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

Andrew Rhodes; Laura E. Evans; Waleed Alhazzani; Mitchell M. Levy; Massimo Antonelli; Ricard Ferrer; Anand Kumar; Jonathan E. Sevransky; Charles L. Sprung; Mark E. Nunnally; Bram Rochwerg; Gordon D. Rubenfeld; Derek C. Angus; Djillali Annane; Richard J. Beale; Geoffrey J. Bellinghan; Gordon R. Bernard; Jean Daniel Chiche; Craig Coopersmith; Daniel P. De Backer; Craig J. French; Seitaro Fujishima; Herwig Gerlach; Jorge Luis Hidalgo; Steven M. Hollenberg; Alan E. Jones; DIlip R. Karnad; Ruth M. Kleinpell; Younsuck Koh; Thiago Costa Lisboa; Flavia R. MacHado; John J. Marini; John C. Marshall; John E. Mazuski; Lauralyn A. McIntyre; Anthony S. McLean; Sangeeta Mehta; Rui P. Moreno; John Myburgh; Paolo Navalesi; Osamu Nishida; Tiffany M. Osborn; Anders Perner; Colleen M. Plunkett; Marco Ranieri; Christa A. Schorr; Maureen A. Seckel; Christopher W. Seymour; Lisa Shieh; Khalid A. Shukri; Steven Q. Simpson; Mervyn Singer; B. Taylor Thompson; Sean R. Townsend; Thomas Van Der Poll; Jean Louis Vincent; W. Joost Wiersinga; Janice L. Zimmerman; R. Phillip Dellinger

doi:10.1097/CCM.0000000000002255

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

Andrew Rhodes, Laura E. Evans, Waleed Alhazzani, Mitchell M. Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E. Sevransky, Charles L. Sprung, Mark E. Nunnally, Bram Rochwerg, Gordon D. Rubenfeld, Derek C. Angus, Djillali Annane, Richard J. Beale, Geoffrey J. Bellinghan, Gordon R. Bernard, Jean Daniel Chiche, Craig Coopersmith, Daniel P. De BackerCraig J. French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M. Hollenberg, Alan E. Jones, DIlip R. Karnad, Ruth M. Kleinpell, Younsuck Koh, Thiago Costa Lisboa, Flavia R. MacHado, John J. Marini, John C. Marshall, John E. Mazuski, Lauralyn A. McIntyre, Anthony S. McLean, Sangeeta Mehta, Rui P. Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M. Osborn, Anders Perner, Colleen M. Plunkett, Marco Ranieri, Christa A. Schorr, Maureen A. Seckel, Christopher W. Seymour, Lisa Shieh, Khalid A. Shukri, Steven Q. Simpson, Mervyn Singer, B. Taylor Thompson, Sean R. Townsend, Thomas Van Der Poll, Jean Louis Vincent, W. Joost Wiersinga, Janice L. Zimmerman, R. Phillip Dellinger

Medicine - Pulmonary, Allergy, Critical

Research output: Contribution to journal › Review article › peer-review

2223 Scopus citations

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.

Original language	English (US)
Pages (from-to)	486-552
Number of pages	67
Journal	Critical care medicine
Volume	45
Issue number	3
DOIs	https://doi.org/10.1097/CCM.0000000000002255
State	Published - Mar 1 2017

Bibliographical note

Publisher Copyright:
© 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Keywords

Development and Evaluation criteria
Grading of Recommendations Assessment
Surviving Sepsis Campaign
evidence-based medicine
guidelines
infection
sepsis
sepsis bundles
sepsis syndrome
septic shock

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Rhodes, A., Evans, L. E., Alhazzani, W., Levy, M. M., Antonelli, M., Ferrer, R., Kumar, A., Sevransky, J. E., Sprung, C. L., Nunnally, M. E., Rochwerg, B., Rubenfeld, G. D., Angus, D. C., Annane, D., Beale, R. J., Bellinghan, G. J., Bernard, G. R., Chiche, J. D., Coopersmith, C., ... Dellinger, R. P. (2017). Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Critical care medicine, 45(3), 486-552. https://doi.org/10.1097/CCM.0000000000002255

Rhodes, A, Evans, LE, Alhazzani, W, Levy, MM, Antonelli, M, Ferrer, R, Kumar, A, Sevransky, JE, Sprung, CL, Nunnally, ME, Rochwerg, B, Rubenfeld, GD, Angus, DC, Annane, D, Beale, RJ, Bellinghan, GJ, Bernard, GR, Chiche, JD, Coopersmith, C, De Backer, DP, French, CJ, Fujishima, S, Gerlach, H, Hidalgo, JL, Hollenberg, SM, Jones, AE, Karnad, DIR, Kleinpell, RM, Koh, Y, Lisboa, TC, MacHado, FR, Marini, JJ, Marshall, JC, Mazuski, JE, McIntyre, LA, McLean, AS, Mehta, S, Moreno, RP, Myburgh, J, Navalesi, P, Nishida, O, Osborn, TM, Perner, A, Plunkett, CM, Ranieri, M, Schorr, CA, Seckel, MA, Seymour, CW, Shieh, L, Shukri, KA, Simpson, SQ, Singer, M, Thompson, BT, Townsend, SR, Van Der Poll, T, Vincent, JL, Wiersinga, WJ, Zimmerman, JL & Dellinger, RP 2017, 'Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016', Critical care medicine, vol. 45, no. 3, pp. 486-552. https://doi.org/10.1097/CCM.0000000000002255

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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.",

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T1 - Surviving Sepsis Campaign

T2 - 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 - 2017/3/1

Y1 - 2017/3/1

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.

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KW - Grading of Recommendations Assessment

KW - Surviving Sepsis Campaign

KW - evidence-based medicine

KW - guidelines

KW - infection

KW - sepsis

KW - sepsis bundles

KW - sepsis syndrome

KW - septic shock

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ER -

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

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