>When should I call a doctor?<\/summary><div><p>Call the GP or out-of-hours GP service immediately if someone with an infection gets worse quickly and is confused, breathes fast, has cold or mottled skin, passes little urine or feels sicker than ever before. Mention the word sepsis. In case of severe breathlessness, unconsciousness or confusion: call 112.<\/p><\/div><\/details><details><summary>Which infections can lead to sepsis?<\/summary><div><p>Any infection can lead to sepsis. The most common sources are pneumonia, urinary tract infections, abdominal infections and skin or wound infections. Usually bacteria are involved, but viruses such as influenza or COVID-19 and fungi can also cause sepsis.<\/p><\/div><\/details><details><summary>Can sepsis be prevented?<\/summary><div><p>Not always, but the risk can be reduced: get vaccinated as advised (for example against influenza and pneumococci), keep wounds clean, wash your hands and contact your doctor again if an infection does not improve or gets worse.<\/p><\/div><\/details><details><summary>How long does recovery from sepsis take?<\/summary><div><p>This varies greatly. Some people recover within weeks, others have symptoms such as fatigue, concentration problems, muscle weakness or anxiety for months to years. This is also called post-sepsis syndrome. Read more on the <a href=\"\/en\/herstel-en-nazorg\/\">Aftercare<\/a> page.<\/p><\/div><\/details><details><summary>Can you get sepsis more than once?<\/summary><div><p>Yes. After sepsis, the risk of a new infection and a new episode of sepsis is increased, especially in the first year. Stay alert to warning signs.<\/p><\/div><\/details><\/div><\/section><section class=\"snl-kb-sec\" id=\"woorden\"><div class=\"snl-kb-in\"><p class=\"lbl\">Glossary<\/p><h2>Terms explained<\/h2><details><summary>Sepsis<\/summary><div><p>Life-threatening organ dysfunction caused by a dysregulated host response to infection.<\/p><\/div><\/details><details><summary>Septic shock<\/summary><div><p>The most severe form of sepsis: persistent low blood pressure requiring drugs, with raised lactate despite adequate fluids.<\/p><\/div><\/details><details><summary>Blood poisoning<\/summary><div><p>A popular name for sepsis, but inaccurate: in sepsis the pathogen is not always in the blood. Sepsis is the preferred term.<\/p><\/div><\/details><details><summary>Lactate<\/summary><div><p>A substance in the blood that rises when tissues receive or use too little oxygen. Used to assess severity and guide treatment.<\/p><\/div><\/details><details><summary>MEWS, NEWS2 and PEWS<\/summary><div><p>Early warning scores based on vital signs (breathing, oxygen, blood pressure, heart rate, temperature, consciousness). PEWS is the paediatric version.<\/p><\/div><\/details><details><summary>qSOFA and SOFA<\/summary><div><p>SOFA measures organ failure and is used to establish sepsis. qSOFA is a shortened version; it is not recommended as a single screening tool.<\/p><\/div><\/details><details><summary>Vasopressors<\/summary><div><p>Drugs that tighten blood vessels and so raise blood pressure, such as norepinephrine.<\/p><\/div><\/details><details><summary>Post-sepsis syndrome<\/summary><div><p>Physical, cognitive and psychological problems that may persist for months to years after sepsis.<\/p><\/div><\/details><\/div><\/section><\/div><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-25","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.sepsisnet.nl\/en\/wp-json\/wp\/v2\/pages\/25","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.sepsisnet.nl\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.sepsisnet.nl\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.sepsisnet.nl\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.sepsisnet.nl\/en\/wp-json\/wp\/v2\/comments?post=25"}],"version-history":[{"count":51,"href":"https:\/\/www.sepsisnet.nl\/en\/wp-json\/wp\/v2\/pages\/25\/revisions"}],"predecessor-version":[{"id":981,"href":"https:\/\/www.sepsisnet.nl\/en\/wp-json\/wp\/v2\/pages\/25\/revisions\/981"}],"wp:attachment":[{"href":"https:\/\/www.sepsisnet.nl\/en\/wp-json\/wp\/v2\/media?parent=25"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}