TY - JOUR
T1 - Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016
AU - Rhodes, Andrew
AU - Evans, Laura E.
AU - Alhazzani, Waleed
AU - Levy, Mitchell M.
AU - Antonelli, Massimo
AU - Ferrer, Ricard
AU - Kumar, Anand
AU - Sevransky, Jonathan E.
AU - Sprung, Charles L.
AU - Nunnally, Mark E.
AU - Rochwerg, Bram
AU - Rubenfeld, Gordon D.
AU - Angus, Derek C.
AU - Annane, Djillali
AU - Beale, Richard J.
AU - Bellinghan, Geoffrey J.
AU - Bernard, Gordon R.
AU - Chiche, Jean-Daniel
AU - Coopersmith, Craig
AU - De Backer, Daniel P.
AU - French, Craig J.
AU - Fujishima, Seitaro
AU - Gerlach, Herwig
AU - Hidalgo, Jorge Luis
AU - Hollenberg, Steven M.
AU - Jones, Alan E.
AU - Karnad, Dilip R.
AU - Kleinpell, Ruth M.
AU - Koh, Younsuck
AU - Lisboa, Thiago Costa
AU - Machado, Flavia R.
AU - Marini, John J.
AU - Marshall, John C.
AU - Mazuski, John E.
AU - Mcintyre, Lauralyn A.
AU - Mclean, Anthony S.
AU - Mehta, Sangeeta
AU - Moreno, Rui P.
AU - Myburgh, John
AU - Navalesi, Paolo
AU - Nishida, Osamu
AU - Osborn, Tiffany M.
AU - Perner, Anders
AU - Plunkett, Colleen M.
AU - Ranieri, Marco
AU - Schorr, Christa A.
AU - Seckel, Maureen A.
AU - Seymour, Christopher W.
AU - Shieh, Lisa
AU - Shukri, Khalid A.
AU - Simpson, Steven Q.
AU - Singer, Mervyn
AU - Thompson, B. Taylor
AU - Townsend, Sean R.
AU - Van Der Poll, Thomas
AU - Vincent, Jean-Louis
AU - Wiersinga, W. Joost
AU - Zimmerman, Janice L.
AU - Dellinger, R. Phillip
PY - 2017
Y1 - 2017
N2 - OBJECTIVE:: To provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012.” DESIGN:: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. METHODS:: The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable. RESULTS:: The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations, and 18 were best-practice statements. No recommendation was provided for four questions. CONCLUSIONS:: Substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality.
AB - OBJECTIVE:: To provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012.” DESIGN:: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. METHODS:: The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable. RESULTS:: The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations, and 18 were best-practice statements. No recommendation was provided for four questions. CONCLUSIONS:: Substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality.
KW - Critical Care and Intensive Care Medicine
KW - Critical Care and Intensive Care Medicine
UR - http://hdl.handle.net/10807/92705
UR - http://journals.lww.com/ccmjournal/pages/default.aspx
U2 - 10.1097/CCM.0000000000002255
DO - 10.1097/CCM.0000000000002255
M3 - Article
SN - 0090-3493
VL - 2017
SP - 1
EP - 74
JO - Critical Care Medicine
JF - Critical Care Medicine
ER -