The Sepsis Treatment in Indonesia

Screening Algorithm1

Patient with suspected infection

Yes

No No supervise clinical conditions:

qSOFA >= 2?
Still suspected re-evaluate for possible sepsis
(look A)
if there are any clinical indications

Yes
Organ A. qSOFA :
disfunction? - Respiration rate
- Mental status
- Systolic blood pressure
No supervise clinical conditions:
SOFA >= 2?
re-evaluate for possible sepsis
(look B)
if there are any clinical indications B. SOFA :
Yes - PaO2/FiO2 ratio
No - GCS score
SEPSIS - MAP
- The use of vasopressin
- Serum creatinine/urine output
Although fluid resuscitation is sufficient, - Bilirubin
Yes - Platelet
1. Need vasopressor to maintain MAP >= 65mmHg SEPSIS SHOCK
2. Serum lactate level >2 mmol/L?

1. Indonesian Society of Intensive Care Medicine. Sepsis and Septic Shock Management. Jakarta: PERDICI. 2017. p. 3,30
Dellinger RP, Schorr CA, Levy MM. A Users’ Guide to the 2016 Surviving Sepsis Guidelines. Critical Care Medicine; 2017:45(3). p. 381-385
 Pharmacological Method of Thromboprophylaxis1
The drugs used for thromboprophylaxis are Unfractionated Heparin (UFH), Low
Molecular Weight Heparin (LMWH), fondaparinux.
Patients without contraindications to prophylactic drugs, use:
1. 1st line: enoxaparin 40 mg SQ Q 12H
2. 2nd line: Low dose UFH 7500 units of SQ Q8H

Patients with Cr Cl <30 ml / min:

1.1st line: Low Dose UFH 5000 units of SQ Q8H
2.2. 2nd line: enoxaparin 30 mg SQ Q24H

1. Indonesian Society of Intensive Care Medicine. Sepsis and Septic Shock Management. Jakarta: PERDICI. 2017. p. 3,30