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

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

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.

Publication types

  • Consensus Development Conference
  • Practice Guideline

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Blood Glucose
  • Calcitonin / blood
  • Critical Illness / therapy
  • Erythrocyte Transfusion
  • Fluid Therapy
  • Humans
  • Nutrition Assessment
  • Patient Care Planning
  • Renal Replacement Therapy
  • Respiration, Artificial
  • Sepsis / diagnosis
  • Sepsis / therapy*
  • Shock, Septic / diagnosis
  • Shock, Septic / therapy
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Blood Glucose
  • Vasoconstrictor Agents
  • Calcitonin