THE ROLE OF THE ANESTHESIOLOGIST IN THE MANAGEMENT OF CRITICALLY ILL SEPTIC PATIENTS: A CLINICAL LITERATURE REVIEW

Maja Osuch; Maciej Osuch; Olga Tatarata; Martyna Jaciubek; Carmena Luty; Amanda Abramowicz; Magdalena Rumin; Anna Kiełboń; Zuzanna Olga Reklewska; Kornelia Domagała

doi:10.31435/ijitss.1(49).2026.5062

Authors

Maja Osuch 4th Military Clinical Hospital with Polyclinic in Wroclaw, Wroclaw, Poland https://orcid.org/0009-0000-9815-2608
Maciej Osuch 4th Military Clinical Hospital with Polyclinic in Wroclaw, Wroclaw, Poland https://orcid.org/0009-0009-2399-2878
Olga Tatarata Military Institute of Aviation Medicine, Warsaw, Mazovia, Poland https://orcid.org/0009-0007-1279-7394
Martyna Jaciubek Military Institute of Aviation Medicine, Warsaw, Mazovia, Poland https://orcid.org/0009-0002-5520-0002
Carmena Luty 118th Military Hospital with Polyclinic SPZOZ in Elk, Ełk, Poland https://orcid.org/0009-0007-6084-0385
Amanda Abramowicz Military Institute of Aviation Medicine, Warsaw, Mazovia, Poland https://orcid.org/0009-0004-6674-0594
Magdalena Rumin Military Institute of Aviation Medicine, Warsaw, Mazovia, Poland https://orcid.org/0009-0009-4281-8971
Anna Kiełboń Military Institute of Medicine in Warsaw, Warsaw, Mazovia, Poland https://orcid.org/0009-0004-9028-6395
Zuzanna Olga Reklewska The Military Medical Training Center, Lodz, Poland https://orcid.org/0009-0008-3539-646X
Kornelia Domagała 7th Naval Hospital in Gdansk, Gdansk, Poland https://orcid.org/0009-0008-4148-9320

DOI:

https://doi.org/10.31435/ijitss.1(49).2026.5062

Keywords:

Sepsis, Septic Shock, Anesthesia Management, Critically Ill Patients, Perioperative Care, Hemodynamic Monitoring

Abstract

Sepsis and septic shock are acute, life threatening syndromes in which infection triggers widespread organ dysfunction and rapid clinical deterioration, demanding fast, coordinated action from multiple specialties. In patients who require surgical source control, the anesthesiologist becomes central to perioperative management, because decisions made in the operating room directly influence perfusion, oxygen delivery, and the safety of the procedure. This review focuses on the anesthesiologist’s tasks before, during, and after surgery, with particular attention to how sepsis alters usual anesthetic practice. In unstable patients, careful evaluation of organ failure, cautious choice and dosing of induction drugs (often favoring ketamine or etomidate rather than propofol), advanced monitoring with individually tailored fluid therapy, lung protective ventilation, and timely escalation to vasopressor support are all essential to reduce perioperative risk. Current Surviving Sepsis Campaign recommendations underline that effective source control should be achieved as early as possible, ideally within the first 6 hours from recognizing sepsis, which places anesthesiologists in a key position to balance the urgency of surgery with the need for initial resuscitation. A solid grasp of sepsis pathophysiology and its hemodynamic consequences is therefore fundamental for anesthesiologists involved in the care of these critically ill patients.

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