Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19)
Open accessAbstract
Background The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed.Methods We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations.Results The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which 4 are best practice statements, 9 are strong recommendations, and 35 are weak recommendations. No recommendation was provided for 6 questions. The topics were: (1) infection control, (2) laboratory diagnosis and specimens, (3) hemodynamic support, (4) ventilatory support, and (5) COVID-19 therapy.Conclusion The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new recommendations in further releases of these guidelines.
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Previous versions of SSC guidelines issued a strong recommendation with moderate-quality evidence for using low tidal volume ventilation (Vt 4-8 mL/kg of predicted body weight) over higher tidal volumes (Vt > 8 mL/kg) in the management of patients with ARDS.
“Previous versions of SSC guidelines issued a strong recommendation with a moderate-quality evidence for using low tidal volume (Vt) ventilation (Vt 4–8 mL/kg of predicted body weight), over higher tidal volumes (Vt > 8 mL/kg) in the management of patients with ARDS [12, 13, 226].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [226]
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Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
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- Authors
- Alhazzani, W., Møller, M. H., Arabi, Y. M., Loeb, M., Gong, M. N., Fan, E., Oczkowski, S., Levy, M. M., Derde, L., Dzierba, A., Du, B., Aboodi, M., Wunsch, H., Cecconi, M., Koh, Y., Chertow, D. S., Maitland, K., Alshamsi, F., Belley-Cote, E., Greco, M., Laundy, M., Morgan, J. S., Kesecioglu, J., McGeer, A., Mermel, L., Mammen, M. J., Alexander, P. E., Arrington, A., Centofanti, J. E., Citerio, G., Baw, B., Memish, Z. A., Hammond, N., Hayden, F. G., Evans, L., & Rhodes, A.
- Affiliations
- McMaster University (CA)
- Copenhagen University Hospital (DK)
- King Saud bin Abdulaziz University for Health Sciences (SA)
- Albert Einstein College of Medicine (US)
- University of Toronto (CA)
- Brown University (US)
- Utrecht University (NL)
- NewYork–Presbyterian Hospital (US)
- Peking Union Medical College Hospital (CN)
- Sunnybrook Health Science Centre (CA)
- Humanitas University (IT)
- Asan Medical Center (KR)
- National Institute of Allergy and Infectious Diseases (US)
- Imperial College London (GB)
- United Arab Emirates University (AE)
- St George's, University of London (GB)
- Emory University Hospital (US)
- University at Buffalo, State University of New York (US)
- Baylor College of Medicine (US)
- Azienda Ospedaliera San Gerardo (IT)
- King Abdulaziz Medical City (SA)
- King Saud Medical City (SA)
- The George Institute for Global Health (GB)
- University of Virginia (US)
- University of Washington (US)
- Corresponding author
- Rhodes, Andrew
- ORCID
- Alhazzani, Waleed
- Møller, Morten Hylander
- Arabi, Yaseen M.
- Loeb, Mark
- Gong, Michelle Ng
- Fan, Eddy
- Oczkowski, Simon
- Levy, Mitchell M.
- Derde, Lennie
- Dzierba, Amy
- Du, Bin
- Wunsch, Hannah
- Cecconi, Maurizio
- Koh, Younsuck
- Chertow, Daniel S.
- Maitland, Kathryn
- Alshamsi, Fayez
- Greco, Massimiliano
- Laundy, Matthew
- Morgan, Jill S.
- McGeer, Allison
- Mermel, Leonard
- Mammen, Manoj J.
- Alexander, Paul E.
- Centofanti, John E.
- Citerio, Giuseppe
- Memish, Ziad A.
- Hammond, Naomi
- Hayden, Frederick G.
- Evans, Laura
- Rhodes, Andrew
- Venue
- Intensive Care Medicine
- Published
- 2020-03-28
- Volume
- 46
- Issue
- 5
- Pages
- 854-887
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- PMC
- PMC7101866
- OpenAlex
- W3013671288
- Cited by
- 2,105
- References
- 227
- Citations by year
- 2026: 32 · 2025: 49 · 2024: 92 · 2023: 157 · 2022: 340 · 2021: 607 · 2020: 821 · 2019: 5 · 2018: 1
- FWCI
- 62.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Intensive Care Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
- St George's Online Research Archive (St George's University of London) (acceptedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- COVID-19 pandemic, SARS-CoV-2, critically ill adults, intensive care unit management, infection control, laboratory diagnosis, hemodynamic support, ventilatory support, COVID-19 treatment, Surviving Sepsis Campaign
- MeSH terms
- COVID-19, Critical Care, Humans, Intensive Care Units, Pneumonia, Viral, Survivors, Coronavirus Infections, Sepsis, Pandemics
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