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Practice Guideline
. 2017 Mar;43(3):304-377.
doi: 10.1007/s00134-017-4683-6. Epub 2017 Jan 18.

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Andrew Rhodes  1 , Laura E Evans  2 , Waleed Alhazzani  3 , Mitchell M Levy  4 , Massimo Antonelli  5 , Ricard Ferrer  6 , Anand Kumar  7 , Jonathan E Sevransky  8 , Charles L Sprung  9 , Mark E Nunnally  2 , Bram Rochwerg  3 , Gordon D Rubenfeld  10 , Derek C Angus  11 , Djillali Annane  12 , Richard J Beale  13 , Geoffrey J Bellinghan  14 , Gordon R Bernard  15 , Jean-Daniel Chiche  16 , Craig Coopersmith  8 , Daniel P De Backer  17 , Craig J French  18 , Seitaro Fujishima  19 , Herwig Gerlach  20 , Jorge Luis Hidalgo  21 , Steven M Hollenberg  22 , Alan E Jones  23 , Dilip R Karnad  24 , Ruth M Kleinpell  25 , Younsuk Koh  26 , Thiago Costa Lisboa  27 , Flavia R Machado  28 , John J Marini  29 , John C Marshall  30 , John E Mazuski  31 , Lauralyn A McIntyre  32 , Anthony S McLean  33 , Sangeeta Mehta  34 , Rui P Moreno  35 , John Myburgh  36 , Paolo Navalesi  37 , Osamu Nishida  38 , Tiffany M Osborn  31 , Anders Perner  39 , Colleen M Plunkett  25 , Marco Ranieri  40 , Christa A Schorr  22 , Maureen A Seckel  41 , Christopher W Seymour  42 , Lisa Shieh  43 , Khalid A Shukri  44 , Steven Q Simpson  45 , Mervyn Singer  46 , B Taylor Thompson  47 , Sean R Townsend  48 , Thomas Van der Poll  49 , Jean-Louis Vincent  50 , W Joost Wiersinga  49 , Janice L Zimmerman  51 , R Phillip Dellinger  22
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Free article
Practice Guideline

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Andrew Rhodes et al. Intensive Care Med. 2017 Mar.
Free article

Abstract

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.

Keywords: Evidence-based medicine; Grading of Recommendations Assessment, Development, and Evaluation criteria; Guidelines; Infection; Sepsis; Sepsis bundles; Sepsis syndrome; Septic shock; Surviving Sepsis Campaign.

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References

    1. Am J Surg. 2013 Jul;206(1):32-9 - PubMed
    1. Circulation. 1997 Mar 4;95(5):1122-5 - PubMed
    1. Intensive Care Med. 2014 Mar;40(3):332-41 - PubMed
    1. Lancet Infect Dis. 2014 Jun;14(6):498-509 - PubMed
    1. Anesth Analg. 1996 Aug;83(2):254-61 - PubMed

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