Cited by 6,621Sepsis Diagnosis and TreatmentAbdominal Surgery and ComplicationsAntibiotics Pharmacokinetics and Efficacy

Surviving Sepsis Campaign: International guidelines for management of sepsis and septic shock: 2016.

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Rhodes, Andrew, Evans, Laura E., Alhazzani, Waleed, Levy, Mitchell M., Antonelli, Massimo, Ferrer, Ricard, Kumar, Anand, Sevransky, Jonathan E. +51 more·2017·Intensive Care Medicine

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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Crossref · 10.1007/s00134-017-4683-6

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  • Effectiveness of erythromycin or other prokinetics is decreased to one third after 72 hours.

    “Effectiveness of erythromycin or other prokinetics is decreased to one third after 72 hours (111)”

    From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [111]

    In the prokinetic-agent recommendation and rationale (page unavailable), the guidelines report that prokinetics, including erythromycin, reduce feeding intolerance. They do not report that effectiveness falls to one third after 72 hours; searches for that timing and magnitude found no supporting passage. (LLM, conf=0.84)

    Experimental — accuracy not yet measured
  • Considering the increasing frequency of MDR bacteria in many parts of the world and associations between delays in active therapy and worse outcomes, the initial use of multidrug therapy is often required to ensure the empiric regimen includes at least one effective agent that is active against the offending organism.

    “Considering the increasing frequency of MDR bacteria in many parts of the world and associations between delays in active therapy and worse outcomes, the initial use of multidrug therapy is often required to ensure the empiric regimen includes at least one effective agent that is active against the offending organism (12,13).”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [13]

    Experimental — accuracy not yet measured
  • Appropriate source control is a key principle in the management of sepsis and septic shock.

    “Appropriate source control is a key principle in the management of sepsis and septic shock (12,13).”
  • Given increasing MDR frequency and associations between delayed active therapy and worse outcomes, initial multidrug therapy is often required to ensure the empiric regimen includes at least one effective agent against the offending organism.

    “Considering the increasing frequency of MDR bacteria in many parts of the world and associations between delays in active therapy and worse outcomes, the initial use of multidrug therapy is often required to ensure the empiric regimen includes at least one effective agent that is active against the offending organism [12, 13].”
  • Appropriate source control is a key principle in managing sepsis and septic shock.

    “Appropriate source control is a key principle in the management of sepsis and septic shock [12, 13].”

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Research works printed but not linked: 5

  1. [28]28. Singer M, Deutschman CS, Seymour CW et al (2016) The Third Inter- national Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 315(8):801-810
  2. [45]45. Yealy DM, Kellum JA, Huang DT et al (2014) A randomized trial of proto- col-based care for early septic shock. N Engl J Med 370(18):1683-1693
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Authors
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., De Backer, D. P., French, C. J., Fujishima, S., Gerlach, H., Hidalgo, J. L., Hollenberg, S. M., Jones, A. E., Karnad, D. R., Kleinpell, R. M., Koh, Y., Lisboa, T. C., Machado, F. R., Marini, J. J., Marshall, J. C., Mazuski, J. E., McIntyre, L. A., McLean, A. S., Mehta, S., Moreno, R. P., Myburgh, J., Navalesi, P., Nishida, O., Osborn, T. M., Perner, A., Plunkett, C. M., Ranieri, M., Schorr, C. A., Seckel, M. A., Seymour, C. W., Shieh, L., Shukri, K. A., Simpson, S. Q., Singer, M., Thompson, B. T., Townsend, S. R., Van der Poll, T., Vincent, J.-L., Wiersinga, W. J., Zimmerman, J. L., & Dellinger, R. P.
Affiliations
  • St George's Hospital (GB)
  • New York University (US)
  • McMaster University (CA)
  • Brown University (US)
  • Università Cattolica del Sacro Cuore (IT)
  • Vall d'Hebron Hospital Universitari (ES)
  • University of Manitoba (CA)
  • Emory University Hospital (US)
  • Hadassah Medical Center (IL)
  • Sunnybrook Health Science Centre (CA)
  • University of Pittsburgh (US)
  • Hôpital Raymond-Poincaré (FR)
  • St Thomas' Hospital (GB)
  • University College London (GB)
  • Vanderbilt University Medical Center (US)
  • Western Hospital (AU)
  • Keio University (JP)
  • Vivantes Klinikum (DE)
  • Cooper Norcross Health (US)
  • University of Mississippi Medical Center (US)
  • Rush University Medical Center (US)
  • Asan Medical Center (KR)
  • Hospital de Clínicas de Porto Alegre (BR)
  • Regions Hospital (US)
  • St. Michael's Hospital (CA)
  • Washington University in St. Louis (US)
  • Ottawa Hospital (CA)
  • The University of Sydney (AU)
  • Mount Sinai Hospital (CA)
  • Unidade Local de Saúde de São José (PT)
  • UNSW Sydney (AU)
  • Magna Graecia University (IT)
  • Fujita Health University (JP)
  • Rigshospitalet (DK)
  • Stanford Medicine (US)
  • University of Kansas Medical Center (US)
  • Massachusetts General Hospital (US)
  • California Pacific Medical Center (US)
  • Erasmus Hospital (BE)
  • University of Amsterdam (NL)
  • Houston Methodist (US)
Corresponding author
Rhodes, Andrew
Venue
Intensive Care Medicine
Published
2017-01-18
Volume
43
Issue
3
Pages
304-377
ISSN
  • 0342-4642 (ISSN-L)
  • 1432-1238
OpenAlex
W3016555942
Cited by
6,621
References
687
Citations by year
2026: 260 · 2025: 414 · 2024: 508 · 2023: 626 · 2022: 821 · 2021: 1160 · 2020: 1089 · 2019: 813 · 2018: 629 · 2017: 278 · 2016: 2 · 2015: 1 · 2014: 1 · 2012: 1
FWCI
602.03
Type
journal article
Language
en
Open access
Locations
  • Intensive Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • St George's Online Research Archive (St George's University of London) (acceptedVersion)
  • Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
  • CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Funders
  • Gordon and Betty Moore Foundation
  • American Heart Association
  • American Thoracic Society
  • Pfizer
  • American College of Surgeons
  • Society for Academic Emergency Medicine
  • CSL Behring
  • European Respiratory Society
  • American Association of Critical-Care Nurses
  • American College of Emergency Physicians
  • Society of Hospital Medicine
  • Society of Critical Care Anesthesiologists
  • Società Italiana Anestesia, Analgesia, Rianimazione e Terapia Intensiva
  • Canadian Blood Services
  • Intensive Care Society
  • European Society of Clinical Microbiology and Infectious Diseases
  • Universiteit van Amsterdam
  • Japanese Respiratory Society
  • European Society of Anaesthesiology
  • European Society of Intensive Care Medicine
  • Grifols
  • Centers for Disease Control and Prevention
  • Allergan
  • Abbott Diagnostics
  • National Institute of General Medical Sciences (R35GM119519)
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Abdominal Surgery and Complications
  • Health Sciences › Medicine › Pharmacology › Antibiotics Pharmacokinetics and Efficacy
Keywords
sepsis, septic shock, sepsis treatment, sepsis resuscitation, hemodynamic management, infection management, adjunctive therapy, metabolic control, mechanical ventilation, critically ill patients
MeSH terms
Anti-Bacterial Agents, Blood Glucose, Calcitonin, Fluid Therapy, Humans, Patient Care Planning, Respiration, Artificial, Shock, Septic, Vasoconstrictor Agents, Nutrition Assessment, Critical Illness, Renal Replacement Therapy, Erythrocyte Transfusion, Sepsis

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