**10.3 Advanced life support**

The presence of **SIRS/SEPSIS** and the septic shock allows the identification of the patients needing advanced life support after the CAL identification, as already addressed. In addition, the Quick SOFA (**Sequential** [Sepsis-related] **Organ Failure Assessment**) helps identify suspected cases of infection that had the risk

of adverse outcomes. There is a significant incidence of septic shock following an anastomotic leak in patients with lower mean arterial pressure, higher heart rate, and high APACHE II score. In those cases, the **ICU admission** time must be short, independently of all other therapeutic measures. These patients need support for all failing organs, the broad spectrum antibiotic therapy, control of the patient immune response beyond glucose control, administration of steroids, recombinant human activated protein C, and total parenteral nutrition [154].
