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

Intensive Care Medicine - Tập 43 - Trang 304-377 - 2017
Andrew Rhodes1, Laura E. Evans2, Waleed Alhazzani3, Mitchell M. Levy4, Massimo Antonelli5, Ricard Ferrer6, Anand Kumar7, Jonathan E. Sevransky8, Charles L. Sprung9, Mark E. Nunnally2, Bram Rochwerg3, Gordon D. Rubenfeld10, Derek C. Angus11, Djillali Annane12, Richard J. Beale13, Geoffrey J. Bellinghan14, Gordon R. Bernard15, Jean-Daniel Chiche16, Craig Coopersmith8, Daniel P. De Backer17, Craig J. French18, Seitaro Fujishima19, Herwig Gerlach20, Jorge Luis Hidalgo21, Steven M. Hollenberg22, Alan E. Jones23, Dilip R. Karnad24, Ruth M. Kleinpell25, Younsuk Koh26, Thiago Costa Lisboa27, Flavia R. Machado28, John J. Marini29, John C. Marshall30, John E. Mazuski31, Lauralyn A. McIntyre32, Anthony S. McLean33, Sangeeta Mehta34, Rui P. Moreno35, John Myburgh36, Paolo Navalesi37, Osamu Nishida38, Tiffany M. Osborn31, Anders Perner39, Colleen M. Plunkett25, Marco Ranieri40, Christa A. Schorr22, Maureen A. Seckel41, Christopher W. Seymour42, Lisa Shieh43, Khalid A. Shukri44, Steven Q. Simpson45, Mervyn Singer46, B. Taylor Thompson47, Sean R. Townsend48, Thomas Van der Poll49, Jean-Louis Vincent50, W. Joost Wiersinga49, Janice L. Zimmerman51, R. Phillip Dellinger22
1St. George’s Hospital, London, England, UK
2New York University School of Medicine, New York, USA
3McMaster University, Hamilton, Canada
4Brown University School of Medicine, Providence, USA
5Instituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Rome, Italy
6Vall d'Hebron University Hospital, Barcelona, Spain
7University of Manitoba, Winnipeg, Canada
8Emory University Hospital, Atlanta, USA
9Hadassah Hebrew University Medical Center, Jerusalem, Israel
10Sunnybrook Health Sciences Centre, Toronto, Canada
11University of Pittsburgh Critical Care Medicine CRISMA Laboratory, Pittsburgh, USA
12Hospital Raymond Poincare, Garches, France
13Saint Thomas Hospital, London, England, UK
14University College London Hospitals, London, England, UK
15Vanderbilt University Medical Center, Nashville, USA
16Service de Reanimation Medicale, Paris, France
17CHIREC Hospitals, Braine L’Alleud, Belgium
18Western Hospital, Victoria, Australia
19Keio University School of Medicine, Tokyo, Japan
20Vivantes-Klinikum Neukölln, Berlin, Germany
21Karl Heusner Memorial Hospital, Belize Healthcare Partners, Belize City, Belize
22Cooper Health System, Camden, USA
23University of Mississippi Medical Center, Jackson, USA
24Jupiter Hospital, Thane, India
25Rush University Medical Center, Chicago, USA
26Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
27Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
28Federal University of Sao Paulo, Sao Paulo, Brazil
29Regions Hospital, St Paul, USA
30Saint Michael’s Hospital, Toronto, Canada
31Washington University School of Medicine, St. Louis, USA.
32Ottawa Hospital, Ottawa, Canada
33Nepean Hospital, University of Sydney, Penrith, Australia
34Mount Sinai Hospital, Toronto, Canada
35UCINC, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
36University of New South Wales, Sydney, Australia
37Università dellla Magna Graecia, Catanzaro, Italy
38Fujita Health University School of Medicine, Toyoake, Japan
39Rigshospitalet, Copenhagen, Denmark
40Università ‘Sapienza’, Rome, Italy
41Christiana Care Health Services, Newark, USA
42University of Pittsburgh School of Medicine, Pittsburgh, USA
43Stanford University School of Medicine, Stanford, USA
44Kaust Medical Services, Thuwal, Saudi Arabia
45University of Kansas Medical Center, Kansas City, USA.
46Wolfson Institute of Biomedical Research, London, England, UK
47Massachusetts General Hospital, Boston, USA
48California Pacific Medical Center, San Francisco, USA
49University of Amsterdam, Amsterdam, Netherlands
50Erasmé University Hospital, Brussels, Belgium
51Houston Methodist Hospital, Houston, USA

Tóm tắt

To provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012”. 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. 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. 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. 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.

Tài liệu tham khảo

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