The DOI matches its Crossref record; 645 of the 645 references it cites were found in a registry or an index; 29 of the 714 sources its claims cite were checked for support.
Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
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Claims the paper makes
393 Not checked yet · 87 Own interpretation · 64 No basis given · 28 Own result · 20 Own method · 8 Partly supported · 3 Supported so far · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In an observational study of 401 ICU patients, authors reported an increase in ICU mortality of 1.5% for each hour delay of ED to ICU transfer [85].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Partly supportedcites [85] Cardoso LT, Grion CM, Matsuo T et al (2011) Impact of delayed admission to intensive care units on mortality of critically ill patients: a cohort study. Crit Care 15(1):R28 sourceExperimental — accuracy not yet measured
The Results report 401 patients and a 1.5% higher risk of ICU death per hour of waiting for ICU admission (HR 1.015). But Materials and methods describes patients from both the emergency ward and general hospital wards; the reported estimate is not specific to ED-to-ICU transfers. (LLM, conf=0.88)
plaindirectn = 401- Asserted: passes — The authors put it forward as true.
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- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Specialist consultation appears to be associated with improved patient outcomes for a variety of infectious syndromes [295–300].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Supportedcites [295] Burnham JP, Olsen MA, Stwalley D et al (2018) Infectious diseases consultation reduces 30-day and 1-year all-cause mortality for multidrug-resistant organism infections. Open Forum Infect Dis 5(3):ofy06 source
The paper’s introductory passage (listed under Abstract > Conclusions; page not provided) reports that prior research associates infectious diseases consultation with improved outcomes in patients with various infections. Its Conclusions also report lower mortality for several multidrug-resistant infection groups, while noting no mortality association for others. The citing sentence’s hedged wording reflects that evidence. (LLM, conf=0.92)
- Could not verifycites [296] Macheda G, Dyar OJ, Luc A et al (2018) Are infection specialists recommending short antibiotic treatment durations? An ESCMID international cross-sectional survey. J Antimicrob Chemother 73(4):1084–1090 sourceExperimental — accuracy not yet measured
The Study design describes a survey of professionals who advise colleagues on antibiotic prescriptions, and the Discussion addresses their treatment-duration recommendations. Neither section reports whether specialist consultation is associated with improved patient outcomes. Searches for consultation and patient outcomes found no passage addressing that association. (LLM, conf=0.76)
- Supportedcites [297] Madaline T, Wadskier Montagne F, Eisenberg R et al (2019) Early infectious disease consultation is associated with lower mortality in patients with severe sepsis or septic shock who complete the 3-hour sepsis treatment bundle. Open Forum Infect Dis 6(10):ofz408 source
The Discussion states that ID consultant involvement has been associated with improved clinical outcomes for various syndromes. The Introduction also describes better outcomes across infectious conditions. No page numbers are provided in our copy. (LLM, conf=0.93)
- Not checked yetcites [298] Schmitt S, McQuillen DP, Nahass R et al (2014) Infectious diseases specialty intervention is associated with decreased mortality and lower healthcare costs. Clin Infect Dis 58(1):22–28 source
- Supportedcites [299] Turner RB, Valcarlos E, Won R et al (2016) Impact of infectious diseases consultation on clinical outcomes of patients with staphylococcus aureus bacteremia in a community health system. Antimicrob Agents Chemother 60(10):5682–5687 source
The Discussion reports that infectious diseases consultation was associated with lower treatment failure and death among patients with Staphylococcus aureus bacteremia. This paper supports the cited sentence by providing an example of improved outcomes for one infectious syndrome; the sentence cites several sources for the broader variety. (LLM, conf=0.88)
- Supportedcites [300] Viale P, Tedeschi S, Scudeller L et al (2017) Infectious diseases team for the early management of severe sepsis and septic shock in the emergency department. Clin Infect Dis 65(8):1253–1259 source
The Discussion reports that bedside infectious-diseases consultation was associated with improved patient outcomes in this sepsis study. It also says this finding is consistent with studies of different patient populations and types of infection, supporting the broader, hedged statement about a variety of infectious syndromes. (LLM, conf=0.91)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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- Supported
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In the paper
“In the 1000-participant ICU-ROX trial [405], conservative oxygen therapy did not significantly affect the primary outcome, which was the number of ventilator-free days, compared with liberal oxygen therapy for ventilated adults in ICU.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Partly supportedcites [405] Investigators I-R, the A, New Zealand Intensive Care Society Clinical Trials G et al (2020) Conservative Oxygen Therapy during Mechanical Ventilation in the ICU. N Engl J Med 382(11):989–998 sourceExperimental — accuracy not yet measured
The Methods and Discussion report a 1000-patient ICU-ROX trial in ventilated adults, with ventilator-free days as the primary outcome and no significant difference between groups. The comparator was usual oxygen therapy, not a liberal oxygen regimen; the Discussion distinguishes its usual-care regimen from more liberal regimens used in other trials. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
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- Partly supported
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In the paper
“Meta-analyses also report a higher incidence of hypoglycemia (glucose < 40 mg/dL) in critically patients where blood glucose was targeted to 80–110 mg/dL [516, 517].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Partly supportedcites [516] Griesdale DE, de Souza RJ, van Dam RM et al (2009) Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ 180(8):821–827 sourceExperimental — accuracy not yet measured
The Hypoglycemic events section reports a sixfold higher pooled risk of hypoglycemia with intensive insulin therapy. The Study characteristics section shows that some trials targeted 4.4–6.1 mmol/L (approximately 80–110 mg/dL), but others used higher targets; the passages do not establish that the pooled increase applies specifically to the 80–110 mg/dL target or define hypoglycemia as glucose below 40 mg/dL. (LLM, conf=0.84)
- Partly supportedcites [517] Song F, Zhong LJ, Han L, et al (2014) Intensive insulin therapy for septic patients: a meta-analysis of randomized controlled trials. Biomed Res Int 2014:698265. https://doi.org/10.1155/2014/698265 sourceExperimental — accuracy not yet measured
The Results (section 3.4) report significantly more hypoglycemia with intensive insulin therapy than with control treatment. The Methods (section 2.2) define hypoglycemia as ≤40 mg/dL, and the Discussion says most trials targeted 80–110 mg/dL. The analysis concerns patients with sepsis, however, not critically ill patients generally; the target was not used in every trial. (LLM, conf=0.86)
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Partly supported
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In the paper
“In an updated meta-analysis of empiric antifungal therapy versus no antifungal therapy in adult critically ill patients, no difference in short-term mortality was observed.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“We identified direct evidence from 13 studies (1968 patients) [277], including 1 RCT [278]. In our meta-analysis, we observed improved short-term mortality in patients who were de-escalated (RR 0.72; 95% CI 0.57–0.91) (Supplementary Appendix 2).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [277] Tabah A, Bassetti M, Kollef MH et al (2020) Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP). Intensive Care Med 46(2):245–265 source
- Not checked yetcites [278] Leone M, Bechis C, Baumstarck K et al (2014) De-escalation versus continuation of empirical antimicrobial treatment in severe sepsis: a multicenter non-blinded randomized noninferiority trial. Intensive Care Med 40(10):1399–1408 source
plaincorrelationaln = 1,968- Asserted: passes — The authors put it forward as true.
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In the paper
“No cost-effectiveness studies compared balanced and unbalanced crystalloid solutions.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
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In the paper
“Limited data precludes a cutoff value for crystalloid infusion above which albumin might be considered as part of resuscitation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
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In the paper
“Gelatin is a synthetic colloid used as a resuscitation fluid; there is a lack of powered well-designed studies supporting its administration in sepsis and septic shock.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
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In the paper
“Large, randomised trials that compare arterial blood pressure monitoring versus non-invasive methods are still lacking.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Since then, no new relevant evidence became available.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
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In the paper
“None of the trials directly compared dobutamine combined with norepinephrine to norepinephrine alone.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“No evidence supports the superiority of dobutamine over epinephrine.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
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In the paper
“No RCTs compared dobutamine to placebo in this population.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Traditional recruitment maneuvers appear to improve 28-day mortality (RR 0.79; 95% CI 0.64–0.96) in patients with ARDS (Supplementary Appendix 4).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“and IVIGM (RR 0.69; 95% CI 0.55–0.85)”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
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In the paper
“On the other hand, continuous NMBA infusion reduced mortality when compared to deep sedation with as needed NMBA boluses (RR 0.71; 95% CI 0.57–0.89).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“Furthermore, after excluding high risk of bias studies, the significant reduction in mortality is no longer apparent.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“No increase in Clostridoides difficile colitis or pneumonia was observed.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The updated meta-analyses demonstrated reduced mortality with IVIG (RR 0.73; 95% CI 0.51–0.91)”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“and a reduction in GI haemorrhage (RR 0.52 95% CI 0.45–0.61).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
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In the paper
“We did not identify new evidence on other modalities such as haemofiltration, combined haemoperfusion and haemofiltration or plasma exchange.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“There are no high-quality studies examining the effect of intravenous (IV) immunoglobulins on the outcomes of patients with sepsis or septic shock.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A continuous NMBA infusion did not improve mortality when compared to a light sedation strategy with as needed NMBA boluses but no continuous infusion (RR 0.99; 95% CI 0.86–1.15).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Our update of the meta-analysis showed no difference in 28-day mortality (OR 0.99 95% CI 0.67–1.46, moderate quality).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“This demonstrated no effect on mortality (RR 1.01 95% CI 0.93–1.10)”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“No data for this population exist.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
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In the paper
“The prior meta-analysis demonstrated significantly lower rates of DVT following the administration of LMWH compared to UFH (RR 0.84 95% CI 0.71–0.98).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
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In the paper
“No significant difference in the risk of hospital mortality was observed between the four blood glucose ranges.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [519] Yatabe T, Inoue S, Sakaguchi M et al (2017) The optimal target for acute glycemic control in critically ill patients: a network meta-analysis. Intensive Care Med 43(1):16–28 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The use of vitamin C did not reduce mortality compared to usual care (RR 0.79; 95% CI 0.57–1.1, low quality).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plainn = 416- Asserted: passes — The authors put it forward as true.
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In the paper
“The effect of mechanical ventilation on clinically important bleeding was unclear (RE 1.93, 0.57–6.50, very low certainty).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [496] Granholm A, Zeng L, Dionne JC et al (2019) Predictors of gastrointestinal bleeding in adult ICU patients: a systematic review and meta-analysis. Intensive Care Med 45(10):1347–1359 source
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“One study reported reduced vasopressor use at 168 h [523].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [523] Fowler AA 3rd, Truwit JD, Hite RD et al (2019) Effect of vitamin C infusion on organ failure and biomarkers of inflammation and vascular injury in patients with sepsis and severe acute respiratory failure: the CITRIS-ALI Randomized Clinical Trial. JAMA 322(13):1261–1270 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Target concentrations of < 110 and 110–144 mg/dL were associated with a four to nine-fold increase in the risk of hypoglycemia compared with 144–180 and > 180 mg/dL.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [519] Yatabe T, Inoue S, Sakaguchi M et al (2017) The optimal target for acute glycemic control in critically ill patients: a network meta-analysis. Intensive Care Med 43(1):16–28 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Our literature review found no new RCT evidence comparing the administration of low molecular weight heparin (LMWH) to unfractionated heparin (UFH).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
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In the paper
“No significant difference in the risk of hypoglycemia comparing a target of 144–180 and > 180 mg/dL was demonstrated (OR 1.72; 95% CI 0.79–3.7).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [519] Yatabe T, Inoue S, Sakaguchi M et al (2017) The optimal target for acute glycemic control in critically ill patients: a network meta-analysis. Intensive Care Med 43(1):16–28 source
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“No effect of the timing of initiation of renal replacement therapy on mortality and renal recovery was observed.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
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In the paper
“No new RCT evidence was identified.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“No significant effect favouring early enteral nutrition was observed for all outcomes evaluated.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“When these data are added to our meta-analysis, the point estimate for mortality becomes RR 0.9 (95% CI 0.69–1.18: low quality).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“No studies were identified that compared discussions of goals of care and prognosis versus no such discussion in critically ill or septic patients.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In contrast, Carson et al. found an increase in PTSD symptoms in family surrogate decision makers with palliative care consultation [543].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [543] Carson SS, Cox CE, Wallenstein S et al (2016) Effect of palliative care-led meetings for families of patients with chronic critical illness: a randomized clinical trial. JAMA 316(1):51–62 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Ethics consultation did not affect overall mortality in any study.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [539] Schneiderman LJ, Gilmer T, Teetzel HD (2000) Impact of ethics consultations in the intensive care setting: a randomized, controlled trial. Crit Care Med 28(12):3920–3924 source
- Not checked yetcites [540] Schneiderman LJ, Gilmer T, Teetzel HD et al (2003) Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial. JAMA 290(9):1166–1172 source
- Not checked yetcites [541] Chen C, Michaels J, Meeker MA (2019) Family outcomes and perceptions of end-of-life care in the intensive care unit: a mixed-methods review. J Palliat Care 35(3):143–153. https://doi.org/10.1177/0825859719874767 source
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Neither study demonstrated an effect of interventions on mortality.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [542] Andereck WS, McGaughey JW, Schneiderman LJ et al (2014) Seeking to reduce nonbeneficial treatment in the ICU: an exploratory trial of proactive ethics intervention. Crit Care Med 42(4):824–830 source
- Not checked yetcites [543] Carson SS, Cox CE, Wallenstein S et al (2016) Effect of palliative care-led meetings for families of patients with chronic critical illness: a randomized clinical trial. JAMA 316(1):51–62 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Criteria for patient inclusion and the interventions in these studies demonstrate significant heterogeneity.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
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In the paper
“The timing of discussions of goals of care and prognosis in the ICU was addressed in one study where 26% of patients had infection or sepsis as a primary diagnosis [538].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [538] White DB, Angus DC, Shields AM et al (2018) A randomized trial of a family-support intervention in intensive care units. N Engl J Med 378(25):2365–2375 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Only one study with a structured palliative care intervention [547] demonstrated a beneficial effect of lower prevalence of anxiety and depression symptoms and PTSD symptoms in family members 90 days after the patient’s death.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [547] Lautrette A, Darmon M, Megarbane B et al (2007) A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 356(5):469–478 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Various outcome measures are reported but none of the studies evaluated critical patient-centered outcomes such as QoL, physical or cognitive recovery, psychological outcomes, or symptoms.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
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In the paper
“No studies described costs associated with support groups, which will vary given the model and resource availability.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Sepsis education is regarded as a low cost intervention and feasible, even in low-resource settings, as a number of online and published sepsis education resources exist [589].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [589] Oermann MH, McInerney SM (2007) An evaluation of sepsis Web sites for patient and family education. Plast Surg Nurs 27(4):192–196 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“A small study of ICU relatives found that anxiety and depression rates were lower in those who preferred an active role or shared responsibility in decision-making compared to those who preferred a passive role [591].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [591] Anderson WG, Arnold RM, Angus DC et al (2009) Passive decision-making preference is associated with anxiety and depression in relatives of patients in the intensive care unit. J Crit Care 24(2):249–254 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Structured handoff interventions for critically ill patients have been evaluated at many transitions of patient care (ED/ICU, OR/ICU, ICU/ward, and hospital/home).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Three qualitative studies identified two common themes of peer support, (1) benefit of knowing that others shared similar experiences and (2) benefit of shared coping with others [564].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [564] Haines KJ, Beesley SJ, Hopkins RO et al (2018) Peer support in critical care: a systematic review. Crit Care Med 46(9):1522–1531 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Overall quality of evidence was judged to be very low.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“We identified six RCTs that evaluated educational interventions for critically ill patients and their families [583–588].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [583] Azoulay E, Pochard F, Chevret S et al (2002) Impact of a family information leaflet on effectiveness of information provided to family members of intensive care unit patients: a multicenter, prospective, randomized, controlled trial. Am J Respir Crit Care Med 165(4):438–442 source
- Not checked yetcites [584] Bench S, Day T, Heelas K et al (2015) Evaluating the feasibility and effectiveness of a critical care discharge information pack for patients and their families: a pilot cluster randomised controlled trial. BMJ Open 5(11):e006852 source
- Not checked yetcites [585] Demircelik MB, Cakmak M, Nazli Y et al (2016) Effects of multimedia nursing education on disease-related depression and anxiety in patients staying in a coronary intensive care unit. Appl Nurs Res 29:5–8 source
- Not checked yetcites [586] Fleischer S, Berg A, Behrens J et al (2014) Does an additional structured information program during the intensive care unit stay reduce anxiety in ICU patients?: a multicenter randomized controlled trial. BMC Anesthesiol 14:48 source
- Not checked yetcites [587] Gehrke-Beck S, Bänfer M, Schilling N et al (2017) The specific needs of patients following sepsis: a nested qualitative interview study. BJGP Open. 1(1):bjgpopen17X100725 source
- Not checked yetcites [588] Schmidt K, Worrack S, Von Korff M et al (2016) Effect of a primary care management intervention on mental health-related quality of life among survivors of sepsis: a randomized clinical trial. JAMA 315(24):2703–2711 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In several qualitative studies, ICU survivors described peer support as a helpful aid to recovery [559–563].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [559] Damianakis T, Tough A, Marziali E et al (2016) Therapy online: A web-based video support group for family caregivers of survivors with traumatic brain injury. J Head Trauma Rehabil 31(4):E12-20 source
- Not checked yetcites [560] Harvey C, Dixon M, Padberg N (1995) Support group for families of trauma patients: a unique approach. Crit Care Nurse 15(4):59–63 source
- Not checked yetcites [561] Jones C, Macmillan RR, Griffiths RD (1994) Providing psychological support for patients after critical illness. Clin Intensive Care 5(4):176–179
- Not checked yetcites [562] Peskett M, Gibb P (2009) Developing and setting up a patient and relatives intensive care support group. Nurs Crit Care 14(1):4–10 source
- Not checked yetcites [563] Sacco TL, Stapleton MF, Ingersoll GL (2009) Support groups facilitated by families of former patients: creating family-inclusive critical care units. Crit Care Nurse 29(3):36–45 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Observational studies of structured handoff process have demonstrated mixed effects, with some finding reductions in unexpected clinical events [569], or ICU readmission [570, 571] and others without impact upon length of stay [572], mortality [572, 573] or hospital readmission [572, 573].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [569] Nanchal R, Aebly B, Graves G et al (2017) Controlled trial to improve resident sign-out in a medical intensive care unit. BMJ Qual Saf 26(12):987–992 source
- Not checked yetcites [570] Hess DR, Tokarczyk A, O’Malley M et al (2010) The value of adding a verbal report to written handoffs on early readmission following prolonged respiratory failure. Chest 138(6):1475–1479 source
- Not checked yetcites [571] Hoffman RL, Saucier J, Dasani S et al (2017) Development and implementation of a risk identification tool to facilitate critical care transitions for high-risk surgical patients. Int J Qual Health Care 29(3):412–419 source
- Not checked yetcites [572] Chaboyer W, Lin F, Foster M et al (2012) Redesigning the ICU nursing discharge process: a quality improvement study. Worldviews Evid Based Nurs 9(1):40–48 source
- Not checked yetcites [573] Medlock S, Eslami S, Askari M et al (2011) Improved communication in post-ICU care by improving writing of ICU discharge letters: a longitudinal before-after study. BMJ Qual Saf 20(11):967–973 source
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“Notably, critically ill patients have a decline in socio-economic status (SES) after their illness [574].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [574] Griffiths J, Hatch RA, Bishop J et al (2013) An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study. Crit Care 17(3):R100 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“There were insufficient data to allow for meta-analysis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Structured handoff processes appear to result in more complete and accurate transfer of information, without any undesirable effects.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgeddirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We did not identify any studies specifically evaluating patients with sepsis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Overall quality of evidence was judged to be very low for the impact of peer support groups on outcomes.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“These studies provided limited data for review.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“No studies were identified comparing screening versus no screening for economic and social support.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A single RCT using a stepped-wedge design in 8 ICUs evaluated the impact of a standardised handoff process, finding no effect upon duration of mechanical ventilation, ICU length of stay or duration of handover [568].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [568] Parent B, LaGrone LN, Albirair MT et al (2018) Effect of standardized handoff curriculum on improved clinician preparedness in the intensive care unit: a stepped-wedge cluster randomized clinical trial. JAMA Surg 153(5):464–470 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Studies of tools employed to promote SDM in patients with other serious illnesses show improved patient knowledge and awareness of treatment options [595].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [595] Austin CA, Mohottige D, Sudore RL et al (2015) Tools to promote shared decision making in serious illness: a systematic review. JAMA Intern Med 175(7):1213–1221 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“No studies were identified that compared SDM with other types of ICU or hospital discharge planning.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Of the structured handover tools studied, none specifically applies to sepsis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We did not identify sufficient studies to allow for meta-analysis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Racial disparities in sepsis [578] are at least partially explained by living in medically underserved neighborhoods [579].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [578] Ogundipe F, Kodadhala V, Ogundipe T et al (2019) Disparities in sepsis mortality by region, urbanization, and race in the USA: a Multiple Cause of Death Analysis. J Racial Ethn Health Dispar 6(3):546–551 source
- Not checked yetcites [579] Goodwin AJ, Nadig NR, McElligott JT et al (2016) Where you live matters: the impact of place of residence on severe sepsis incidence and mortality. Chest 150(4):829–836 source
plainconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“In view of these findings, the panel judged there to be insufficient evidence to make a recommendation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“These outcomes were consistent with a 2019 qualitative analysis of health related QoL domains identified by sepsis survivors [621].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [621] Konig C, Matt B, Kortgen A et al (2019) What matters most to sepsis survivors: a qualitative analysis to identify specific health-related quality of life domains. Qual Life Res 28(3):637–647 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In an analysis of older adults with severe sepsis, one study found that the combination of early home health care and a visit with a medical provider was associated with a reduced readmission risk [631].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [631] Deb P, Murtaugh CM, Bowles KH et al (2019) Does early follow-up improve the outcomes of sepsis survivors discharged to home health care? Med Care 57(8):633–640 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Several studies, mostly before-and-after design, have examined the impact of critical care transition programmes on reducing ICU readmission or death among patients transferred from ICU to the ward [597, 601, 603–611].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [597] Fabes J, Seligman W, Barrett C et al (2017) Does the implementation of a novel intensive care discharge risk score and nurse-led inpatient review tool improve outcome? A prospective cohort study in two intensive care units in the UK. BMJ Open 7(12):e018322 source
- Not checked yetcites [601] Stelfox HT, Bastos J, Niven DJ et al (2016) Critical care transition programs and the risk of readmission or death after discharge from ICU. Intensive Care Med 42(3):401–410 source
- Not checked yetcites [603] Ball C, Kirkby M, Williams S (2003) Effect of the critical care outreach team on patient survival to discharge from hospital and readmission to critical care: non-randomised population based study. BMJ 327(7422):1014 source
- Not checked yetcites [604] Baxter AD, Cardinal P, Hooper J et al (2008) Medical emergency teams at The Ottawa Hospital: the first two years. Can J Anaesth 55(4):223–231 source
- Not checked yetcites [605] Choi S, Lee J, Shin Y et al (2016) Effects of a medical emergency team follow-up programme on patients discharged from the medical intensive care unit to the general ward: a single-centre experience. J Eval Clin Pract 22(3):356–362 source
- Not checked yetcites [606] Elliott D, McKinley S, Alison J et al (2011) Health-related quality of life and physical recovery after a critical illness: a multi-centre randomised controlled trial of a home-based physical rehabilitation program. Crit Care 15:R142 source
- Not checked yetcites [607] Garcea G, Thomasset S, McClelland L et al (2004) Impact of a critical care outreach team on critical care readmissions and mortality. Acta Anaesthesiol Scand 48(9):1096–1100 source
- Not checked yetcites [608] Green A, Edmonds L (2004) Bridging the gap between the intensive care unit and general wards-the ICU Liaison Nurse. Intensive Crit Care Nurs 20(3):133–143 source
- Not checked yetcites [609] Leary T, Ridley S (2003) Impact of an outreach team on re-admissions to a critical care unit. Anaesthesia 58(4):328–332 source
- Not checked yetcites [610] Pittard AJ (2003) Out of our reach? Assessing the impact of introducing a critical care outreach service. Anaesthesia 58(9):882–885 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Many sepsis survivors experience short and/or long-term sequela such as cognitive and/or physical disability, with ongoing recovery persisting for months to years [620].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [620] Iwashyna TJ, Ely EW, Smith DM et al (2010) Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 304:1787–1794 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Information on post-intensive care syndrome (PICS) may be provided to only one in three ICU survivors [550, 618], mechanical ventilation, dialysis), and common impairments after sepsis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [550] Govindan S, Iwashyna TJ, Watson SR et al (2014) Issues of survivorship are rarely addressed during intensive care unit stays. Baseline results from a statewide quality improvement collaborative. Ann Am Thorac Soc 11(4):587–591 source
- Not checked yetcites [618] Weissman GE, Harhay MO, Lugo RM et al (2016) Natural language processing to assess documentation of features of critical illness in discharge documents of acute respiratory distress syndrome survivors. Ann Am Thorac Soc 13(9):1538–1545 source
hedged- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Several randomised studies have assessed physical rehabilitation programmes for survivors of critical illness [581, 606, 644–651].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [581] Gruther W, Pieber K, Steiner I et al (2017) Can early rehabilitation on the general ward after an intensive care unit stay reduce hospital length of stay in survivors of critical illness?: A randomized controlled trial. Am J Phys Med Rehabil 96(9):607–615 source
- Not checked yetcites [606] Elliott D, McKinley S, Alison J et al (2011) Health-related quality of life and physical recovery after a critical illness: a multi-centre randomised controlled trial of a home-based physical rehabilitation program. Crit Care 15:R142 source
- Not checked yetcites [644] Batterham AM, Bonner S, Wright J et al (2014) Effect of supervised aerobic exercise rehabilitation on physical fitness and quality-of-life in survivors of critical illness: an exploratory minimized controlled trial (PIX study). Br J Anaesth 113:130–137 source
- Not checked yetcites [645] Battle C, James K, Temblett P et al (2019) Supervised exercise rehabilitation in survivors of critical illness: a randomised controlled trial. J Intensive Care Soc 20(1):18–26 source
- Not checked yetcites [646] Connolly B, Thompson A, Douiri A et al (2015) Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit-acquired weakness: a pilot feasibility trial. J Crit Care 30(3):589–598 source
- Not checked yetcites [647] Jones C, Skirrow P, Griffiths RD et al (2003) Rehabilitation after critical illness: a randomized, controlled trial. Crit Care Med 31:2456–2461 source
- Not checked yetcites [648] Jones TK, Fuchs BD, Small DS et al (2015) Post-acute care use and hospital readmission after sepsis. Ann Am Thorac Soc 12(6):904–913 source
- Not checked yetcites [649] McDowell K, O’Neill B, Blackwood B et al (2017) Effectiveness of an exercise programme on physical function in patients discharged from hospital following critical illness: a randomised controlled trial (the REVIVE trial). Thorax 72(7):594–595 source
- Not checked yetcites [650] McWilliams DJ, Benington S, Atkinson D (2016) Outpatient-based physical rehabilitation for survivors of prolonged critical illness: a randomized controlled trial. Physiother Theory Pract 32(3):179–190 source
- Not checked yetcites [651] Walsh TS, Salisbury LG, Merriweather JL et al (2015) Increased hospital-based physical rehabilitation and information provision after intensive care unit discharge: The RECOVER randomized clinical trial. JAMA Intern Med 175:901–910 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A feasibility, pilot, randomised trial in general medical/surgical ICU survivors comparing usual care to an intervention of combined in-home cognitive, physical, and functional rehabilitation following discharge showed improved executive functioning at 3 months [633].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [633] Jackson JC, Ely EW, Morey MC et al (2012) Cognitive and physical rehabilitation of intensive care unit survivors: results of the RETURN randomized controlled pilot investigation. Crit Care Med 40(4):1088–1097 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Three studies, one RCT [628] and two observational studies [629, 630] evaluated early post-hospital follow-up in patients with critical illness.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [628] Douglas SL, Daly BJ, Kelley CG et al (2007) Chronically critically ill patients: health-related quality of life and resource use after a disease management intervention. Am J Crit Care 16(5):447–457 source
- Not checked yetcites [629] Jónasdóttir RJ, Jónsdóttir H, Gudmundsdottir B et al (2018) Psychological recovery after intensive care: Outcomes of a long-term quasi-experimental study of structured nurse-led follow-up. Intensive Crit Care Nurs 44:59–66 source
- Not checked yetcites [630] Kansagara D, Ramsay RS, Labby D et al (2012) Post-discharge intervention in vulnerable, chronically ill patients. J Hosp Med 7(2):124–130 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Sepsis is associated with newly acquired cognitive impairment and functional disability amongst survivors [620].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [620] Iwashyna TJ, Ely EW, Smith DM et al (2010) Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 304:1787–1794 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Some small single centre studies tested specific early cognitive therapies to enhance cognitive and overall functional recovery after critical illness [634, 635].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [634] Brummel NE, Girard TD, Ely EW et al (2014) Feasibility and safety of early combined cognitive and physical therapy for critically ill medical and surgical patients: the Activity and Cognitive Therapy in ICU (ACT-ICU) trial. Intensive Care Med 40(3):370–379 source
- Not checked yetcites [635] Zhao J, Yao L, Li M et al (2019) Effects of early intervention training on cognitive impairment in critical patients. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 31(3):298–302
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Among older adults, early post discharge follow-up (within 7 days) with a primary care physician was associated with lower risk of 30-day readmission [626, 627].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [626] Field TS, Ogarek J, Garber L et al (2015) Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization among older adults. J Gen Intern Med 30(5):565–571 source
- Not checked yetcites [627] Shen E, Koyama SY, Huynh DN et al (2017) Association of a dedicated post-hospital discharge follow-up visit and 30-Day readmission risk in a Medicare Advantage population. JAMA Intern Med 177(1):132–135 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Key information from hospitalisation is often missing on hospital discharge documentation [615–618].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [615] Etesse B, Jaber S, Mura T et al (2010) How the relationships between general practitioners and intensivists can be improved: the general practitioners’ point of view. Crit Care 14(3):R112 source
- Not checked yetcites [616] Kripalani S, LeFevre F, Phillips CO et al (2007) Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA 297:831–841 source
- Not checked yetcites [617] Robelia PM, Kashiwagi DT, Jenkins SM et al (2017) Information transfer and the hospital discharge summary: National primary care provider perspectives of challenges and opportunities. J Am Board Fam Med 30(6):758–765 source
- Not checked yetcites [618] Weissman GE, Harhay MO, Lugo RM et al (2016) Natural language processing to assess documentation of features of critical illness in discharge documents of acute respiratory distress syndrome survivors. Ann Am Thorac Soc 13(9):1538–1545 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Observational studies in patients with congestive heart failure have associated early (within 7–14 days) post-discharge follow-up with reduced hospital readmissions [625].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [625] Hernandez AF, Greiner MA, Fonarow GC et al (2010) Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure. JAMA 303(17):1716–1722 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Effects on ICU workload and workflow have not been systematically examined.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A meta-analysis of 2 RCTs in Sub-Saharan Africa found higher mortality (RR 1.26; 95% CI 1.00–1.58) with standard operating procedures compared with usual care”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [39] Morton B, Stolbrink M, Kagima W et al (2018) The early recognition and management of sepsis in Sub-Saharan African adults: a systematic review and meta-analysis. Int J Environ Res Public Health 15(9):2017 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“while it was decreased in one observational study (adjusted hazard ratio [HR]; 95% CI 0.55–0.98) [39].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [39] Morton B, Stolbrink M, Kagima W et al (2018) The early recognition and management of sepsis in Sub-Saharan African adults: a systematic review and meta-analysis. Int J Environ Res Public Health 15(9):2017 source
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, while there is wide variation in sensitivity and specificity of sepsis screening tools, they are an important component of identifying sepsis early for timely intervention.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: Early identification and appropriate management in the initial hours after sepsis onset improve outcomes.
None of the sources cited for this claim have been checked yet.
In the paper
“A pooled analysis of three RCTs did not demonstrate a mortality benefit of active screening (RR 0.90; 95% CI 0.51–1.58) [33–35].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [33] Downing NL, Rolnick J, Poole SF et al (2019) Electronic health record-based clinical decision support alert for severe sepsis: a randomised evaluation. BMJ Qual Saf 28(9):762–768 source
- Not checked yetcites [34] Hooper MH, Weavind L, Wheeler AP et al (2012) Randomized trial of automated, electronic monitoring to facilitate early detection of sepsis in the intensive care unit*. Crit Care Med 40(7):2096–2101 source
- Not checked yetcites [35] Shimabukuro DW, Barton CW, Feldman MD et al (2017) Effect of a machine learning-based severe sepsis prediction algorithm on patient survival and hospital length of stay: a randomised clinical trial. BMJ Open Respir Res 4(1):e000234 source
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“The specific components of performance improvement did not appear to be as important as the presence of a programme that included sepsis screening and metrics.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [27] Damiani E, Donati A, Serafini G et al (2015) Effect of performance improvement programs on compliance with sepsis bundles and mortality: a systematic review and meta-analysis of observational studies. PLoS One 10(5):e0125827 source
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“Since that time numerous studies have investigated the potential use of the qSOFA as a screening tool for sepsis [40–42]. The results have been contradictory as to its usefulness.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [40] Fernando SM, Tran A, Taljaard M et al (2018) Prognostic accuracy of the quick sequential organ failure assessment for mortality in patients with suspected infection: a systematic review and meta-analysis. Ann Intern Med 168(4):266–275 source
- Not checked yetcites [41] Herwanto V, Shetty A, Nalos M et al (2019) Accuracy of quick sequential organ failure assessment score to predict sepsis mortality in 121 studies including 1,716,017 individuals: a systematic review and meta-analysis. Crit Care Explor. 1(9):e0043 source
- Not checked yetcites [42] Serafim R, Gomes JA, Salluh J et al (2018) A comparison of the Quick-SOFA and systemic inflammatory response syndrome criteria for the diagnosis of sepsis and prediction of mortality: a systematic review and meta-analysis. Chest 153(3):646–655 source
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In the paper
“A retrospective cohort study of 1,012,410 sepsis admissions to 509 hospitals in the United States in a retrospective cohort examined mortality before (27 months) and after (30 months) implementation of New York state sepsis regulations, with a concurrent control population from 4 other states [38]. In this comparative interrupted time series, mortality was lower in hospitals with higher compliance”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [38] Kahn JM, Davis BS, Yabes JG et al (2019) Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis. JAMA 322(3):240–250 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“in a meta-analysis of 42,623 patients from seven studies for predicting hospital-acquired sepsis the pooled area under the receiving-operating curve (SAUROC) (0.89; 95% CI 0.86–0.92); sensitivity (81%; 95% CI 80–81), and specificity (72%; 95% CI 72–72) was higher for machine learning than the SAUROC for traditional screening tools such as SIRS (0.70), MEWS (0.50), and SOFA (0.78) [32].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [32] Islam MM, Nasrin T, Walther BA et al (2019) Prediction of sepsis patients using machine learning approach: a meta-analysis. Comput Methods Programs Biomed 170:1–9 source
plaincorrelationaln = 42,623- Asserted: passes — The authors put it forward as true.
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In the paper
“Ninety-day mortality in the permissive hypotension and usual care groups was similar (41.0% vs 43.8%).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [82] Lamontagne F, Meade MO, Hebert PC et al (2016) Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial. Intensive Care Med 42(4):542–550 source
- Not checked yetcites [83] Lamontagne F, Richards-Belle A, Thomas K et al (2020) Effect of reduced exposure to vasopressors on 90-day mortality in older critically ill patients with vasodilatory hypotension: a randomized clinical trial. JAMA 323(10):938–949 source
plainn = 2,463- Asserted: passes — The authors put it forward as true.
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In the paper
“Pooled positive and negative likelihood ratios from the three studies are 4.75 and 0.29, respectively.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [50] Contenti J, Corraze H, Lemoel F et al (2015) Effectiveness of arterial, venous, and capillary blood lactate as a sepsis triage tool in ED patients. Am J Emerg Med 33(2):167–172 source
- Not checked yetcites [51] Karon BS, Tolan NV, Wockenfus AM et al (2017) Evaluation of lactate, white blood cell count, neutrophil count, procalcitonin and immature granulocyte count as biomarkers for sepsis in emergency department patients. Clin Biochem 50(16–17):956–958 source
- Not checked yetcites [52] Ljungstrom L, Pernestig AK, Jacobsson G et al (2017) Diagnostic accuracy of procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis. PLoS One 12(7):e0181704 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“However, in one other meta-analysis, there was no significant difference in mortality between septic patients resuscitated with a volume responsiveness-guided approach compared with standard resuscitative strategies [68].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [68] Ehrman RR, Gallien JZ, Smith RK et al (2019) Resuscitation guided by volume responsiveness does not reduce mortality in sepsis: a meta-analysis. Crit Care Explor. 1(5):e0015 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The association of lactate level with mortality in patients with suspected infection and sepsis is well established [45, 46].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [45] Borthwick HA, Brunt LK, Mitchem KL et al (2012) Does lactate measurement performed on admission predict clinical outcome on the intensive care unit? A concise systematic review. Ann Clin Biochem 49(Pt 4):391–394 source
- Not checked yetcites [46] Liu G, An Y, Yi X et al (2017) Early lactate levels for prediction of mortality in patients with sepsis or septic shock: a meta-analysis. Int J Exp Med 10:37–47
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In resource-limited regions where measurement of CO or SV may not be possible, a > 15% increase in pulse pressure could indicate that the patient is fluid responsive utilizing a passive leg-raise test for 60–90 seconds [71, 72].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [71] Cherpanath TG, Hirsch A, Geerts BF et al (2016) Predicting fluid responsiveness by passive leg raising: a systematic review and meta-analysis of 23 clinical trials. Crit Care Med 44(5):981–991 source
- Not checked yetcites [72] Misango D, Pattnaik R, Baker T et al (2017) Haemodynamic assessment and support in sepsis and septic shock in resource-limited settings. Trans R Soc Trop Med Hyg 111(11):483–489 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The 2016 SSC guideline issued a recommendation for using a minimum of 30 ml/kg (ideal body weight) of IV crystalloids in initial fluid resuscitation. This fixed volume of initial resuscitation was based on observational evidence [62].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [62] Levy MM, Dellinger RP, Townsend SR et al (2010) The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Intensive Care Med 36(2):222–231 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Lactate testing may not be readily available in many resource-limited settings [54–61].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [54] Abdu M, Wilson A, Mhango C et al (2018) Resource availability for the management of maternal sepsis in Malawi, other low-income countries, and lower-middle-income countries. Int J Gynaecol Obstet 140(2):175–183 source
- Not checked yetcites [55] Baelani I, Jochberger S, Laimer T et al (2011) Availability of critical care resources to treat patients with severe sepsis or septic shock in Africa: a self-reported, continent-wide survey of anaesthesia providers. Crit Care 15(1):R10 source
- Not checked yetcites [56] Baelani I, Jochberger S, Laimer T et al (2012) Identifying resource needs for sepsis care and guideline implementation in the Democratic Republic of the Congo: a cluster survey of 66 hospitals in four eastern provinces. Middle East J Anaesthesiol 21(4):559–575
- Not checked yetcites [57] Bataar O, Lundeg G, Tsenddorj G et al (2010) Nationwide survey on resource availability for implementing current sepsis guidelines in Mongolia. Bull World Health Organ 88(11):839–846 source
- Not checked yetcites [58] Hernandez G, Ospina-Tascon GA, Damiani LP et al (2019) Effect of a resuscitation strategy targeting peripheral perfusion status vs serum lactate levels on 28-day mortality among patients with septic shock: the ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA 321(7):654–664 source
- Not checked yetcites [59] Machado FR, Cavalcanti AB, Bozza FA et al (2017) The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study. Lancet Infect Dis 17(11):1180–1189 source
- Not checked yetcites [60] Shrestha GS, Kwizera A, Lundeg G et al (2017) International Surviving Sepsis Campaign guidelines 2016: the perspective from low-income and middle-income countries. Lancet Infect Dis 17(9):893–895 source
- Not checked yetcites [61] Taniguchi LU, Azevedo LCP, Bozza FA et al (2019) Availability of resources to treat sepsis in Brazil: a random sample of Brazilian institutions. Rev Bras Ter Intensiva 31(2):193–201 source
hedged- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“However, lactate alone is neither sensitive nor specific enough to rule-in or rule-out the diagnosis on its own.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [50] Contenti J, Corraze H, Lemoel F et al (2015) Effectiveness of arterial, venous, and capillary blood lactate as a sepsis triage tool in ED patients. Am J Emerg Med 33(2):167–172 source
- Not checked yetcites [51] Karon BS, Tolan NV, Wockenfus AM et al (2017) Evaluation of lactate, white blood cell count, neutrophil count, procalcitonin and immature granulocyte count as biomarkers for sepsis in emergency department patients. Clin Biochem 50(16–17):956–958 source
- Not checked yetcites [52] Ljungstrom L, Pernestig AK, Jacobsson G et al (2017) Diagnostic accuracy of procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis. PLoS One 12(7):e0181704 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“although a sub-group analysis demonstrated a 10.5% absolute reduction in renal replacement therapy (RRT) with higher MAP targets among patients with chronic hypertension.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [80] Asfar P, Meziani F, Hamel JF et al (2014) High versus low blood-pressure target in patients with septic shock. N Engl J Med 370(17):1583–1593 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“At day 3, the CRT group had significantly less organ dysfunction as assessed by SOFA score [mean SOFA score 5.6 (SD 4.3) versus 6.6 (SD 4.7); p = 0.045].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [58] Hernandez G, Ospina-Tascon GA, Damiani LP et al (2019) Effect of a resuscitation strategy targeting peripheral perfusion status vs serum lactate levels on 28-day mortality among patients with septic shock: the ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA 321(7):654–664 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In addition, targeting higher MAP with vasopressors was associated with a higher risk of atrial fibrillation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [80] Asfar P, Meziani F, Hamel JF et al (2014) High versus low blood-pressure target in patients with septic shock. N Engl J Med 370(17):1583–1593 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“and higher hospital mortality (48.1% versus 33%) than standard care [69].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [69] Andrews B, Semler MW, Muchemwa L et al (2017) Effect of an early resuscitation protocol on in-hospital mortality among adults with sepsis and hypotension: a randomized clinical trial. JAMA 318(13):1233–1240 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In post-cardiac surgery patients, fluid challenges of 4 ml/kg compared to 1–3 ml/kg increased the sensitivity of detecting fluid responders and non-responders based on measurement of CO [70].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [70] Aya HD, Rhodes A, Chis Ster I et al (2017) Hemodynamic effect of different doses of fluids for a fluid challenge: a quasi-randomized controlled study. Crit Care Med 45(2):e161–e168 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“A meta-analysis of two RCTs on this topic supported that higher MAP targets did not improve survival in septic shock (RR 1.05; 95% CI 0.90–1.23) [81].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [81] Hylands M, Moller MH, Asfar P et al (2017) A systematic review of vasopressor blood pressure targets in critically ill adults with hypotension. Can J Anaesth 64(7):703–715 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A retrospective analysis of adults presenting to an emergency department with sepsis or septic shock showed that failure to receive 30 ml/kg of crystalloid fluid therapy within 3 h of sepsis onset was associated with increased odds of in-hospital mortality, delayed resolution of hypotension and increased length of stay in ICU, irrespective of comorbidities, including end-stage kidney disease and”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [63] Kuttab HI, Lykins JD, Hughes MD et al (2019) Evaluation and predictors of fluid resuscitation in patients with severe sepsis and septic shock. Crit Care Med 47(11):1582–1590 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Among 2463 analysed patients, there was significantly less exposure to vasopressors in the intervention group, measured by duration of vasopressor infusion and total vasopressor doses expressed in norepinephrine equivalents.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [82] Lamontagne F, Meade MO, Hebert PC et al (2016) Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial. Intensive Care Med 42(4):542–550 source
- Not checked yetcites [83] Lamontagne F, Richards-Belle A, Thomas K et al (2020) Effect of reduced exposure to vasopressors on 90-day mortality in older critically ill patients with vasodilatory hypotension: a randomized clinical trial. JAMA 323(10):938–949 source
plaindirectn = 2,463- Asserted: passes — The authors put it forward as true.
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In the paper
“The recommendation was based principally on a RCT in septic shock comparing patients who were given vasopressors to target a MAP of 65–70 mm Hg, versus a target of 80–85 mm Hg [80]. This study found no difference in mortality”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [80] Asfar P, Meziani F, Hamel JF et al (2014) High versus low blood-pressure target in patients with septic shock. N Engl J Med 370(17):1583–1593 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“An RCT in patients with sepsis and hypotension in Zambia showed that early protocolised resuscitation with administration of IV fluids guided by jugular venous pressure, respiratory rate, and arterial oxygen saturation only, was associated with significantly more fluid administration in the first 6 h [median 3.5L (IQR 2.7–4.0) versus 2.0L (IQR 1.0–2.5)]”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [69] Andrews B, Semler MW, Muchemwa L et al (2017) Effect of an early resuscitation protocol on in-hospital mortality among adults with sepsis and hypotension: a randomized clinical trial. JAMA 318(13):1233–1240 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Based on existing data, timely admission of critically ill patients to an ICU environment may result in better patient outcomes.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: The outcome of critically ill patients depends on timely application of critical care interventions in an appropriate environment.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Since there is no “gold standard” test to diagnose sepsis, the bedside provider cannot have a differential diagnosis of sepsis alone in a patient with organ dysfunction.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“One failed to achieve a difference in time-to-antimicrobials between arms [120].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [120] Bloos F, Ruddel H, Thomas-Ruddel D et al (2017) Effect of a multifaceted educational intervention for anti-infectious measures on sepsis mortality: a cluster randomized trial. Intensive Care Med 43(11):1602–1612 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In a meta-analysis of 30 studies (3244 patients), procalcitonin had a pooled sensitivity of 77% and specificity of 79% for sepsis in critically ill patients [128].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [128] Wacker C, Prkno A, Brunkhorst FM et al (2013) Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis. Lancet Infect Dis 13(5):426–435 source
plaincorrelationaln = 3,244- Asserted: passes — The authors put it forward as true.
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In the paper
“Early administration of appropriate antimicrobials is one of the most effective interventions to reduce mortality in patients with sepsis [96–98].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [96] Ferrer R, Artigas A, Suarez D et al (2009) Effectiveness of treatments for severe sepsis: a prospective, multicenter, observational study. Am J Respir Crit Care Med 180(9):861–866 source
- Not checked yetcites [97] Kalil AC, Johnson DW, Lisco SJ et al (2017) Early goal-directed therapy for sepsis: a novel solution for discordant survival outcomes in clinical trials. Crit Care Med 45(4):607–614 source
- Not checked yetcites [98] Seymour CW, Gesten F, Prescott HC et al (2017) Time to treatment and mortality during mandated emergency care for sepsis. N Engl J Med 376(23):2235–2244 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“A retrospective observational study of 14,788 critically ill patients in the Netherlands showed a higher hospital mortality for the higher ED to ICU time quintiles (2.4–3.7 h and > 3.7 h) compared with the lowest ED to ICU time quintile (< 1.2 h) [86].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [86] Groenland CNL, Termorshuizen F, Rietdijk WJR et al (2019) emergency department to icu time is associated with hospital mortality: a registry analysis of 14,788 patients from six University Hospitals in The Netherlands. Crit Care Med 47(11):1564–1571 source
plaincorrelationaln = 14,788- Asserted: passes — The authors put it forward as true.
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In the paper
“Another study evaluated 50,322 ED patients admitted to 120 US ICUs [87]. Mortality increased when ED stay exceeded 6 h (17% vs 12.9%, p < 0.001).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [87] Chalfin DB, Trzeciak S, Likourezos A et al (2007) Impact of delayed transfer of critically ill patients from the emergency department to the intensive care unit. Crit Care Med 35(6):1477–1483 source
plaindirectn = 50,322- Asserted: passes — The authors put it forward as true.
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In the paper
“A meta-analysis of the three trials (n = 1769 ICU patients) found no difference in short-term mortality (RR 0.99; 95% CI 0.86–1.15)”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [129] Jensen JU, Hein L, Lundgren B et al (2011) Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial. Crit Care Med 39(9):2048–2058 source
- Not checked yetcites [130] Layios N, Lambermont B, Canivet JL et al (2012) Procalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients. Crit Care Med 40(8):2304–2309 source
- Not checked yetcites [131] Najafi A, Khodadadian A, Sanatkar M et al (2015) The comparison of procalcitonin guidance administer antibiotics with empiric antibiotic therapy in critically ill patients admitted in intensive care unit. Acta Med Iran 53(9):562–567
plainn = 1,769- Asserted: passes — The authors put it forward as true.
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In the paper
“When adjusted for severity of illness, an ED to ICU time > 2.4 h was associated with increased hospital mortality in patients with higher illness severity (ORs of 1.20 (95% CI 1.03–1.39).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [86] Groenland CNL, Termorshuizen F, Rietdijk WJR et al (2019) emergency department to icu time is associated with hospital mortality: a registry analysis of 14,788 patients from six University Hospitals in The Netherlands. Crit Care Med 47(11):1564–1571 source
plaincorrelationaln = 14,788 ·- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Observational studies do, however, suggest that mortality may increase after intervals exceeding 3–5 h from hospital arrival and/or sepsis recognition [98, 111, 119, 120].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [98] Seymour CW, Gesten F, Prescott HC et al (2017) Time to treatment and mortality during mandated emergency care for sepsis. N Engl J Med 376(23):2235–2244 source
- Not checked yetcites [111] Peltan ID, Brown SM, Bledsoe JR et al (2019) ED door-to-antibiotic time and long-term mortality in sepsis. Chest 155(5):938–946 source
- Not checked yetcites [119] Alam N, Oskam E, Stassen PM et al (2018) Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. Lancet Respir Med 6(1):40–50 source
- Not checked yetcites [120] Bloos F, Ruddel H, Thomas-Ruddel D et al (2017) Effect of a multifaceted educational intervention for anti-infectious measures on sepsis mortality: a cluster randomized trial. Intensive Care Med 43(11):1602–1612 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“The other found no significant difference in mortality despite a 90-min difference in median time interval to antimicrobial administration [119].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [119] Alam N, Oskam E, Stassen PM et al (2018) Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. Lancet Respir Med 6(1):40–50 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Access and availability of a wide range of antimicrobials in such settings may however vary [54, 55, 57, 59, 61].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [54] Abdu M, Wilson A, Mhango C et al (2018) Resource availability for the management of maternal sepsis in Malawi, other low-income countries, and lower-middle-income countries. Int J Gynaecol Obstet 140(2):175–183 source
- Not checked yetcites [55] Baelani I, Jochberger S, Laimer T et al (2011) Availability of critical care resources to treat patients with severe sepsis or septic shock in Africa: a self-reported, continent-wide survey of anaesthesia providers. Crit Care 15(1):R10 source
- Not checked yetcites [57] Bataar O, Lundeg G, Tsenddorj G et al (2010) Nationwide survey on resource availability for implementing current sepsis guidelines in Mongolia. Bull World Health Organ 88(11):839–846 source
- Not checked yetcites [59] Machado FR, Cavalcanti AB, Bozza FA et al (2017) The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study. Lancet Infect Dis 17(11):1180–1189 source
- Not checked yetcites [61] Taniguchi LU, Azevedo LCP, Bozza FA et al (2019) Availability of resources to treat sepsis in Brazil: a random sample of Brazilian institutions. Rev Bras Ter Intensiva 31(2):193–201 source
hedged- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“In patients with sepsis without shock, the association between time to antimicrobials and mortality within the first few hours from presentation is less consistent [98, 110].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [98] Seymour CW, Gesten F, Prescott HC et al (2017) Time to treatment and mortality during mandated emergency care for sepsis. N Engl J Med 376(23):2235–2244 source
- Not checked yetcites [110] Liu VX, Fielding-Singh V, Greene JD et al (2017) The timing of early antibiotics and hospital mortality in sepsis. Am J Respir Crit Care Med 196(7):856–863 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Indeed, a third or more of patients initially diagnosed with sepsis turn out to have non-infectious conditions [90, 93, 94].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [90] Klein Klouwenberg PM, Cremer OL, van Vught LA et al (2015) Likelihood of infection in patients with presumed sepsis at the time of intensive care unit admission: a cohort study. Crit Care 19:319 source
- Not checked yetcites [93] Heffner AC, Horton JM, Marchick MR et al (2010) Etiology of illness in patients with severe sepsis admitted to the hospital from the emergency department. Clin Infect Dis 50(6):814–820 source
- Not checked yetcites [94] Tidswell R, Parker T, Brealey D, et al (2020) Sepsis–the broken code how accurately is sepsis being diagnosed? J Infect 81(6):e31–e32. source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Other studies, however, did not observe an association between antimicrobial timing and mortality [112–117].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [112] Abe T, Kushimoto S, Tokuda Y et al (2019) Implementation of earlier antibiotic administration in patients with severe sepsis and septic shock in Japan: a descriptive analysis of a prospective observational study. Crit Care 23(1):360 source
- Not checked yetcites [113] Gaieski DF, Mikkelsen ME, Band RA et al (2010) Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med 38(4):1045–1053 source
- Not checked yetcites [114] Ko BS, Choi SH, Kang GH et al (2020) Time to antibiotics and the outcome of patients with septic shock: a propensity score analysis. Am J Med 133(4):485-91e4 source
- Not checked yetcites [115] Puskarich MA, Trzeciak S, Shapiro NI et al (2011) Association between timing of antibiotic administration and mortality from septic shock in patients treated with a quantitative resuscitation protocol. Crit Care Med 39(9):2066–2071 source
- Not checked yetcites [116] Rothrock SG, Cassidy DD, Barneck M, et al (2020) Outcome of immediate versus early antibiotics in severe sepsis and septic shock: a systematic review and meta-analysis. Ann Emerg Med 76(4):427–441 source
- Not checked yetcites [117] Ryoo SM, Kim WY, Sohn CH et al (2015) Prognostic value of timing of antibiotic administration in patients with septic shock treated with early quantitative resuscitation. Am J Med Sci 349(4):328–333 source
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“length of ICU stays (MD 0.19 days; 95% CI −0.98 to 1.36)”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [129] Jensen JU, Hein L, Lundgren B et al (2011) Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial. Crit Care Med 39(9):2048–2058 source
- Not checked yetcites [130] Layios N, Lambermont B, Canivet JL et al (2012) Procalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients. Crit Care Med 40(8):2304–2309 source
- Not checked yetcites [131] Najafi A, Khodadadian A, Sanatkar M et al (2015) The comparison of procalcitonin guidance administer antibiotics with empiric antibiotic therapy in critically ill patients admitted in intensive care unit. Acta Med Iran 53(9):562–567
plainn = 1,769- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the empiric phase—before causative agent(s) and susceptibilities are known, the optimal choice of antibiotic therapy depends on the local prevalence of resistant organisms, patient risk factors for resistant organisms, and the severity of illness.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“This was borne out in a recent systematic review with meta-analysis of 10 RCTs, no differences in mortality or other patient-important outcomes between empiric mono- vs. combination antibiotic therapy in adult ICU patients with severe sepsis or septic shock were observed, also when taking disease severity into consideration [160].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [160] Sjovall F, Perner A, Hylander MM (2017) Empirical mono- versus combination antibiotic therapy in adult intensive care patients with severe sepsis—a systematic review with meta-analysis and trial sequential analysis. J Infect 74(4):331–344 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Among undifferentiated patients with pneumonia or sepsis, broad-spectrum regimens including agents active against MRSA were associated with higher mortality, particularly among patients without MRSA [137, 151, 155, 156].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [137] Rhee C, Kadri SS, Dekker JP et al (2020) Prevalence of antibiotic-resistant pathogens in culture-proven sepsis and outcomes associated with inadequate and broad-spectrum empiric antibiotic use. JAMA Netw Open 3(4):e202899 source
- Not checked yetcites [151] Kett DH, Cano E, Quartin AA et al (2011) Implementation of guidelines for management of possible multidrug-resistant pneumonia in intensive care: an observational, multicentre cohort study. Lancet Infect Dis 11(3):181–189 source
- Not checked yetcites [155] Jones BE, Ying J, Stevens V, et al (2020) Empirical anti-MRSA vs standard antibiotic therapy and risk of 30-day mortality in patients hospitalized for pneumonia. JAMA Intern Med 180(4):552–560 source
- Not checked yetcites [156] Webb BJ, Sorensen J, Jephson A, et al (2019) Broad-spectrum antibiotic use and poor outcomes in community-onset pneumonia: a cohort study. Eur Respir J 54(1):1900057 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“More recently, SARS-CoV-2 (causing COVID-19) is now responsible for many cases of infection and sepsis [223].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [223] Aziz S, Arabi YM, Alhazzani W, et al (2020) Managing ICU surge during the COVID-19 crisis: rapid guidelines. Intensive Care Med 46(7):1303–1325 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Beta-lactam antibiotics may be subject to changes in important pharmacokinetic parameters in the setting of sepsis and septic shock resulting in sub-therapeutic concentrations [230, 231].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [230] Goncalves-Pereira J, Povoa P (2011) Antibiotics in critically ill patients: a systematic review of the pharmacokinetics of beta-lactams. Crit Care 15(5):R206 source
- Not checked yetcites [231] Mohd Hafiz AA, Staatz CE, Kirkpatrick CM et al (2012) Continuous infusion vs. bolus dosing: implications for beta-lactam antibiotics. Minerva Anestesiol 78(1):94–104
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“In the largest and most recent RCT—EMPIRICUS—there was also no difference in outcome between patients receiving empiric antifungal therapy (micafungin) and patients receiving placebo [174].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [174] Timsit JF, Azoulay E, Schwebel C et al (2016) Empirical micafungin treatment and survival without invasive fungal infection in adults with ICU-acquired sepsis, candida colonization, and multiple organ failure: the EMPIRICUS Randomized Clinical Trial. JAMA 316(15):1555–1564 source
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the directed/targeted phase, once causative agent(s) and susceptibilities are known, sustained double gram-negative coverage is rarely necessary except for patients with highly resistant organisms.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“patients with febrile neutropenia who fail to defervesce after 4–7 days of broad-spectrum antibacterial therapy are at increased risk of having fungal disease (Table 2) [175, 176].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [175] Freifeld AG, Bow EJ, Sepkowitz KA et al (2011) Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis 52(4):e56-93 source
- Not checked yetcites [176] Taplitz RA, Kennedy EB, Bow EJ et al (2018) Outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update. J Clin Oncol 36(14):1443–1453 source
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In the paper
“In a recent large international point prevalence study, viruses were documented in less than 4% of infections [133].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [133] Vincent JL, Sakr Y, Singer M, et al (2020) Prevalence and outcomes of infection among patients in intensive care units in 2017. JAMA 323(15):1478–1487 source
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In the paper
“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].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [12] Rhodes A, Evans LE, Alhazzani W et al (2017) Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med 45(3):486–552 source
- Not checked yetcites [13] Rhodes A, Evans LE, Alhazzani W et al (2017) surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 43(3):304–377 source
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In the paper
“Results from the largest RCT included in the meta-analysis (a comparison of sustained courses of moxifloxacin and meropenem vs meropenem alone in a low endemic resistance setting) were consistent with the findings from the meta-analysis [161].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [161] Brunkhorst FM, Oppert M, Marx G et al (2012) Effect of empirical treatment with moxifloxacin and meropenem vs meropenem on sepsis-related organ dysfunction in patients with severe sepsis: a randomized trial. JAMA 307(22):2390–2399 source
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In the paper
“Viral infections encompass a broad spectrum of pathogens and diseases in humans but—apart from specific clinical situations such as epidemics/pandemics—are rarely the primary cause of sepsis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [133] Vincent JL, Sakr Y, Singer M, et al (2020) Prevalence and outcomes of infection among patients in intensive care units in 2017. JAMA 323(15):1478–1487 source
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As opposed to conventional intermittent infusion (infusion ≤ 30 min), administration by prolonged IV infusion, either as an extended infusion (antibiotic infused over at least half of the dosing interval) or as a continuous infusion, results in sustained beta-lactam concentrations which align with the pharmacodynamics of these drugs.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
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In the paper
“studies showing an association between early discontinuation of MRSA coverage and better outcomes in patients with negative nares or bronchoalveolar lavage (BAL) MRSA PCR [157–159].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [157] Baby N, Faust AC, Smith T, et al (2017) Nasal methicillin-resistant Staphylococcus aureus (MRSA) PCR testing reduces the duration of MRSA-targeted therapy in patients with suspected MRSA pneumonia. Antimicrob Agents Chemother 61(4):e02432-16 source
- Not checked yetcites [158] Cowley MC, Ritchie DJ, Hampton N et al (2019) Outcomes associated with de-escalating therapy for methicillin-resistant Staphylococcus aureus in culture-negative nosocomial pneumonia. Chest 155(1):53–59 source
- Not checked yetcites [159] Paonessa JR, Shah RD, Pickens CI et al (2019) Rapid detection of methicillin-resistant Staphylococcus aureus in BAL: a pilot randomized controlled trial. Chest 155(5):999–1007 source
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In the paper
“Published guidelines for the management of community-acquired pneumonia recommend initiation of antimicrobials for patients with community-acquired pneumonia regardless of procalcitonin level [132].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [132] Metlay JP, Waterer GW, Long AC et al (2019) Diagnosis and treatment of adults with community-acquired pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 200(7):e45–e67 source
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In the paper
“Two meta-analyses reported similar results supporting reduced short-term mortality (RR 0.70; 95% CI 0.57–0.87) with prolonged infusion of beta-lactams [232, 233].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [232] Roberts JA, Abdul-Aziz MH, Davis JS et al (2016) Continuous versus intermittent beta-lactam infusion in severe sepsis. A meta-analysis of individual patient data from randomized trials. Am J Respir Crit Care Med 194(6):681–691 source
- Not checked yetcites [233] Vardakas KZ, Voulgaris GL, Maliaros A et al (2018) Prolonged versus short-term intravenous infusion of antipseudomonal beta-lactams for patients with sepsis: a systematic review and meta-analysis of randomised trials. Lancet Infect Dis 18(1):108–120 source
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In the paper
“or length of hospitalisation (MD 7.00 days; 95% CI −26.24 to 12.24).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [129] Jensen JU, Hein L, Lundgren B et al (2011) Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial. Crit Care Med 39(9):2048–2058 source
- Not checked yetcites [130] Layios N, Lambermont B, Canivet JL et al (2012) Procalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients. Crit Care Med 40(8):2304–2309 source
- Not checked yetcites [131] Najafi A, Khodadadian A, Sanatkar M et al (2015) The comparison of procalcitonin guidance administer antibiotics with empiric antibiotic therapy in critically ill patients admitted in intensive care unit. Acta Med Iran 53(9):562–567
plainn = 1,769- Asserted: passes — The authors put it forward as true.
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In the paper
“MRSA accounts for approximately 5% of culture-positive infections among critically ill patients [133]”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [133] Vincent JL, Sakr Y, Singer M, et al (2020) Prevalence and outcomes of infection among patients in intensive care units in 2017. JAMA 323(15):1478–1487 source
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The failure to show benefit with source control implemented in less than 6 h may be a consequence of the limited number of patients and the heterogeneity of the intervention.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Removal of a potentially infected intravascular access device is considered a part of adequate source control [262].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [262] Jimenez MF, Marshall JC, International Sepsis F (2001) Source control in the management of sepsis. Intensive Care Med 27(Suppl 1):S49-62 source
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In the paper
“Given the lack of definitive and generalizable data regarding the optimal duration of therapy for patients who are critically ill, it is not surprising that there is considerably practice variation [281, 294].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [281] Fernandez-Lazaro CI, Brown KA, Langford BJ et al (2019) Late-career physicians prescribe longer courses of antibiotics. Clin Infect Dis 69(9):1467–1475 source
- Not checked yetcites [294] Corona A, Bertolini G, Ricotta AM et al (2003) Variability of treatment duration for bacteraemia in the critically ill: a multinational survey. J Antimicrob Chemother 52(5):849–852 source
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In the paper
“Administration of antibiotics using an approach that adheres to PK/PD principles and using dosing regimens developed in patients with sepsis and septic shock is more likely to result in effective and safe drug concentrations compared to use of dosing recommendations provided in the manufacturer’s product information [247].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [247] Guilhaumou R, Benaboud S, Bennis Y et al (2019) Optimization of the treatment with beta-lactam antibiotics in critically ill patients-guidelines from the French Society of Pharmacology and Therapeutics (Societe Francaise de Pharmacologie et Therapeutique-SFPT) and the French Society of Anaesthesia and Intensive Care Medicine (Societe Francaise d’Anesthesie et Reanimation-SFAR). Crit Care 23(1):104 source
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In the paper
“Administration of a loading dose of antibiotic before prolonged infusion is essential to avoid delays to achieving effective beta-lactam concentrations [234].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [234] De Waele JJ, Lipman J, Carlier M et al (2015) Subtleties in practical application of prolonged infusion of beta-lactam antibiotics. Int J Antimicrob Agents 45(5):461–463 source
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In the paper
“In the absence of septic shock or fungemia, some implanted tunnelled catheter infections may be treated effectively with prolonged antimicrobial therapy if removal of the catheter is not practical [273].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [273] Mermel LA, Allon M, Bouza E et al (2009) Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis 49(1):1–45 source
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In the paper
“Augmented renal clearance [240], AKI [241], hypoalbuminemia [242], RRT [243, 244], and extracorporeal membrane oxygenation [245, 246] are examples of common scenarios that affect the concentrations of some antibiotics.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [240] Nelson NR, Morbitzer KA, Jordan JD et al (2019) The impact of capping creatinine clearance on achieving therapeutic vancomycin concentrations in neurocritically ill patients with traumatic brain injury. Neurocrit Care 30(1):126–131 source
- Not checked yetcites [241] Gregoire N, Marchand S, Ferrandiere M et al (2019) Population pharmacokinetics of daptomycin in critically ill patients with various degrees of renal impairment. J Antimicrob Chemother 74(1):117–125
- Not checked yetcites [242] Ulldemolins M, Roberts JA, Rello J et al (2011) The effects of hypoalbuminaemia on optimizing antibacterial dosing in critically ill patients. Clin Pharmacokinet 50(2):99–110 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Appropriate source control is a key principle in the management of sepsis and septic shock [12, 13].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [12] Rhodes A, Evans LE, Alhazzani W et al (2017) Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med 45(3):486–552 source
- Not checked yetcites [13] Rhodes A, Evans LE, Alhazzani W et al (2017) surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 43(3):304–377 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Some studies in critically ill patients have reported benefits in terms of clinical cure [237, 250–253].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [237] Roberts JA, Abdul-Aziz MH, Lipman J et al (2014) Individualised antibiotic dosing for patients who are critically ill: challenges and potential solutions. Lancet Infect Dis 14(6):498–509 source
- Not checked yetcites [250] McKinnon PS, Paladino JA, Schentag JJ (2008) Evaluation of area under the inhibitory curve (AUIC) and time above the minimum inhibitory concentration (T>MIC) as predictors of outcome for cefepime and ceftazidime in serious bacterial infections. Int J Antimicrob Agents 31(4):345–351 source
- Not checked yetcites [251] Rayner CR, Forrest A, Meagher AK et al (2003) Clinical pharmacodynamics of linezolid in seriously ill patients treated in a compassionate use programme. Clin Pharmacokinet 42(15):1411–1423 source
- Not checked yetcites [252] Rubino CM, Bhavnani SM, Forrest A et al (2012) Pharmacokinetics-pharmacodynamics of tigecycline in patients with community-acquired pneumonia. Antimicrob Agents Chemother 56(1):130–136 source
- Not checked yetcites [253] Wong G, Taccone F, Villois P et al (2020) beta-Lactam pharmacodynamics in Gram-negative bloodstream infections in the critically ill. J Antimicrob Chemother 75(2):429–433
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The optimal duration of antimicrobial therapy for a given patient with sepsis or septic shock depends on many factors, including host, microbe, drug, and anatomical site (Table 2) [99, 100].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [99] Klompas M, Calandra T, Singer M (2018) Antibiotics for sepsis-finding the equilibrium. JAMA 320(14):1433–1434 source
- Not checked yetcites [100] Prescott HC, Iwashyna TJ (2019) Improving sepsis treatment by embracing diagnostic uncertainty. Ann Am Thorac Soc 16(4):426–429 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Although there are no data on this topic directly derived from adults with sepsis and septic shock, data from a broader patient population, critically ill patients, support an increased likelihood of achieving effective and safe antibiotic concentrations when applying PK/PD principles to dosing [248].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [248] Turner RB, Kojiro K, Shephard EA et al (2018) Review and validation of bayesian dose-optimizing software and equations for calculation of the vancomycin area under the curve in critically ill patients. Pharmacotherapy 38(12):1174–1183 source
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In the paper
“Source control of infectious foci was associated with improved survival in recent observational and cluster randomised studies [120, 263, 264].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [120] Bloos F, Ruddel H, Thomas-Ruddel D et al (2017) Effect of a multifaceted educational intervention for anti-infectious measures on sepsis mortality: a cluster randomized trial. Intensive Care Med 43(11):1602–1612 source
- Not checked yetcites [263] Kim H, Chung SP, Choi SH et al (2019) Impact of timing to source control in patients with septic shock: a prospective multi-center observational study. J Crit Care 53:176–182 source
- Not checked yetcites [264] Martinez ML, Ferrer R, Torrents E et al (2017) Impact of Source Control in Patients With Severe Sepsis and Septic Shock. Crit Care Med 45(1):11–19 source
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In the paper
“In the pre-specified subgroup of patients admitted with sepsis in all participating ICUs, 30-day mortality was lower in those receiving balanced solutions, compared to normal saline (OR 0.80; 95% CI 0.67−0.94).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [334] Semler MW, Self WH, Wanderer JP et al (2018) Balanced crystalloids versus saline in critically ill adults. N Engl J Med 378(9):829–839 source
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In the paper
“Similarly, another RCT did not find an effect on mortality with gelatin use (RR 0.87; 95% CI 0.66–1.12) [344].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [344] Annane D, Siami S, Jaber S et al (2013) Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with hypovolemic shock: the CRISTAL randomized trial. JAMA 310(17):1809–1817 source
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In the paper
“A meta-analysis found no difference in mortality rates between angiotensin II and norepinephrine (46.2% vs 54.2%; RR 0.85 (95% CI 0.69–1.06); very low quality).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
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In the paper
“Adverse effects of gelatin have been reviewed in a network meta-analysis, which demonstrated higher risk of RRT with gelatin use compared to normal saline (OR 1.27; 95% CrI 0.44–3.64) and balanced crystalloids (OR 1.50; 95% CrI 0.56–3.96) [345].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [345] Rochwerg B, Alhazzani W, Gibson A et al (2015) Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis. Intensive Care Med 41(9):1561–1571 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“however, critically ill patients often receive antimicrobials for more days than necessary [288, 301, 306].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [288] Kalil AC, Metersky ML, Klompas M et al (2016) Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the infectious diseases society of America and the American Thoracic Society. Clin Infect Dis 63(5):e61–e111 source
- Not checked yetcites [301] Pugh R, Grant C, Cooke RP et al (2015) Short-course versus prolonged-course antibiotic therapy for hospital-acquired pneumonia in critically ill adults. Cochrane Database Syst Rev 8:CD007577
- Not checked yetcites [306] Mazuski JE, Sawyer RG, Nathens AB et al (2002) The Surgical Infection Society guidelines on antimicrobial therapy for intra-abdominal infections: evidence for the recommendations. Surg Infect (Larchmt) 3(3):175–233 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In an indirect comparison, a 4-node network meta-analysis conducted in patients with sepsis, showed no clear effect on mortality when compared to crystalloids (OR 1.24; 95% credible interval [CrI] 0.61–2.55) [331].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [331] Rochwerg B, Alhazzani W, Sindi A et al (2014) Fluid resuscitation in sepsis: a systematic review and network meta-analysis. Ann Intern Med 161(5):347–355 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Selepressin at a dose of 2.5 ng/kg/min was demonstrated to be effective in maintaining MAP > 60 mmHg without norepinephrine in about 50% of patients at 12 h and about 70% of patients at 24 h.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [363] Russell JA, Vincent JL, Kjolbye AL et al (2017) Selepressin, a novel selective vasopressin V1A agonist, is an effective substitute for norepinephrine in a phase IIa randomized, placebo-controlled trial in septic shock patients. Crit Care 21(1):213 source
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In the paper
“The primary endpoint, an increase of MAP of at least 10 mmHg or to at least 75 mmHg, was achieved in 114 of 163 patients in the angiotensin II group and in 37 of 158 patients in the placebo group (69.9% vs 23.4%, p < 0.001).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [366] Khanna A, English SW, Wang XS et al (2017) Angiotensin II for the treatment of vasodilatory shock. N Engl J Med 377(5):419–430 source
plaindirectn = 163- Asserted: passes — The authors put it forward as true.
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In the paper
“the main study (the VASST trial) comparing norepinephrine alone to norepinephrine plus vasopressin (0.01–0.03 U/min) showed no improvement in 28-day mortality (39.3% vs 35.4%, p = 0.26) [356].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [356] Russell JA, Walley KR, Singer J et al (2008) Vasopressin versus norepinephrine infusion in patients with septic shock. N Engl J Med 358(9):877–887 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A network meta-analysis of patients with sepsis or septic shock also demonstrated a higher risk of death (OR 1.1; 95% CI 0.99–1.30) and need for RRT (OR 1.39; 95% CI 1.17–1.66) [331] with starches in a direct comparison with crystalloids.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [331] Rochwerg B, Alhazzani W, Sindi A et al (2014) Fluid resuscitation in sepsis: a systematic review and network meta-analysis. Ann Intern Med 161(5):347–355 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“In a systematic review of RCTs including patients with hypovolemia, gelatin use increased the risk of anaphylaxis (RR 3.01; 95% CI 1.27–7.14) in comparison with crystalloids use [346].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [346] Moeller C, Fleischmann C, Thomas-Rueddel D et al (2016) How safe is gelatin? A systematic review and meta-analysis of gelatin-containing plasma expanders vs crystalloids and albumin. J Crit Care 35:75–83 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“although a single centre study reported decreased hospital costs associated with PCT-guided antibiotic in medical ICU patient with undifferentiated sepsis [323].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [323] Collins CD, Brockhaus K, Sim T et al (2019) Analysis to determine cost-effectiveness of procalcitonin-guided antibiotic use in adult patients with suspected bacterial infection and sepsis. Am J Health Syst Pharm 76(16):1219–1225 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The meta-analysis of the two studies did not show significant difference in mortality [selepressin: 41.8% vs norepinephrine: 40.45%; RR 0.99 (95% CI 0.84–1.18)].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The absence of clear benefit following the administration of colloids compared to crystalloid solutions supports the use of crystalloid solutions in the resuscitation of patients with sepsis and septic shock [324].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [324] Lewis SR, Pritchard MW, Evans DJ et al (2018) Colloids versus crystalloids for fluid resuscitation in critically ill people. Cochrane Database Syst Rev 8:CD000567
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“Procalcitonin has been studied most extensively both in critically ill and non-critically ill patients, both for initiation and discontinuation of therapy [307].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [307] van Engelen TSR, Wiersinga WJ, Scicluna BP et al (2018) Biomarkers in Sepsis. Crit Care Clin 34(1):139–152 source
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“it is more costly and there is no clear benefit with its routine use.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plainn = 12,492- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: Albumin is more costly than crystalloids.
In the paper
“In the SPLIT multicentre, double-blinded clinical trial, the comparison between balanced solutions and normal saline yielded no differences in mortality or AKI [332].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [332] Young P, Bailey M, Beasley R et al (2015) Effect of a buffered crystalloid solution vs saline on acute kidney injury among patients in the intensive care unit: the SPLIT Randomized Clinical Trial. JAMA 314(16):1701–1710 source
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The modest volume of infused fluid, the predominance of surgical patients, and the low number of septic patients (4%) precludes generalizability of the results.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“a network meta-analysis of 14 RCTs of patients with sepsis showed in an indirect comparison that balanced crystalloids were associated with decreased mortality, compared to saline [331].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [331] Rochwerg B, Alhazzani W, Sindi A et al (2014) Fluid resuscitation in sepsis: a systematic review and network meta-analysis. Ann Intern Med 161(5):347–355 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“There was no significant difference between the vasopressin and norepinephrine groups in 28-day mortality [30.9% vs 27.5%; RR 1.13 (95% CI 0.85–1.51).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [354] Gordon AC, Mason AJ, Thirunavukkarasu N et al (2016) Effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock: the VANISH randomized clinical trial. JAMA 316(5):509–518 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“in a subgroup analysis, patients with less severe shock receiving norepinephrine < 15 μg/min had improved survival with the addition of vasopressin (26.5% vs. 35.7%, p = 0.05).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [356] Russell JA, Walley KR, Singer J et al (2008) Vasopressin versus norepinephrine infusion in patients with septic shock. N Engl J Med 358(9):877–887 source
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the use of balanced solutions in sepsis may be associated with improved outcomes compared with chloride-rich solutions.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The primary outcome, a composite outcome including mortality, new RRT or persistent renal dysfunction (major adverse kidney event within 30 days, MAKE30), was similar between groups (24.6% vs. 24.7%).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [333] Semler MW, Wanderer JP, Ehrenfeld JM et al (2017) Balanced crystalloids versus saline in the intensive care unit. The SALT Randomized Trial. Am J Respir Crit Care Med 195(10):1362–1372 source
plainn = 974- Asserted: passes — The authors put it forward as true.
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In the paper
“The largest clinical trial in sepsis, the ALBIOS trial comparing a combination of albumin and crystalloids to crystalloids alone in 1818 patients with sepsis or septic shock did not demonstrate a difference in 28-day (RR 1.0; 95% CI 0.87–1.14) or 90-day mortality (RR 0.94; 95% CI 0.85–1.05) [339].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [339] Caironi P, Tognoni G, Gattinoni L (2014) Albumin replacement in severe sepsis or septic shock. N Engl J Med 371(1):84 source
boostedn = 1,818- Asserted: passes — The authors put it forward as true.
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In the paper
“In an indirect comparison, a network meta-analysis did not find any significant difference between epinephrine and vasopressin in terms of mortality (RR 0.94; 95% CI 0.47–1.88) [362].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [362] Belletti A, Benedetto U, Biondi-Zoccai G et al (2017) The effect of vasoactive drugs on mortality in patients with severe sepsis and septic shock. A network meta-analysis of randomized trials. J Crit Care 37:91–98 source
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no clear increase in adverse events with the use of angiotensin II.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“Both VANISH and VASST demonstrated a catecholamine-sparing effect of vasopressin; as such, the early use of vasopressin in combination with norepinephrine may help reduce the adrenergic burden associated with traditional vasoactive agents [357].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [357] Ukor IF, Walley KR (2019) Vasopressin in Vasodilatory Shock. Crit Care Clin 35(2):247–261 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Another meta-analysis of RCTs on distributive shock showed a lower risk of atrial fibrillation with the combination of vasopressin and norepinephrine compared to norepinephrine alone [358].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [358] McIntyre WF, Um KJ, Alhazzani W et al (2018) Association of vasopressin plus catecholamine vasopressors vs catecholamines alone with atrial fibrillation in patients with distributive shock: a systematic review and meta-analysis. JAMA 319(18):1889–1900 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“A meta-analysis of seven RCTs comparing levosimendan with dobutamine showed that levosimendan was not superior to dobutamine in adults with sepsis in terms of mortality (OR 0.80; 95% CI 0.48, 1.33; p = 0.39) [374].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [374] Bhattacharjee S, Soni KD, Maitra S et al (2017) Levosimendan does not provide mortality benefit over dobutamine in adult patients with septic shock: a meta-analysis of randomized controlled trials. J Clin Anesth 39:67–72 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“There were three cases of mesenteric ischaemia in the terlipressin group versus one in the norepinephrine group.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [367] Liu ZM, Chen J, Kou Q et al (2018) Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre, randomised, double-blinded trial. Intensive Care Med 44(11):1816–1825 source
plainn = 3- Asserted: passes — The authors put it forward as true.
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In the paper
“Other authors also showed that central lines could be avoided by peripheral line insertion [387].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [387] Cardenas-Garcia J, Schaub KF, Belchikov YG et al (2015) Safety of peripheral intravenous administration of vasoactive medication. J Hosp Med 10(9):581–585 source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The occurrence of local tissue injury may be more likely with prolonged administration of vasopressors.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [389] Loubani OM, Green RS (2015) A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters. J Crit Care 30(3):653e9-17 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“In addition, the inotropic response may be blunted in sepsis with a preserved chronotropic effect causing tachycardia without an increase in stroke volume (SV) [370].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [370] Dubin A, Lattanzio B, Gatti L (2017) The spectrum of cardiovascular effects of dobutamine—from healthy subjects to septic shock patients. Rev Bras Ter Intensiva 29(4):490–498 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“The lack of availability and expertise in placement of central venous catheters in different settings is an important consideration [55].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [55] Baelani I, Jochberger S, Laimer T et al (2011) Availability of critical care resources to treat patients with severe sepsis or septic shock in Africa: a self-reported, continent-wide survey of anaesthesia providers. Crit Care 15(1):R10 source
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Delay in vasopressor initiation and achieving MAP of 65 is associated with increased mortality [390, 391].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [390] Beck V, Chateau D, Bryson GL et al (2014) Timing of vasopressor initiation and mortality in septic shock: a cohort study. Crit Care 18(3):R97 source
- Not checked yetcites [391] Black LP, Puskarich MA, Smotherman C et al (2020) Time to vasopressor initiation and organ failure progression in early septic shock. J Am Coll Emerg Physicians Open 1(3):222–230 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“The four largest clinical trials in sepsis resuscitation used moderate to large amounts of fluids in the first 72 h.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [393] Rivers E, Nguyen B, Havstad S et al (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345(19):1368–1377 source
- Not checked yetcites [64] Investigators P, Yealy DM, Kellum JA et al (2014) A randomized trial of protocol-based care for early septic shock. N Engl J Med 370(18):1683–1693 source
- Not checked yetcites [65] Peake SL, Delaney A, Bellomo R et al (2015) Goal-directed resuscitation in septic shock. N Engl J Med 372(2):190–191
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Although Rivers [393] administered over 13 L of fluids”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [393] Rivers E, Nguyen B, Havstad S et al (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345(19):1368–1377 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A recent systematic review showed that extravasation occurred in 3.4% (95% CI 2.5–4.7%) of patients with no reported episodes of tissue necrosis or limb ischaemia [388].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [388] Tian DH, Smyth C, Keijzers G et al (2020) Safety of peripheral administration of vasopressor medications: a systematic review. Emerg Med Australas 32(2):220–227 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, most patients who had vasopressors started peripherally achieved a MAP > 65 mmHg within 1 h.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [385] Delaney A, Finnis M, Bellomo R et al (2020) Initiation of vasopressor infusions via peripheral versus central access in patients with early septic shock: a retrospective cohort study. Emerg Med Australas 32(2):210–219 source
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In view of the low complication rate and likely higher accuracy of blood pressure measurement, the benefits of arterial catheters probably outweigh the risks.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“A meta-analysis of three RCTs (n = 781) showed that levosimendan, compared to no inotropic agents, did not impact mortality (RR 0.87; 95% CI 0.59–1.28).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [373] Gordon AC, Perkins GD, Singer M et al (2016) Levosimendan for the prevention of acute organ dysfunction in sepsis. N Engl J Med 375(17):1638–1648 source
plainn = 781- Asserted: passes — The authors put it forward as true.
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In the paper
“Indirect comparison from network meta-analysis showed that dobutamine with norepinephrine had no clear impact on mortality when compared to no inotropic agents (OR 0.69; 95% CI 0.32–1.47) [362].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [362] Belletti A, Benedetto U, Biondi-Zoccai G et al (2017) The effect of vasoactive drugs on mortality in patients with severe sepsis and septic shock. A network meta-analysis of randomized trials. J Crit Care 37:91–98 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The administration of vasopressors through peripheral IV catheters is generally safe.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [388] Tian DH, Smyth C, Keijzers G et al (2020) Safety of peripheral administration of vasopressor medications: a systematic review. Emerg Med Australas 32(2):220–227 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In an indirect comparison of dobutamine versus epinephrine, a network meta-analysis showed no clear effect on mortality (OR 1.18; 95% CI 0.47–3.97) [362].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [362] Belletti A, Benedetto U, Biondi-Zoccai G et al (2017) The effect of vasoactive drugs on mortality in patients with severe sepsis and septic shock. A network meta-analysis of randomized trials. J Crit Care 37:91–98 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, these effects may not be predictable [370].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [370] Dubin A, Lattanzio B, Gatti L (2017) The spectrum of cardiovascular effects of dobutamine—from healthy subjects to septic shock patients. Rev Bras Ter Intensiva 29(4):490–498 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“a study of mostly senior resident doctors in Nigeria concluded that knowledge of central venous catheter placement was limited [392].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [392] Edaigbini SAAM, Delia IZ, Ibrahim A, Okwunodulo O, Alegbejo-Olarinoye M (2017) Clinical competence with central venous lines by resident doctors in a Nigerian teaching hospital. Sub-Saharan Afr J Med 4:47–51 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Administration of vasopressors for a short period of time (< 6 h) in a well-placed peripheral catheter proximal to the antecubital fossa is unlikely to cause local tissue injury [389].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [389] Loubani OM, Green RS (2015) A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters. J Crit Care 30(3):653e9-17 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Given the low complication rate of peripheral vasopressors and the possibility of restoring blood pressure faster, the benefits of initiating vasopressors for a short period of time in a vein proximal to the antecubital fossa probably outweigh the risks.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The current evidence evaluating a restrictive IV fluid strategy in the management of septic patients varies with respect to the inclusion criteria, the definition of restrictive and liberal fluid strategies, the criteria guiding the administration of additional IV fluids (e.g., perfusion parameters vs. haemodynamic variables), and the duration of the interventions [397–401].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [397] Chen C, Kollef MH (2015) Targeted fluid minimization following initial resuscitation in septic shock: a pilot study. Chest 148(6):1462–1469 source
- Not checked yetcites [398] Corl KA, Prodromou M, Merchant RC et al (2019) The restrictive IV Fluid trial in severe sepsis and septic shock (RIFTS): a randomized pilot study. Crit Care Med 47(7):951–959 source
- Not checked yetcites [399] Hjortrup PB, Haase N, Bundgaard H et al (2016) Restricting volumes of resuscitation fluid in adults with septic shock after initial management: the CLASSIC randomised, parallel-group, multicentre feasibility trial. Intensive Care Med 42(11):1695–1705 source
- Not checked yetcites [400] Macdonald SPJ, Keijzers G, Taylor DM et al (2018) Restricted fluid resuscitation in suspected sepsis associated hypotension (REFRESH): a pilot randomised controlled trial. Intensive Care Med 44(12):2070–2078 source
- Not checked yetcites [401] Semler MW, Janz DR, Casey JD, et al (2019) Conservative fluid management after sepsis resuscitation: a pilot randomized trial. J Intensive Care Med 35(12):1374–1382. https://doi.org/10.1177/0885066618823183 source
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In the paper
“Several meta-analyses suggest decreased mortality in patients with a pressure- and volume-limited strategy for established ARDS [353, 354].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [353] Landry DW, Levin HR, Gallant EM et al (1997) Vasopressin deficiency contributes to the vasodilation of septic shock. Circulation 95(5):1122–1125 source
- Not checked yetcites [354] Gordon AC, Mason AJ, Thirunavukkarasu N et al (2016) Effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock: the VANISH randomized clinical trial. JAMA 316(5):509–518 source
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In the paper
“A recent systematic review which included five RCTs also identified a strong relationship between plateau pressure and mortality [434].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [434] Papazian L, Aubron C, Brochard L et al (2019) Formal guidelines: management of acute respiratory distress syndrome. Ann Intensive Care 9(1):69 source
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In the paper
“In that trial, conservative oxygen therapy in the ICU was associated with a markedly lower rate of death than usual oxygen therapy [404].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [404] Girardis M, Busani S, Damiani E et al (2016) Effect of Conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial. JAMA 316(15):1583–1589 source
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In the paper
“Since the last guideline distribution, only one additional study was added for analysis [420].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [420] Belenguer-Muncharaz A, Cubedo-Bort M, Blasco-Asensio D et al (2017) Non-invasive ventilation versus invasive mechanical ventilation in patients with hypoxemic acute respiratory failure in an Intensive Care Unit. A randomized controlled study. Minerva Pneumologica 56:1–10
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In the paper
“This recommendation is unchanged from the previous guidelines, as no new trials evaluating plateau pressure have been published since then.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“These findings are at variance with the results of a previous single-centre trial, which was stopped early after an unplanned interim analysis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“However, HFNC is less effective at reducing work of breathing and supplying a moderate or higher level of PEEP [410].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [410] Mauri T, Turrini C, Eronia N et al (2017) Physiologic effects of high-flow nasal cannula in acute hypoxemic respiratory failure. Am J Respir Crit Care Med 195(9):1207–1215 source
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In the paper
“No single mode of ventilation (pressure control, volume control) has consistently been shown to be advantageous when compared with any other that respects the same principles of lung protection.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“The evidence for the use of conservative oxygen targets (generally defined as PaO2 55–70 mmHg; SpO2 88–92%) and therapy in patients with sepsis is limited, with three randomised trials in the critically ill population [404–406].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [404] Girardis M, Busani S, Damiani E et al (2016) Effect of Conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial. JAMA 316(15):1583–1589 source
- Not checked yetcites [405] Investigators I-R, the A, New Zealand Intensive Care Society Clinical Trials G et al (2020) Conservative Oxygen Therapy during Mechanical Ventilation in the ICU. N Engl J Med 382(11):989–998 source
- Not checked yetcites [406] Panwar R, Hardie M, Bellomo R et al (2016) Conservative versus liberal oxygenation targets for mechanically ventilated patients. A pilot multicenter randomized controlled trial. Am J Respir Crit Care Med 193(1):43–51 source
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In the paper
“Several multicentre RCTs have been performed in patients with established ARDS to evaluate the effects of limiting inspiratory pressure through moderation of tidal volume [424–427].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [424] Brower RG, Matthay MA, Acute Respiratory Distress Syndrome N et al (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342(18):1301–1308 source
- Not checked yetcites [425] Amato MB, Barbas CS, Medeiros DM et al (1998) Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 338(6):347–354 source
- Not checked yetcites [426] Brochard L, Roudot-Thoraval F, Roupie E et al (1998) Tidal volume reduction for prevention of ventilator-induced lung injury in acute respiratory distress syndrome. The Multicenter Trail Group on Tidal Volume reduction in ARDS. Am J Respir Crit Care Med 158(6):1831–1838 source
- Not checked yetcites [427] Brower RG, Shanholtz CB, Fessler HE et al (1999) Prospective, randomized, controlled clinical trial comparing traditional versus reduced tidal volume ventilation in acute respiratory distress syndrome patients. Crit Care Med 27(8):1492–1498 source
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In the paper
“A recent patient-level mediation analysis suggested that a tidal volume that results in a driving pressure (plateau pressure minus set PEEP) below 12–15 cm H2O may be advantageous in patients without spontaneous breathing efforts [433].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [433] Amato MB, Meade MO, Slutsky AS et al (2015) Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 372(8):747–755 source
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In the paper
“The use of lung-protective strategies for patients with ARDS is supported by clinical trials and has been widely accepted; however, the precise tidal volume for an individual ARDS patient requires adjustment for factors such as the plateau pressure, the selected positive end-expiratory pressure (PEEP), thoracoabdominal compliance, and the patient’s breathing effort.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“A few small RCTs have shown benefit with NIV for early or mild ARDS or de novo hypoxic respiratory failure [418, 419].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [418] Antonelli M, Conti G, Rocco M et al (1998) A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. N Engl J Med 339(7):429–435 source
- Not checked yetcites [419] Honrubia T, Garcia Lopez FJ, Franco N et al (2005) Noninvasive vs conventional mechanical ventilation in acute respiratory failure: a multicenter, randomized controlled trial. Chest 128(6):3916–3924 source
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In the paper
“In a post hoc analysis of patients with severe hypoxemia (PaO2/FiO2 ≤ 200 mmHg) from the above trial, HFNC resulted in lower intubation rates compared with NIV (35 versus 58 percent, respectively).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [411] Frat JP, Thille AW, Mercat A et al (2015) High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med 372(23):2185–2196 source
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In the paper
“Of note, the studies that guide the recommendations in this section enrolled patients using criteria from the American-European Consensus Criteria Definition for Acute Lung Injury and ARDS [422].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [422] Bernard GR, Artigas A, Brigham KL et al (1994) The American-European Consensus Conference on ARDS definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 149(3 Pt 1):818–824 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In a recent systematic review and meta-analysis of multiple clinical syndromes, investigators found that a conservative oxygen strategy was associated with a lower rate of death in acutely ill adults than a liberal oxygen strategy [407].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [407] Chu DK, Kim LH, Young PJ et al (2018) Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet 391(10131):1693–1705 source
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In the paper
“For example, the LUNG SAFE trial demonstrated that NIV was used in 15% of patients with ARDS with varying failure and mortality rates, depending on ARDS severity [417].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [417] Bellani G, Laffey JG, Pham T et al (2017) Noninvasive ventilation of patients with acute respiratory distress syndrome. Insights from the LUNG SAFE Study. Am J Respir Crit Care Med 195(1):67–77 source
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In the paper
“When comparing the strategies of NIV versus HFNC for acute hypoxemic respiratory failure despite conventional oxygen, a single, large randomised trial has been conducted for direct comparison [411].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [411] Frat JP, Thille AW, Mercat A et al (2015) High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med 372(23):2185–2196 source
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In the paper
“The largest trial of a volume- and pressure-limited strategy showed 9% absolute decrease in mortality in ARDS patients ventilated with tidal volumes of 6 mL/kg compared with 12 mL/ kg predicted body weight (PBW), and aiming for plateau pressure ≤ 30 cm H2O [424].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [424] Brower RG, Matthay MA, Acute Respiratory Distress Syndrome N et al (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342(18):1301–1308 source
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In the paper
“Conversely, patients with very stiff chest/ abdominal walls and high pleural pressures may tolerate plateau pressures > 30 cm H2O because transpulmonary pressures will be lower.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“A secondary analysis of five observational studies identified a plateau pressure cut-off value of 29 cm H2O, above which an ordinal increment was accompanied by an increment of risk of death [436].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [436] Villar J, Martin-Rodriguez C, Dominguez-Berrot AM et al (2017) A quantile analysis of plateau and driving pressures: effects on mortality in patients with acute respiratory distress syndrome receiving lung-protective ventilation. Crit Care Med 45(5):843–850 source
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In the paper
“At this point in time, there is insufficient evidence to make an evidence-based recommendation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“Patients requiring HFNC for acute hypoxemic respiratory failure are at high risk of requiring intubation; therefore, such trials must be accompanied by careful surveillance for ventilatory failure.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“Due to the presence of significant statistical and clinical heterogeneity, a meta-analysis of all seven trials was not appropriate.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“This repeat meta-analysis confirmed the results from the previous published work: In patients with ARDS and a PaO2/FiO2 ratio < 200, the use of prone compared with supine position within the first 36 h of intubation, when performed for > 12 h a day, showed improved survival.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [454] Munshi L, Del Sorbo L, Adhikari NKJ et al (2017) Prone position for acute respiratory distress syndrome. A systematic review and meta-analysis. Ann Am Thorac Soc 14(Supplement_4):S280-s8 source
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In the paper
“There were no new randomised, controlled trials evaluating the use of prone ventilation in sepsis induced severe ARDS published since the 2016 guidelines.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“There are limited data on ventilation strategies for patients with sepsis-induced respiratory failure who do not meet criteria for ARDS.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“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].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [12] Rhodes A, Evans LE, Alhazzani W et al (2017) Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med 45(3):486–552 source
- Not checked yetcites [13] Rhodes A, Evans LE, Alhazzani W et al (2017) surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 43(3):304–377 source
- Not checked yetcites [226] Alhazzani W, Moller MH, Arabi YM et al (2020) Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med 46(5):854–887 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“We included three multicentre RCTs [439–441] and one pilot RCT [442], investigating use of higher PEEP versus lower PEEP strategies in conjunction with low tidal volumes for the management of patients with ARDS.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [439] Brower RG, Lanken PN, MacIntyre N et al (2004) Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med 351(4):327–336 source
- Not checked yetcites [440] Meade MO, Cook DJ, Guyatt GH et al (2008) Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 299(6):637–645 source
- Not checked yetcites [441] Mercat A, Richard JC, Vielle B et al (2008) Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 299(6):646–655 source
- Not checked yetcites [442] Kacmarek RM, Villar J, Sulemanji D et al (2016) Open lung approach for the acute respiratory distress syndrome: a pilot randomized. controlled trial. Crit Care Med 44(1):32–42 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A PEEP > 5 cm H2O is usually required to avoid lung collapse [446].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [446] Gattinoni L, Caironi P, Cressoni M et al (2006) Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med 354(17):1775–1786 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Our conclusions did not change in a sensitivity analysis which includes these two trials.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
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In the paper
“In addition, use of NMBA may reduce oxygen consumption by decreasing the work of breathing [464].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [464] Hansenflaschen JH, Brazinsky S, Basile C et al (1991) USE OF sedating drugs and neuromuscular blocking-agents in patients requiring mechanical ventilation for respiratory-failure—a National Survey. JAMA 266(20):2870–2875 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“There is not as strong an evidence base, however, for the patients presenting with acute respiratory failure requiring mechanical ventilation who do not fulfil the criteria for ARDS.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A 2015 systematic review and meta-analysis found a reduction in the risk of a composite endpoint of ARDS or pneumonia during the hospital stay in the low tidal volume ventilation group compared to the high tidal volume ventilation group (RR 0.72; 95% CI 0.52–0.98) [450].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [450] Serpa Neto A, Cardoso SO, Manetta JA et al (2012) Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis. JAMA 308(16):1651–1659 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Instead of the “traditional” recruitment maneuver which consists of the application of sustained continuous positive airway pressure (e.g., 30–40 cm H2O for 30–40 s), both trials conducted lung recruitment with incremental PEEP levels, followed by a decremental PEEP titration according to either best respiratory-system static compliance [452] or oxygen saturation [437].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [452] Cavalcanti AB, Suzumura ÉA, Laranjeira LN et al (2017) Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 318(14):1335–1345 source
- Not checked yetcites [437] Hodgson CL, Cooper DJ, Arabi Y et al (2019) Maximal recruitment open lung ventilation in acute respiratory distress syndrome (PHARLAP). A phase II, multicenter randomized controlled clinical trial. Am J Respir Crit Care Med 200(11):1363–1372 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Esophageal pressure guided PEEP titration has been evaluated in two trials [447, 448].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [447] Beitler JR, Sarge T, Banner-Goodspeed VM et al (2019) Effect of titrating positive end-expiratory pressure (PEEP) with an esophageal pressure-guided strategy vs an empirical high PEEP-Fio2 strategy on death and days free from mechanical ventilation among patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 321(9):846–857 source
- Not checked yetcites [448] Talmor D, Sarge T, Malhotra A et al (2008) Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med 359(20):2095–2104 source
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, the use of low tidal volume ventilation avoids the risk of promoting ventilator induced lung injury in septic patients in whom the diagnosis of ARDS has been missed.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The evidence in this guideline was downgraded to very low quality due to indirectness.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“It may also be used to facilitate a reduction in the intensity of mechanical ventilation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“At 90 days after randomisation, mortality rate in the liberal group was lower (59% vs 70%) than in the restrictive group (hazard ratio, 0.72; 95% CI 0.53–0.97).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [487] Bergamin FS, Almeida JP, Landoni G et al (2017) Liberal versus restrictive transfusion strategy in critically ill oncologic patients: the transfusion requirements in critically ill oncologic patients randomized controlled trial. Crit Care Med 45(5):766–773 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is used in patients with severe acute respiratory failure to facilitate gas exchange in the setting of refractory hypoxaemia or hypercapnic respiratory acidosis [475].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [475] Munshi L, Walkey A, Goligher E et al (2019) Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a systematic review and meta-analysis. Lancet Respir Med 7(2):163–172 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Since then, three large RCTs have been published [354, 478, 479].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [354] Gordon AC, Mason AJ, Thirunavukkarasu N et al (2016) Effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock: the VANISH randomized clinical trial. JAMA 316(5):509–518 source
- Not checked yetcites [478] Annane D, Renault A, Brun-Buisson C et al (2018) Hydrocortisone plus Fludrocortisone for Adults with Septic Shock. N Engl J Med 378(9):809–818 source
- Not checked yetcites [479] Venkatesh B, Finfer S, Cohen J et al (2018) Adjunctive glucocorticoid therapy in patients with septic shock. N Engl J Med 378(9):797–808 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In the 2016 guidance, the accumulated evidence did not support a recommendation for their use if adequate fluid resuscitation and vasopressor therapy were able to restore haemodynamic stability [12, 13]”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [12] Rhodes A, Evans LE, Alhazzani W et al (2017) Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med 45(3):486–552 source
- Not checked yetcites [13] Rhodes A, Evans LE, Alhazzani W et al (2017) surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 43(3):304–377 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Overall, the quality of evidence is judged as low (Supplementary Appendix 5).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“An updated meta-analysis [480] found systemic corticosteroid to accelerate resolution of shock (MD 1.52 days; 95% CI 1.71–1.32).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [480] Rygård SL, Butler E, Granholm A et al (2018) Low-dose corticosteroids for adult patients with septic shock: a systematic review with meta-analysis and trial sequential analysis. Intensive Care Med 44(7):1003–1016 source
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, the balance of effects (beneficial and undesirable) remains uncertain.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“There were methodological limitations of the included studies.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Overall, the quality of evidence was judged moderate.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A recent meta-analysis published since the finalisation of the literature searches has suggested that there is a higher risk of recurrent Clostridioides difficile infections with proton pump inhibitors [495].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [495] D'Silva KM, Mehta R, Mitchell M, et al (2021) Proton pump inhibitor use and risk for recurrent Clostridioides difficile infection: a systematic review and meta-analysis. Clin Microbiol Infect source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A restrictive strategy is feasible in low- and middle-income countries.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In addition, some of the participants in this trial did not receive the intervention [477].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [477] Peek GJ, Mugford M, Tiruvoipati R et al (2009) Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 374(9698):1351–1363 source
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“The Transfusion requirements in in Critical Care trial (TRICC), which compared a restrictive transfusion threshold of 70 g/L versus 100 g/L in 838 euvolemic ICU patients, demonstrated no difference in the primary outcome (30-day mortality).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [484] Hébert PC, Wells G, Blajchman MA et al (1999) a multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 340(6):409–417 source
- Not checked yetcites [485] Holst LB, Haase N, Wetterslev J et al (2014) Lower versus higher hemoglobin threshold for transfusion in septic shock. N Engl J Med 371(15):1381–1391 source
boostedn = 838- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The overall quality of evidence was moderate.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In the subgroup of 218 patients with sepsis or septic shock 30-day mortality was similar in the two groups (22.8% in the restrictive group vs. 29.7% in the liberal group, p = 0.36).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [484] Hébert PC, Wells G, Blajchman MA et al (1999) a multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 340(6):409–417 source
- Not checked yetcites [485] Holst LB, Haase N, Wetterslev J et al (2014) Lower versus higher hemoglobin threshold for transfusion in septic shock. N Engl J Med 371(15):1381–1391 source
plainn = 218- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This is due to the inclusion of the TRICOP study where lower 28 mortality was observed with a liberal strategy.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaindirectn = 67- Asserted: passes — The authors put it forward as true.
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In the paper
“A sensitivity analysis including only trials at low risk of bias provided similar results.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“No dose response benefit was seen in a prior systematic review and meta-analysis [480].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [480] Rygård SL, Butler E, Granholm A et al (2018) Low-dose corticosteroids for adult patients with septic shock: a systematic review with meta-analysis and trial sequential analysis. Intensive Care Med 44(7):1003–1016 source
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The most widely investigated technique involves the use of polymyxin B-immobilised polystyrene-derived fibers.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Its cost also limits its feasibility in countries with low- and middle-income economies.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The inclusion criteria of the trials were strict and focused on a very sick population of patients with severe ARDS refractory to conventional ventilation strategies and other rescue therapies such as prone position.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“However, one recent systematic review found that VV ECMO delivered at expert centers reduced mortality for patients with severe ARDS [475].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [475] Munshi L, Walkey A, Goligher E et al (2019) Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a systematic review and meta-analysis. Lancet Respir Med 7(2):163–172 source
plaindirect- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The quality of evidence was judged as low.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The overall quality of evidence was rated as moderate: it was downgraded for imprecision.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It was determined that the balance of overall effects favoured LMWH over UFH.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This is principally driven by the higher rate of CVAD infection in the “early” initiation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Two systematic reviews and meta-analyses [501, 502] summarised the total body of evidence: they do not show a difference in mortality between patients who receive continuous (CRRT) versus intermittent haemodialysis (IHD).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [501] Kellum JA, Angus DC, Johnson JP et al (2002) Continuous versus intermittent renal replacement therapy: a meta-analysis. Intensive Care Med 28(1):29–37 source
- Not checked yetcites [502] Tonelli M, Manns B, Feller-Kopman D (2002) Acute renal failure in the intensive care unit: a systematic review of the impact of dialytic modality on mortality and renal recovery. Am J Kidney Dis 40(5):875–885 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“and chronic liver disease (RE 7.64; 95% CI 3.32–17.58).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [496] Granholm A, Zeng L, Dionne JC et al (2019) Predictors of gastrointestinal bleeding in adult ICU patients: a systematic review and meta-analysis. Intensive Care Med 45(10):1347–1359 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This was principally driven by the increased risk of hypoglycemia observed with lower targets.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“It was stopped early, after the second planned interim analysis, for futility.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [507] Barbar SD, Clere-Jehl R, Bourredjem A et al (2018) Timing of renal-replacement therapy in patients with acute kidney injury and sepsis. N Engl J Med 379(15):1431–1442 source
plainn = 488- Asserted: passes — The authors put it forward as true.
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In the paper
“After excluding high risk of bias studies, risk factors included: coagulopathy (relative effect (RE) 4.76; 95% CI 2.62–8.63)”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [496] Granholm A, Zeng L, Dionne JC et al (2019) Predictors of gastrointestinal bleeding in adult ICU patients: a systematic review and meta-analysis. Intensive Care Med 45(10):1347–1359 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“No differential effect was observed in the a priori sepsis subgroup of 1689 patients [508].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [508] Investigators S-A, Canadian Critical Care Trials G, Australian et al (2020) Timing of Initiation of Renal-Replacement Therapy in Acute Kidney Injury. N Engl J Med 383(3):240–251 source
plainn = 1,689- Asserted: passes — The authors put it forward as true.
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In the paper
“shock (RE 2.60; 95% CI 1.25–5.42)”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [496] Granholm A, Zeng L, Dionne JC et al (2019) Predictors of gastrointestinal bleeding in adult ICU patients: a systematic review and meta-analysis. Intensive Care Med 45(10):1347–1359 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, it was judged that the evidence probably favoured the administration of stress ulcer prophylaxis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“No difference in lower extremity ischaemia was demonstrated.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [500] Arabi YM, Al-Hameed F, Burns KEA et al (2019) Adjunctive intermittent pneumatic compression for venous thromboprophylaxis. N Engl J Med 380(14):1305–1315 source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The authors reported no difference for the primary outcome of time alive and free of vasopressors up to 168 h between the intervention and control group (median 122.1 h [IQR 76.3–145.4 h] vs 124.6 h [IQR 82.1–147 h]; p = 0.83).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [524] Fujii T, Luethi N, Young PJ et al (2020) Effect of vitamin C, hydrocortisone, and thiamine vs hydrocortisone alone on time alive and free of vasopressor support among patients with septic shock: the VITAMINS Randomized Clinical Trial. JAMA 323(5):423–431 source
plainn = 211- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It was judged that any effects of the intervention (mechanical prophylaxis in addition to pharmacologic), either beneficial or undesirable, were likely trivial (Supplementary Appendix 5).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The balance of effects favoured neither (IHD) nor CRRT.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On balance, the effect favours the intervention with a moderate quality of evidence.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, the balance of effects favoured delayed rather than early initiation of RRT.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, the balance of effects favoured initiation of insulin therapy at a glucose level of > 180 mg/dl.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“However, hypernatremia, hypocalcaemia, and metabolic alkalosis were observed more frequently in those randomised to bicarbonate.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [528] Jaber S, Paugam C, Futier E et al (2018) Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet 392(10141):31–40 source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“No between-group difference was observed in the primary outcome of a composite of 28-day mortality and organ failure at day 7.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [528] Jaber S, Paugam C, Futier E et al (2018) Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet 392(10141):31–40 source
plainn = 400- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, the quality of evidence is low (Supplementary Appendix 5).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“No difference in the primary outcome of mean SOFA score change at 72 h post enrolment was observed.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [525] Moskowitz A, Huang DT, Hou PC et al (2020) Effect of ascorbic acid, corticosteroids, and thiamine on organ injury in septic shock: the ACTS Randomized Clinical Trial. JAMA 324(7):642–650 source
plainn = 200- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although the available evidence is of low quality, it does not suggest harm following the institution of early enteral feeding.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The overall balance of effects did not favour either early enteral feeding (within 72 h) compared with enteral feeding commenced after that time.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The overall size of any desirable effect was judged as small with a low quality of evidence (Supplementary Appendix 5).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Sepsis was present in 61% (238/389) of patients at the time of randomisation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [528] Jaber S, Paugam C, Futier E et al (2018) Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet 392(10141):31–40 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The institution of early enteral nutrition was also considered feasible in low- and middle-income economies.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“No differential effect was observed between patients with vs without sepsis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [528] Jaber S, Paugam C, Futier E et al (2018) Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet 392(10141):31–40 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, when considering the subset of patients with septic shock, severe metabolic acidosis and AKI, the balance of effects probably favours IV bicarbonate.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The early administration of enteral nutrition in patients with sepsis and septic shock has potential physiologic advantages related to the maintenance of gut integrity and prevention of intestinal permeability, dampening of the inflammatory response, and modulation of metabolic responses that may reduce insulin resistance [529, 530].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [529] Kudsk KA (2002) Current aspects of mucosal immunology and its influence by nutrition. Am J Surg 183(4):390–398 source
- Not checked yetcites [530] McClave SA, Heyland DK (2009) The physiologic response and associated clinical benefits from provision of early enteral nutrition. Nutr Clin Pract 24(3):305–315 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Neither intervention was considered more beneficial when considering resources utilisation, cost effectiveness, and equity issues.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The balance of effects was accordingly judged as favouring neither the intervention nor the comparator.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“At 30 days, 34.7% (35/101) of patients randomised to combination therapy had died vs. 29.3% (29/99) randomised to placebo (HR, 1.3; 95% CI 0.8–2.2; p = 0.26).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [525] Moskowitz A, Huang DT, Hou PC et al (2020) Effect of ascorbic acid, corticosteroids, and thiamine on organ injury in septic shock: the ACTS Randomized Clinical Trial. JAMA 324(7):642–650 source
plainn = 200- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In the subgroup of patients with AKI defined as AKI Network (AKIN) stage 2 or 3 at randomisation (182/389–47%), lower mortality was observed with bicarbonate therapy: control 57/90 (63%), bicarbonate (42/92–46%), absolute risk reduction (ARR) −17.7% (−33.0 to −2.3), p = 0.016.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [528] Jaber S, Paugam C, Futier E et al (2018) Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet 392(10141):31–40 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“1504 (62%) of the participants had sepsis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [531] Reignier J, Boisramé-Helms J, Brisard L et al (2018) Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet 391(10116):133–143 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Ninety-day mortality was 28.6% (30/105) in the vitamin C group, and 24.5% (25/102) in the control group (HR 1.18; 95% CI 0.69–2.0).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [524] Fujii T, Luethi N, Young PJ et al (2020) Effect of vitamin C, hydrocortisone, and thiamine vs hydrocortisone alone on time alive and free of vasopressor support among patients with septic shock: the VITAMINS Randomized Clinical Trial. JAMA 323(5):423–431 source
plainn = 211- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, indirect evidence from these studies was judged likely to apply to patients with sepsis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The quality of evidence was assessed low or very low: downgrades were for risk of bias, inconsistency, and imprecision.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
In the paper
“There was a significant differential effect between patients with an AKIN score of 2 or 3 compared with those with a score of 0–1 (p value for heterogeneity = 0.023).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [528] Jaber S, Paugam C, Futier E et al (2018) Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet 392(10141):31–40 source
plaincorrelationaln = 400 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The panel judged that education would likely have variable acceptability, as a qualitative study showed that patients who survived sepsis had diverse viewpoints ranging from appreciating the education about sepsis to not being able to recall the education session, to even disliking it as a reminder of the severity of their condition [587].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [587] Gehrke-Beck S, Bänfer M, Schilling N et al (2017) The specific needs of patients following sepsis: a nested qualitative interview study. BJGP Open. 1(1):bjgpopen17X100725 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Despite these variations, social and economic screening may identify challenges that sepsis survivors are experiencing, allowing clinicians to identify potential resources and referrals, which can assist to improve long-term health outcomes.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Non-medical social needs and modifiable factors such as economic and social support largely influence health outcomes.
- Rests on an assumption: Long-term health requires survivors to have the resources to recover and thrive.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Given the risk of post-sepsis morbidity, sepsis education may have a role in the timely healthcare seeking behavior in sepsis survivors who experience complications.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“With increased recognition of post-intensive care syndrome (PICS) in survivors of critical illness and their families, peer support represents a patient-centered approach to improve long-term outcomes [552, 553].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [552] McPeake J, Hirshberg EL, Christie LM et al (2019) Models of peer support to remediate post-intensive care xyndrome: a report developed by the Society of Critical Care Medicine Thrive International Peer Support Collaborative. Crit Care Med 47(1):e21–e27 source
- Not checked yetcites [553] Mikkelsen ME, Jackson JC, Hopkins RO et al (2016) Peer support as a novel strategy to mitigate post-intensive care syndrome. AACN Adv Crit Care 27(2):221–229 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Despite the lack of evidence, SDM in discharge planning as in other care decisions is more likely to result in decisions consistent with the values and preferences of the patient and family.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
- Rests on an assumption: Shared decision making is less routinely used in post-ICU and hospital discharge planning than in other aspects of acute patient care.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patient and family involvement in discharge planning may also increase family satisfaction.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Improving handoff at transitions in care represents an opportunity to improve patient outcomes across the entire spectrum of sepsis care, from hospitalisation to return to the community.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Post-critical illness programmes have been developed as a means of screening for and addressing the multi-faceted issues faced by ICU survivors.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sepsis patients, with longer than average hospitalisations and higher comorbidity burden, may be at particular risk for poor outcomes with transitions.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Timely, coordinated resources and provider follow-up may lead to improved QoL for sepsis survivors, however further research on the impact of post-discharge follow-up is needed.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Hospitalisation and ICU admission are high-risk periods for unintentional medication error—both continuations of medications for temporary indications and unintentional discontinuations of chronic medications [596, 599, 600, 602].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [596] Bell CM, Brener SS, Gunraj N et al (2011) Association of ICU or hospital admission with unintentional discontinuation of medications for chronic diseases. JAMA 306:840–847 source
- Not checked yetcites [599] Morandi A, Vasilevskis E, Pandharipande PP et al (2013) Inappropriate medication prescriptions in elderly adults surviving an intensive care unit hospitalization. J Am Geriatr Soc 61:1128–1134 source
- Not checked yetcites [600] Scales DC, Fischer HD, Li P et al (2016) Unintentional continuation of medications intended for acute illness after hospital discharge: A population-based cohort study. J Gen Intern Med 31:196–202 source
- Not checked yetcites [602] Tomichek JE, Stollings JL, Pandharipande PP et al (2016) Antipsychotic prescribing patterns during and after critical illness: a prospective cohort study. Crit Care 20:378 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Long-term impairments in memory, attention, verbal fluency, decision-making and executive functioning may be linked to a variety of mechanisms such as metabolic derangements, cerebral ischaemia, overwhelming inflammation, disrupted blood–brain barrier, oxidative stress, and severe microglial activation, particularly within the limbic system [632].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [632] Annane D, Sharshar T (2015) Cognitive decline after sepsis. Lancet Respir Med 3(1):61–69 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Nonetheless, based on their strong rationale, and benefit in related populations [580] (e.g., older patients with cognitive impairment, patients following stroke or traumatic brain injury), we suggest referral to rehabilitation programmes in survivors of sepsis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [580] Prescott HC, Angus DC (2018) Enhancing recovery from sepsis: a review. JAMA 319(1):62–75 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 234
- Probably not a substantial claim. 64
- The quote only partly states this claim. 6
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“These include a range of adverse events such as allergic or hypersensitivity reactions, kidney injury, thrombocytopenia, Clostridioides difficile infection, and antimicrobial resistance [101–106].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Partly supportedcites [101] Baggs J, Jernigan JA, Halpin AL et al (2018) Risk of subsequent sepsis within 90 days after a hospital stay by type of antibiotic exposure. Clin Infect Dis 66(7):1004–1012 sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) identifies allergic reactions, renal toxicity, and C. difficile infection as harms of antibiotics; its conclusion also names antimicrobial resistance as an outcome stewardship may prevent. The paper does not mention thrombocytopenia, so it supports most, but not all, of the attributed list. (LLM, conf=0.88)
- Not checked yetcites [102] Branch-Elliman W, O’Brien W, Strymish J et al (2019) Association of duration and type of surgical prophylaxis with antimicrobial-associated adverse events. JAMA Surg 154(7):590–598 source
- Partly supportedcites [103] Hranjec T, Rosenberger LH, Swenson B et al (2012) Aggressive versus conservative initiation of antimicrobial treatment in critically ill surgical patients with suspected intensive-care-unit-acquired infection: a quasi-experimental, before and after observational cohort study. Lancet Infect Dis 12(10):774–780 sourceExperimental — accuracy not yet measured
The Introduction (page not provided) identifies resistance as a harm of excessive antimicrobial use, and the Methods list C. difficile infection among the outcomes tracked. The paper does not identify allergic or hypersensitivity reactions, kidney injury, or thrombocytopenia as harms of unnecessary antimicrobials. (LLM, conf=0.86)
- Partly supportedcites [104] Ong DSY, Frencken JF, Klein Klouwenberg PMC et al (2017) Short-course adjunctive gentamicin as empirical therapy in patients with severe sepsis and septic shock: a prospective observational cohort study. Clin Infect Dis 64(12):1731–1736 sourceExperimental — accuracy not yet measured
The Association With Clinical Outcomes section (p. 5) reports that gentamicin exposure was associated with more renal-failure days, supporting kidney injury as a potential harm. The paper does not address allergic or hypersensitivity reactions, thrombocytopenia, or C. difficile infection; its resistance data (pp. 4–5) describe bacteria carried by patients, not resistance caused by unnecessary antimicrobial use. (LLM, conf=0.88)
- Not checked yetcites [105] Tamma PD, Avdic E, Li DX et al (2017) Association of adverse events with antibiotic use in hospitalized patients. JAMA Intern Med 177(9):1308–1315 source
- Partly supportedcites [106] Teshome BF, Vouri SM, Hampton N et al (2019) Duration of exposure to antipseudomonal beta-lactam antibiotics in the critically ill and development of new resistance. Pharmacotherapy 39(3):261–270 sourceExperimental — accuracy not yet measured
The Conclusions report that, among patients with severe sepsis or septic shock, each additional day of antipseudomonal β-lactam exposure was associated with increased risk of new resistance. The cited passages do not support the other listed harms—allergic or hypersensitivity reactions, kidney injury, thrombocytopenia, or Clostridioides difficile infection. Page numbers are not provided in our copy. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The incidence of MRSA varies, however, by region (ranging from ~ 2% in Western Europe to 10% in North America) and by patient-related characteristics [133, 136, 137].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Partly supportedcites [133] Vincent JL, Sakr Y, Singer M, et al (2020) Prevalence and outcomes of infection among patients in intensive care units in 2017. JAMA 323(15):1478–1487 sourceExperimental — accuracy not yet measured
The Prevalence and Characteristics of Infections section reports MRSA in 2% of patients with positive cultures in Western Europe and 10% in North America. These are proportions in a point-prevalence study, not incidence rates. The section associates patient characteristics with infection overall, but does not establish that MRSA specifically varies by those characteristics. (LLM, conf=0.88)
- Partly supportedcites [136] Aliberti S, Reyes LF, Faverio P et al (2016) Global initiative for meticillin-resistant Staphylococcus aureus pneumonia (GLIMP): an international, observational cohort study. Lancet Infect Dis 16(12):1364–1376 sourceExperimental — accuracy not yet measured
The Results (pp. 8–9) support regional variation in MRSA pneumonia prevalence and variation by patient risk factors. But the reported MRSA prevalence is 2.4% in Europe and 4.8% in North America, not about 2% in Western Europe and 10% in North America; the paper studies community-dwelling adults hospitalised with pneumonia, not MRSA incidence generally. (LLM, conf=0.90)
- Partly supportedcites [137] Rhee C, Kadri SS, Dekker JP et al (2020) Prevalence of antibiotic-resistant pathogens in culture-proven sepsis and outcomes associated with inadequate and broad-spectrum empiric antibiotic use. JAMA Netw Open 3(4):e202899 sourceExperimental — accuracy not yet measured
The Results (Patient Characteristics and Pathogen Epidemiology; page not provided) show that MRSA prevalence differed by patient condition: 14.0% among patients with septic shock versus 10.7% among those without it. The paper does not provide the claimed comparison of approximately 2% in Western Europe and 10% in North America; its reported measures are prevalence in a sepsis cohort, not regional incidence. (LLM, conf=0.86)
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Applying a PK/PD approach to antibiotic dosing requires support from knowledgeable clinician team members [254], use of a patient population-specific guideline document [255], use of therapeutic drug monitoring [256], and/or use of dosing software [238, 248].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Supportedcites [254] Fleuren LM, Roggeveen LF, Guo T et al (2019) Clinically relevant pharmacokinetic knowledge on antibiotic dosing among intensive care professionals is insufficient: a cross-sectional study. Crit Care 23(1):185 source
Citation [254] is attached to support from knowledgeable clinician team members, not to the later claims about guidelines, monitoring, or software. The Background says pharmacokinetic knowledge is pivotal to optimizing bedside antibiotic dosing, and the Discussion identifies support from clinical pharmacists and microbiologists as a potential solution. (LLM, conf=0.91)
- Not checked yetcites [255] Ehmann L, Zoller M, Minichmayr IK et al (2019) Development of a dosing algorithm for meropenem in critically ill patients based on a population pharmacokinetic/pharmacodynamic analysis. Int J Antimicrob Agents 54(3):309–317 source
- Not checked yetcites [256] Wong G, Briscoe S, McWhinney B et al (2018) Therapeutic drug monitoring of beta-lactam antibiotics in the critically ill: direct measurement of unbound drug concentrations to achieve appropriate drug exposures. J Antimicrob Chemother 73(11):3087–3094 source
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“smaller studies suggest that source control within 6–12 h is advantageous [265–271]. Studies generally show reduced survival beyond that point.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Supportedcites [265] Azuhata T, Kinoshita K, Kawano D et al (2014) Time from admission to initiation of surgery for source control is a critical determinant of survival in patients with gastrointestinal perforation with associated septic shock. Crit Care 18(3):R87 source
The Results report that 60-day survival decreased as surgery was delayed and was 0% when surgery began more than 6 hours after admission. The Discussion recommends initiating surgical source control in less than 6 hours for patients with gastrointestinal perforation and septic shock, supporting the early-control point at the lower end of the cited 6–12-hour window. (LLM, conf=0.88)
- Partly supportedcites [266] Bloos F, Thomas-Ruddel D, Ruddel H et al (2014) Impact of compliance with infection management guidelines on outcome in patients with severe sepsis: a prospective observational multi-center study. Crit Care 18(2):R42 sourceExperimental — accuracy not yet measured
The Results (Time and adequacy to source control) report higher 28-day mortality when surgical source control was delayed beyond 6 hours, supporting the early-control part of the claim. The Discussion says the 12-hour window is a guideline recommendation and that evidence is insufficient to determine an optimal time point; this paper does not establish reduced survival specifically beyond 12 hours. (LLM, conf=0.85)
- Not checked yetcites [267] Buck DL, Vester-Andersen M, Moller MH (2013) Surgical delay is a critical determinant of survival in perforated peptic ulcer. Br J Surg 100(8):1045–1049 source
- Not checked yetcites [268] Chao WN, Tsai CF, Chang HR et al (2013) Impact of timing of surgery on outcome of Vibrio vulnificus-related necrotizing fasciitis. Am J Surg 206(1):32–39 source
- Supportedcites [269] Karvellas CJ, Abraldes JG, Zepeda-Gomez S et al (2016) The impact of delayed biliary decompression and anti-microbial therapy in 260 patients with cholangitis-associated septic shock. Aliment Pharmacol Ther 44(7):755–766 source
The Conclusions report that biliary decompression more than 12 hours after shock onset was associated with adverse hospital outcomes in patients with cholangitis-associated septic shock. They suggest that decompression within 12 hours could improve outcomes. The paper supports the cited point for this high-risk population, without establishing a separate 6-hour cutoff. (LLM, conf=0.90)
- Not checked yetcites [270] Moss RL, Musemeche CA, Kosloske AM (1996) Necrotizing fasciitis in children: prompt recognition and aggressive therapy improve survival. J Pediatr Surg 31(8):1142–1146 source
- Not checked yetcites [271] Wong CH, Chang HC, Pasupathy S et al (2003) Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am 85(8):1454–1460 source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Transfer from ICU to general floor and discharge from the hospital are both vulnerable periods for patients, with high frequency of medication errors and information loss [596–602].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [596] Bell CM, Brener SS, Gunraj N et al (2011) Association of ICU or hospital admission with unintentional discontinuation of medications for chronic diseases. JAMA 306:840–847 source
- Partly supportedcites [597] Fabes J, Seligman W, Barrett C et al (2017) Does the implementation of a novel intensive care discharge risk score and nurse-led inpatient review tool improve outcome? A prospective cohort study in two intensive care units in the UK. BMJ Open 7(12):e018322 sourceExperimental — accuracy not yet measured
The Background describes patients as vulnerable after ICU discharge, and the Results (Retrospective study population; page unavailable) report readmissions and ward deaths soon after transfer. The paper does not address hospital discharge or establish a high frequency of medication errors or information loss at either transition; searches for those terms and medication reconciliation found no supporting passage. (LLM, conf=0.86)
- Partly supportedcites [598] Mekonnen AB, McLachlan AJ, Brien JA (2016) Pharmacy-led medication reconciliation programmes at hospital transitions: a systematic review and meta-analysis. J Clin Pharm Ther 41(2):128–144 sourceExperimental — accuracy not yet measured
The paper’s “What Is Known and Objective” section (p. 1) says patients are vulnerable at hospital discharge and that poor information communication at care transitions can lead to medication errors. Its results also report discharge medication errors (p. 6). Our copy does not establish the same claim specifically for transfer from ICU to a general floor. (LLM, conf=0.88)
- Partly supportedcites [599] Morandi A, Vasilevskis E, Pandharipande PP et al (2013) Inappropriate medication prescriptions in elderly adults surviving an intensive care unit hospitalization. J Am Geriatr Soc 61:1128–1134 sourceExperimental — accuracy not yet measured
The Discussion (page not available) identifies ICU discharge and hospital discharge as points for reviewing medication appropriateness, and the Introduction reports frequent inappropriate medications at hospital discharge among elderly ICU survivors. The paper does not report a high frequency of medication errors at both transitions or address information loss. (LLM, conf=0.85)
- Partly supportedcites [600] Scales DC, Fischer HD, Li P et al (2016) Unintentional continuation of medications intended for acute illness after hospital discharge: A population-based cohort study. J Gen Intern Med 31:196–202 sourceExperimental — accuracy not yet measured
The Introduction (p. 1) identifies ICU-to-ward transfers as occasions for errors and communication failures, and the Background (p. 1) describes medication-related vulnerability at discharge. The paper does not establish a high frequency of medication errors and information loss at both transitions; its measured post-discharge outcome is continuation of selected medications without a documented indication. (LLM, conf=0.84)
- Not checked yetcites [601] Stelfox HT, Bastos J, Niven DJ et al (2016) Critical care transition programs and the risk of readmission or death after discharge from ICU. Intensive Care Med 42(3):401–410 source
- Partly supportedcites [602] Tomichek JE, Stollings JL, Pandharipande PP et al (2016) Antipsychotic prescribing patterns during and after critical illness: a prospective cohort study. Crit Care 20:378 sourceExperimental — accuracy not yet measured
The Discussion describes hospital discharge as a transition with high risk of medication errors and reports frequent medication discrepancies. The Background discusses antipsychotics being continued upon transfer out of the ICU, but does not establish a high frequency of medication errors at that transfer. Neither passage addresses information loss at either transition. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Few randomised studies have assessed post-critical illness clinics [588, 628, 638, 639], and—consistent with a recent Cochrane review [640]—our meta-analysis found no differences from usual care in terms of mortality, QoL, physical function, or cognition, with possible small improvements in psychological symptoms (anxiety, depression, PTSD).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Partly supportedcites [588] Schmidt K, Worrack S, Von Korff M et al (2016) Effect of a primary care management intervention on mental health-related quality of life among survivors of sepsis: a randomized clinical trial. JAMA 315(24):2703–2711 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Partly supportedcites [628] Douglas SL, Daly BJ, Kelley CG et al (2007) Chronically critically ill patients: health-related quality of life and resource use after a disease management intervention. Am J Crit Care 16(5):447–457 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Supportedcites [638] Cuthbertson BH, Rattray J, Campbell MK et al (2009) The PRaCTICaL study of nurse led, intensive care follow-up programmes for improving long term outcomes from critical illness: a pragmatic randomised controlled trial. BMJ 339:b3723 source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked yetcites [639] Jensen JF, Egerod I, Bestle MH et al (2016) A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: a multicenter randomized controlled trial, the RAPIT study. Intensive Care Med 42(11):1733–1743 source
- Not checked yetcites [640] Schofield-Robinson OJ, Lewis SR, Smith AF et al (2018) Follow-up services for improving long-term outcomes in intensive care unit (ICU) survivors. Cochrane Database Syst Rev 11:CD012701
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Sepsis survivors are at risk for hospital readmission, which has been associated with increased mortality or discharge to hospice [622, 623].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [622] Dietz BW, Jones TK, Small DS et al (2017) The relationship between index hospitalizations, sepsis, and death or transition to hospice care during 30-day hospital readmissions. Med Care 55(4):362–370 source
- Supportedcites [623] Ortego A, Gaieski DF, Fuchs BD et al (2015) Hospital-based acute care use in survivors of septic shock. Crit Care Med 43(4):729–737 source
The Discussion reports that 23% of at-risk septic shock survivors were readmitted within 30 days, and nearly one in six readmissions resulted in death or a transition to hospice. This supports the cited statement about readmission risk and serious outcomes, though the study specifically examined septic shock survivors. (LLM, conf=0.90)
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no evidence of a difference in mortality, however, the studies were hampered by significant limitations, including risk of confounding by indication (the observational studies) and imprecision (the RCT), which is why the results should be interpreted cautiously.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“De-escalation was associated with shorter length of stay in the hospital (MD −5.56 days; 95% CI −7.68 to −3.44), but not in the ICU (MD −2.6 days; 95% CI −5.91 to 0.72).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plaincorrelationaln = 1,968- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Long-term mortality was evaluated in one study only and did not demonstrate a difference (RR 0.99; 95% CI 0.64–1.52).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Antibiotic exposure was consistently lower in patients who were managed with procalcitonin and clinical evaluation, however, in many trials the total duration of therapy was still 7 days or longer in the intervention group.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plaindirectn = 4,499- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Included studies are generally small and include mostly post-operative, non-critically ill patients.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In our systematic review of 10 RCTs, vasopressin with norepinephrine reduced mortality as compared to norepinephrine alone (RR 0.91; 95% CI 0.83–0.99) but did not reduce the need for RRT (RR 0.79; 95% CI 0.57–1.10).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no difference in the risks of digital ischaemia (RR 1.01; 95% CI 0.33–9.84) or arrhythmias (RR 0.88; 95% CI 0.63–1.23).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our meta-analysis showed no difference in mortality (terlipressin: 42.9% vs 49.0%; RR 0.89 (95% CI 0.70–1.13); low quality) but an increase in adverse events.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plaindirectn = 950- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our analysis of three RCTs (1129 patients) showed no difference in mortality with low Vt ventilation (RR 1.07; 95% CI 0.91–1.26), with a trend towards lower risk of developing ARDs (RR 0.59; 95% CI 0.34–1.02) (Supplementary Appendix 4).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plainn = 1,129- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When the incremental PEEP recruitment studies are analysed separately from studies utilizing traditional recruitment maneuvers, recruitment with incremental PEEP is associated with increased 28-day mortality RR 1.12; 95% CI 1.00–1.25), which justifies the strong recommendation against using incremental PEEP titration for recruitment.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Among patients with ARDS receiving lower VTs, we did not identify a significant benefit for use of a higher PEEP versus lower PEEP strategy for improving mortality (RR = 0.93; 95% CI 0.83–1.03), days on mechanical ventilation (RR = 0.00; 95% CI −1.02 to 1.02), or ventilator-free days (RR = 1.48; 95% CI 0.19–2.76); and there was no increase in the risk of barotrauma (RR = 1.49; 95% CI 0.99–2.23).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Overall, continuous NMBA infusion reduced the risk of barotrauma (RR 0.55; 95% CI 0.35–0.85), but the effect on ventilator-free days, duration of mechanical ventilation, and ICU-acquired weakness was unclear [472, 473].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [472] Alhazzani W, Belley-Cote E, Moller MH, et al (2020) Neuromuscular blockade in patients with ARDS: a rapid practice guideline. Intensive Care Med source
- Not checked yetcites [473] Tarazan N, Alshehri M, Sharif S et al (2020) Neuromuscular blocking agents in acute respiratory distress syndrome: updated systematic review and meta-analysis of randomized trials. Intensive Care Med Exp 8(1):61 source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A meta-analysis conducted for this guideline revision (Supplementary Appendix 5) found an increase vasopressor-free days (MD 1.5 days; 95% CI 0.8–3.11 days); however, corticosteroid use increased neuromuscular weakness (RR 1.21; 95% CI 1.01–1.45), without a clear effect on short- or long-term mortality.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“An updated meta-analysis of all available RCTs (Supplementary Appendix 5) demonstrated a possible reduction in mortality (RR 0.87; 95% CI 0.77–0.98, low quality), however this finding was challenged by sensitivity analyses: after excluding high risk of bias trials the risk ratio is 1.14 (95% CI 0.96–1.36); and after excluding trials published prior to 2010 we observed higher mortality with haemope”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The IDEAL-ICU trial [507] did not report central venous access device (CVAD) infections: the results for this outcome are unchanged from 2016.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [507] Barbar SD, Clere-Jehl R, Bourredjem A et al (2018) Timing of renal-replacement therapy in patients with acute kidney injury and sepsis. N Engl J Med 379(15):1431–1442 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Our updated literature search identified no new RCTs but two meta-analysis comparing continuous and intermittent renal replacement therapies [503, 504].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [503] Zha J, Li C, Cheng G et al (2019) The efficacy of renal replacement therapy strategies for septic-acute kidney injury: a PRISMA-compliant network meta-analysis. Medicine (Baltimore) 98(16):e15257 source
- Not checked yetcites [504] Zhao Y, Chen Y (2020) Effect of renal replacement therapy modalities on renal recovery and mortality for acute kidney injury: A PRISMA-compliant systematic review and meta-analysis. Semin Dial 33(2):127–132 source
plain- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“No difference in the rates of clinically significant bleeding, mortality or PE were observed.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“No significant differences existed between the two-insulin initiation blood glucose levels evaluated.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our previous meta-analysis demonstrated a significant reduction in both DVT and PE and no increase in bleeding complications.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Reductions in ICU and ventilator days in intervention patients who died before hospital discharge were found in two studies [539, 540], and the third study found overall shorter ICU and hospital stay in the ethics consultation group [541].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [539] Schneiderman LJ, Gilmer T, Teetzel HD (2000) Impact of ethics consultations in the intensive care setting: a randomized, controlled trial. Crit Care Med 28(12):3920–3924 source
- Not checked yetcites [540] Schneiderman LJ, Gilmer T, Teetzel HD et al (2003) Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial. JAMA 290(9):1166–1172 source
- Not checked yetcites [541] Chen C, Michaels J, Meeker MA (2019) Family outcomes and perceptions of end-of-life care in the intensive care unit: a mixed-methods review. J Palliat Care 35(3):143–153. https://doi.org/10.1177/0825859719874767 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There are limited available data of any undesirable effects: it was noted that the point estimate of the HR for 90-day mortality in the largest RCT [524] was 1.18 (95% CI 0.69–2.00) i.e. favouring the control group.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [524] Fujii T, Luethi N, Young PJ et al (2020) Effect of vitamin C, hydrocortisone, and thiamine vs hydrocortisone alone on time alive and free of vasopressor support among patients with septic shock: the VITAMINS Randomized Clinical Trial. JAMA 323(5):423–431 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Palliative care meetings failed to show benefit in decreasing anxiety and depression in surrogate decision makers in the intervention group but did increase post-traumatic stress disorder (PTSD) symptoms.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [543] Carson SS, Cox CE, Wallenstein S et al (2016) Effect of palliative care-led meetings for families of patients with chronic critical illness: a randomized clinical trial. JAMA 316(1):51–62 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“We identified several studies exploring the use of specific criteria to trigger a goals of care discussion in critically ill patients, though none report the proportion of patients with sepsis or septic shock.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The support intervention did not affect family psychological outcomes but did improve perceived quality of communication and perception of patient- and family-centeredness of care.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [538] White DB, Angus DC, Shields AM et al (2018) A randomized trial of a family-support intervention in intensive care units. N Engl J Med 378(25):2365–2375 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The outcomes of patients with both sepsis and AKI were not reported.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Palliative care interventions had no significant impact on family satisfaction with care, ICU length of stay [543, 545–548], hospital length of stay [543, 545, 548], or mortality [543, 545, 548].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [543] Carson SS, Cox CE, Wallenstein S et al (2016) Effect of palliative care-led meetings for families of patients with chronic critical illness: a randomized clinical trial. JAMA 316(1):51–62 source
- Not checked yetcites [545] Cheung W, Aggarwal G, Fugaccia E et al (2010) Palliative care teams in the intensive care unit: a randomised, controlled, feasibility study. Crit Care Resusc 12(1):28–35
- Not checked yetcites [546] Curtis JR, Nielsen EL, Treece PD et al (2011) Effect of a quality-improvement intervention on end-of-life care in the intensive care unit: a randomized trial. Am J Respir Crit Care Med 183(3):348–355 source
- Not checked yetcites [547] Lautrette A, Darmon M, Megarbane B et al (2007) A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 356(5):469–478 source
- Not checked yetcites [548] Ma J, Chi S, Buettner B et al (2019) Early palliative care consultation in the medical ICU: a cluster randomized crossover trial. Crit Care Med 47(12):1707–1715 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies have evaluated palliative care interventions in the ICU but not specifically in patients with sepsis [543, 545–548].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [543] Carson SS, Cox CE, Wallenstein S et al (2016) Effect of palliative care-led meetings for families of patients with chronic critical illness: a randomized clinical trial. JAMA 316(1):51–62 source
- Not checked yetcites [545] Cheung W, Aggarwal G, Fugaccia E et al (2010) Palliative care teams in the intensive care unit: a randomised, controlled, feasibility study. Crit Care Resusc 12(1):28–35
- Not checked yetcites [546] Curtis JR, Nielsen EL, Treece PD et al (2011) Effect of a quality-improvement intervention on end-of-life care in the intensive care unit: a randomized trial. Am J Respir Crit Care Med 183(3):348–355 source
- Not checked yetcites [547] Lautrette A, Darmon M, Megarbane B et al (2007) A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 356(5):469–478 source
- Not checked yetcites [548] Ma J, Chi S, Buettner B et al (2019) Early palliative care consultation in the medical ICU: a cluster randomized crossover trial. Crit Care Med 47(12):1707–1715 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The early warning system did not impact hospital mortality or hospital length of stay, but did reduce ICU transfers and ICU length of stay and increased documentation of advance directives and resuscitation status compared to the usual care group.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [544] Picker D, Dans M, Heard K et al (2017) A randomized trial of palliative care discussions linked to an automated early warning system alert. Crit Care Med 45(2):234–240 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Ethics consultation did not result in a reduction in ICU stay, hospital stay, or life-sustaining treatments in patients who did not survive to discharge.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [542] Andereck WS, McGaughey JW, Schneiderman LJ et al (2014) Seeking to reduce nonbeneficial treatment in the ICU: an exploratory trial of proactive ethics intervention. Crit Care Med 42(4):824–830 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“No benefit was demonstrated on family satisfaction, ICU days, or hospital days.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [543] Carson SS, Cox CE, Wallenstein S et al (2016) Effect of palliative care-led meetings for families of patients with chronic critical illness: a randomized clinical trial. JAMA 316(1):51–62 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A reduction in ICU length of stay was noted, yet it is unknown if the reduction is due to increased mortality.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [538] White DB, Angus DC, Shields AM et al (2018) A randomized trial of a family-support intervention in intensive care units. N Engl J Med 378(25):2365–2375 source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, generating a robust evidence base upon which to make concrete recommendations about changes in the care paradigm has proven to be extraordinarily difficult.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Many observational studies describe the relationship between various socioeconomic supports and patient outcomes that suggest that low SES, substance abuse and poor nutritional status lead to poor outcomes, and that critical illness itself results in lower SES post-illness.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“ICU education did not appear to impact patients’ anxiety and depression [584, 586, 588], but did improve families’ satisfaction with care [583].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [583] Azoulay E, Pochard F, Chevret S et al (2002) Impact of a family information leaflet on effectiveness of information provided to family members of intensive care unit patients: a multicenter, prospective, randomized, controlled trial. Am J Respir Crit Care Med 165(4):438–442 source
- Not checked yetcites [584] Bench S, Day T, Heelas K et al (2015) Evaluating the feasibility and effectiveness of a critical care discharge information pack for patients and their families: a pilot cluster randomised controlled trial. BMJ Open 5(11):e006852 source
- Not checked yetcites [586] Fleischer S, Berg A, Behrens J et al (2014) Does an additional structured information program during the intensive care unit stay reduce anxiety in ICU patients?: a multicenter randomized controlled trial. BMC Anesthesiol 14:48 source
- Not checked yetcites [588] Schmidt K, Worrack S, Von Korff M et al (2016) Effect of a primary care management intervention on mental health-related quality of life among survivors of sepsis: a randomized clinical trial. JAMA 315(24):2703–2711 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The majority are observational pre-post studies and report process measures such as completeness and accuracy of communication rather than clinical outcomes.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In an international survey of sepsis survivors from 41 countries, 45% and 63% reported dissatisfaction with sepsis education at the acute and post-acute phase, respectively [582].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [582] Huang CY, Daniels R, Lembo A et al (2019) Life after sepsis: an international survey of survivors to understand the post-sepsis syndrome. Int J Qual Health Care 31(3):191–198 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Additionally, living in neighborhoods with low SES is associated with an increased risk of sepsis [575], community-acquired bacteremia [575] and death from bacteremia [576] and worse outcomes [577].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [575] Donnelly JP, Lakkur S, Judd SE et al (2018) Association of neighborhood socioeconomic status with risk of infection and sepsis. Clin Infect Dis 66(12):1940–1947 source
- Not checked yetcites [576] Koch K, Norgaard M, Schonheyder HC et al (2013) Effect of socioeconomic status on mortality after bacteremia in working-age patients A Danish population-based cohort study. PLoS One 8(7):e70082 source
- Not checked yetcites [577] Ho KM, Dobb GJ, Knuiman M et al (2008) The effect of socioeconomic status on outcomes for seriously ill patients: a linked data cohort study. Med J Aust 189(1):26–30 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Almost 40% of sepsis survivors are re-hospitalised within 3 months, often for preventable conditions [580], contributing to increased healthcare costs [581].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [580] Prescott HC, Angus DC (2018) Enhancing recovery from sepsis: a review. JAMA 319(1):62–75 source
- Not checked yetcites [581] Gruther W, Pieber K, Steiner I et al (2017) Can early rehabilitation on the general ward after an intensive care unit stay reduce hospital length of stay in survivors of critical illness?: A randomized controlled trial. Am J Phys Med Rehabil 96(9):607–615 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Four observational studies examined the impact of peer support groups on ICU patients, though they were not specific to sepsis patients.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [554] Halm MA (1990) Effects of support groups on anxiety of family members during critical illness. Heart Lung 19(1):62–71
- Not checked yetcites [555] Fridlund B, Stener-Bengtsson A, Wannman AL (1993) Social support and social network after acute myocardial infarction; the critically ill male patient’s needs, choice and motives. Intensive Crit Care Nurs 9(2):88–94 source
- Not checked yetcites [556] McPeake J, Shaw M, Iwashyna TJ et al (2017) Intensive care syndrome: promoting independence and return to employment (InS:PIRE). Early evaluation of a complex intervention. PLoS One 12(11):e0188028 source
- Not checked yetcites [557] Sabo KA, Kraay C, Rudy E et al (1989) ICU family support group sessions: family members’ perceived benefits. Appl Nurs Res 2(2):82–89 source
- Not checked yetcites [558] Parent N, Fortin F (2000) A randomized, controlled trial of vicarious experience through peer support for male first-time cardiac surgery patients: impact on anxiety, self-efficacy expectation, and self-reported activity. Heart Lung 29(6):389–400 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Overall evidence for routine formal palliative care interventions in ICU patients is of low quality and provides mixed evidence of benefit.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A family care conference with nursing staff at the time of discharge from the ICU resulted in lower anxiety scores for family members compared to a control group although it is not clear that families participated in SDM [592].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [592] Bokinskie JC (1992) Family conferences: a method to diminish transfer anxiety. J Neurosci Nurs 24(3):129–133 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Family caregivers of critically ill patients discharged home felt overwhelmed and unprepared and had difficulty managing expectations [593].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [593] Choi J, Lingler JH, Donahoe MP et al (2018) Home discharge following critical illness: a qualitative analysis of family caregiver experience. Heart Lung 47(4):401–407 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Only one specifically studied patients with sepsis [588], evaluating a complex intervention, which included education along with primary care follow-up and post-discharge monitoring.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [588] Schmidt K, Worrack S, Von Korff M et al (2016) Effect of a primary care management intervention on mental health-related quality of life among survivors of sepsis: a randomized clinical trial. JAMA 315(24):2703–2711 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Medication reconciliation has been associated with fewer medication errors [598, 612] and may help reduce hospital readmission [613, 614].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [598] Mekonnen AB, McLachlan AJ, Brien JA (2016) Pharmacy-led medication reconciliation programmes at hospital transitions: a systematic review and meta-analysis. J Clin Pharm Ther 41(2):128–144 source
- Not checked yetcites [612] Pronovost P, Weast B, Schwarz M et al (2003) Medication reconciliation: a practical tool to reduce the risk of medication errors. J Crit Care 18(4):201–205 source
- Not checked yetcites [613] Ravn-Nielsen LV, Duckert ML, Lund ML et al (2018) Effect of an in-hospital multifaceted clinical pharmacist intervention on the risk of readmission: a randomized clinical trial. JAMA Intern Med 178(3):375–382 source
- Not checked yetcites [614] Taylor SP, Chou SH, Sierra MF et al (2020) Association between Adherence to Recommended Care and Outcomes for Adult Survivors of Sepsis. Ann Am Thorac Soc 17(1):89–97 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Medication reconciliation is broadly recognised to be important during patient transitions.
In the paper
“Hospital readmission within 90 days of discharge occurs in approximately 40% of sepsis survivors and is associated with high costs [624].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [624] Mayr FB, Talisa VB, Balakumar V et al (2017) Proportion and cost of unplanned 30-day readmissions after sepsis compared with other medical conditions. JAMA 317(5):530–531 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There are insufficient data to suggest any specific tool to assess for these problems, and the optimal approach will vary by patient and setting.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There were insufficient studies to allow meta-analysis and the limited evidence is of very low quality.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“While efficacy data are equivocal, these programmes are consistently well-liked by patients and offer an environment to learn about challenges sepsis survivors face, as well as to pilot and test interventions for enhancing recovery [637, 643].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [637] Teixeira C, Rosa RG (2018) Post-intensive care outpatient clinic: is it feasible and effective? A literature review. Rev Bras Ter Intensiva 30(1):98–111 source
- Not checked yetcites [643] Prescott HC, Iwashyna TJ, Blackwood B et al (2019) Understanding and enhancing sepsis survivorship. Priorities for research and practice. Am J Respir Crit Care Med 200(8):972–981 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“None of the three studies specifically evaluated a sepsis population or reported the proportion of sepsis patients.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In addition, sepsis survivors are at increased risk for recurrent infection, AKI and new cardiovascular events compared to patients hospitalised for other diagnoses [580].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [580] Prescott HC, Angus DC (2018) Enhancing recovery from sepsis: a review. JAMA 319(1):62–75 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In addition, a prospective cohort study testing a series of cognitive training sessions starting in the ICU and continued for up to 2 months, found overall minimal clinical relevance as Minimum Clinically Important Difference (MID) of Montreal Cognitive Assessment (MOCA) was small, with some meaningful results in younger patients, but not in the middle-aged or older population [635, 636].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [635] Zhao J, Yao L, Li M et al (2019) Effects of early intervention training on cognitive impairment in critical patients. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 31(3):298–302
- Not checked yetcites [636] Wong GKC, Mak JSY, Wong A et al (2017) Minimum clinically important difference of Montreal Cognitive Assessment in aneurysmal subarachnoid hemorrhage patients. J Clin Neurosci 46:41–44 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The results demonstrated that the intervention was feasible and safe, but the study was underpowered and therefore inconclusive regarding its clinical effects on cognitive function and health-related QoL outcomes at 3-month follow-up.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [634] Brummel NE, Girard TD, Ely EW et al (2014) Feasibility and safety of early combined cognitive and physical therapy for critically ill medical and surgical patients: the Activity and Cognitive Therapy in ICU (ACT-ICU) trial. Intensive Care Med 40(3):370–379 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Meta-analysis of these studies suggests that critical care transition programmes reduce risk of in-hospital mortality and potentially reduce risk of ICU readmission.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“There are a growing number of online resources and informational brochures regarding “post intensive care” / “post-sepsis syndrome”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [580] Prescott HC, Angus DC (2018) Enhancing recovery from sepsis: a review. JAMA 319(1):62–75 source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“More studies of post-sepsis follow-up programmes are in process [641, 642].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [641] Kowalkowski M, Chou SH, McWilliams A et al (2019) Structured, proactive care coordination versus usual care for Improving Morbidity during Post-Acute Care Transitions for Sepsis (IMPACTS): a pragmatic, randomized controlled trial. Trials 20(1):660 source
- Not checked yetcites [642] Paratz JD, Kenardy J, Mitchell G et al (2014) IMPOSE (IMProving Outcomes after Sepsis)-the effect of a multidisciplinary follow-up service on health-related quality of life in patients postsepsis syndromes-a double-blinded randomised controlled trial: protocol. BMJ Open 4(5):e004966 source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The interventions and QoL measures varied among the three studies each with severe limitations.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“These programmes vary in their structure, and are not consistently available worldwide [637].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [637] Teixeira C, Rosa RG (2018) Post-intensive care outpatient clinic: is it feasible and effective? A literature review. Rev Bras Ter Intensiva 30(1):98–111 source
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“These studies focused on critically ill patients, generally defined by days in ICU or days with mechanical ventilation and begin on the floor or post-hospital setting.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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In the paper
“Meta-analysis suggests possible small improvements in QoL and depressive symptoms, but no difference in mortality, physical function, or anxiety.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“This suggestion is consistent with the guidance of several expert panels [646, 652, 653].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [646] Connolly B, Thompson A, Douiri A et al (2015) Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit-acquired weakness: a pilot feasibility trial. J Crit Care 30(3):589–598 source
- Not checked yetcites [652] Health NIf, Excellence C (2014) Rehabilitation after critical illness in adults: NICE Reino Unido; 2014. https://www.nice.org.uk/guidance/qs158/resources/rehabilitation-after-critical-illness-in-adults-pdf-75545546693317. Accessed 17 Mar 2021
- Not checked yetcites [653] Major ME, Kwakman R, Kho ME et al (2016) Surviving critical illness: what is next? An expert consensus statement on physical rehabilitation after hospital discharge. Crit Care 2016 20:354
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Data analysis used to support the recommendations of the 3rd International Consensus Conference on the Definitions of Sepsis identified qSOFA as a predictor of poor outcome in patients with known or suspected infection, but no analysis was performed to support its use as a screening tool [5].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [5] Seymour CW, Liu VX, Iwashyna TJ et al (2016) Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 315(8):762–774 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“a meta-analysis of 50 observational studies on the effect of performance improvement programmes showed that these programmes were associated with better adherence to sepsis bundles along with a reduction in mortality (OR 0.66; 95% CI 0.61–0.72) in patients with sepsis and septic shock [27].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [27] Damiani E, Donati A, Serafini G et al (2015) Effect of performance improvement programs on compliance with sepsis bundles and mortality: a systematic review and meta-analysis of observational studies. PLoS One 10(5):e0125827 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“There is wide variation in diagnostic accuracy of these tools with most having poor predictive values, although the use of some was associated with improvements in care processes [28–31].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [28] Alberto L, Marshall AP, Walker R et al (2017) Screening for sepsis in general hospitalized patients: a systematic review. J Hosp Infect 96(4):305–315 source
- Not checked yetcites [29] Bhattacharjee P, Edelson DP, Churpek MM (2017) Identifying patients with sepsis on the hospital wards. Chest 151(4):898–907 source
- Not checked yetcites [30] Makam AN, Nguyen OK, Auerbach AD (2015) Diagnostic accuracy and effectiveness of automated electronic sepsis alert systems: a systematic review. J Hosp Med 10(6):396–402 source
- Not checked yetcites [31] Warttig S, Alderson P, Evans DJ et al (2018) Automated monitoring compared to standard care for the early detection of sepsis in critically ill patients. Cochrane Database oSyste Rev. 6(6):CD012404-CD
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“While some tissues, such as the brain and kidneys have the ability to auto-regulate blood flow, MAPs below a threshold, usually understood to be approximately 60 mm Hg, are associated with decreased organ perfusion, which tracks linearly with MAP [79].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [79] LeDoux D, Astiz ME, Carpati CM et al (2000) Effects of perfusion pressure on tissue perfusion in septic shock. Crit Care Med 28(8):2729–2732 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“The lactate cutoffs determining an elevated level ranged from 1.6 to 2.5 mmol/L, although diagnostic characteristics were similar regardless of the cutoff.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [50] Contenti J, Corraze H, Lemoel F et al (2015) Effectiveness of arterial, venous, and capillary blood lactate as a sepsis triage tool in ED patients. Am J Emerg Med 33(2):167–172 source
- Not checked yetcites [51] Karon BS, Tolan NV, Wockenfus AM et al (2017) Evaluation of lactate, white blood cell count, neutrophil count, procalcitonin and immature granulocyte count as biomarkers for sepsis in emergency department patients. Clin Biochem 50(16–17):956–958 source
- Not checked yetcites [52] Ljungstrom L, Pernestig AK, Jacobsson G et al (2017) Diagnostic accuracy of procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis. PLoS One 12(7):e0181704 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In a systematic review and meta-analysis, dynamic assessment to guide fluid therapy was associated with reduced mortality (RR 0.59; 95% CI 0.42–0.83), ICU length of stay (MD −1.16 days; 95% CI −1.97 to −0.36), and duration of mechanical ventilation (−2.98 h; 95% CI −5.08 to −0.89) [3].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [3] Fleischmann-Struzek C, Mellhammar L, Rose N et al (2020) Incidence and mortality of hospital- and ICU-treated sepsis: results from an updated and expanded systematic review and meta-analysis. Intensive Care Med 46(8):1552–1562 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies have shown that qSOFA is more specific but less sensitive than having two of four SIRS criteria for early identification of infection induced organ dysfunction [40–43].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [40] Fernando SM, Tran A, Taljaard M et al (2018) Prognostic accuracy of the quick sequential organ failure assessment for mortality in patients with suspected infection: a systematic review and meta-analysis. Ann Intern Med 168(4):266–275 source
- Not checked yetcites [41] Herwanto V, Shetty A, Nalos M et al (2019) Accuracy of quick sequential organ failure assessment score to predict sepsis mortality in 121 studies including 1,716,017 individuals: a systematic review and meta-analysis. Crit Care Explor. 1(9):e0043 source
- Not checked yetcites [42] Serafim R, Gomes JA, Salluh J et al (2018) A comparison of the Quick-SOFA and systemic inflammatory response syndrome criteria for the diagnosis of sepsis and prediction of mortality: a systematic review and meta-analysis. Chest 153(3):646–655 source
- Not checked yetcites [43] Cinel I, Kasapoglu US, Gul F et al (2020) The initial resuscitation of septic shock. J Crit Care 57:108–117 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Serum lactate is an important biomarker of tissue hypoxia and dysfunction, but is not a direct measure of tissue perfusion [73].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [73] Levy B (2006) Lactate and shock state: the metabolic view. Curr Opin Crit Care 12(4):315–321 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“failure to receive 30 ml/kg of crystalloid fluid therapy within 3 h of sepsis onset was associated with increased odds of in-hospital mortality, delayed resolution of hypotension and increased length of stay in ICU”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [63] Kuttab HI, Lykins JD, Hughes MD et al (2019) Evaluation and predictors of fluid resuscitation in patients with severe sepsis and septic shock. Crit Care Med 47(11):1582–1590 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Temperature of the extremities, skin mottling and capillary refill time (CRT) have been validated and shown to be reproducible signs of tissue perfusion [76, 77].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [76] Cecconi M, Hernandez G, Dunser M et al (2019) Fluid administration for acute circulatory dysfunction using basic monitoring: narrative review and expert panel recommendations from an ESICM task force. Intensive Care Med 45(1):21–32 source
- Not checked yetcites [77] Lara B, Enberg L, Ortega M et al (2017) Capillary refill time during fluid resuscitation in patients with sepsis-related hyperlactatemia at the emergency department is related to mortality. PLoS One 12(11):e0188548 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Sensitivities range from 66 to 83%, with specificities ranging from 80 to 85%.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [50] Contenti J, Corraze H, Lemoel F et al (2015) Effectiveness of arterial, venous, and capillary blood lactate as a sepsis triage tool in ED patients. Am J Emerg Med 33(2):167–172 source
- Not checked yetcites [51] Karon BS, Tolan NV, Wockenfus AM et al (2017) Evaluation of lactate, white blood cell count, neutrophil count, procalcitonin and immature granulocyte count as biomarkers for sepsis in emergency department patients. Clin Biochem 50(16–17):956–958 source
- Not checked yetcites [52] Ljungstrom L, Pernestig AK, Jacobsson G et al (2017) Diagnostic accuracy of procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis. PLoS One 12(7):e0181704 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the PROCESS [64], ARISE [65] and PROMISE [66] trials, the average volume of fluid received pre-randomisation was also in the range of 30 ml/kg, suggesting that this fluid volume has been adopted in routine clinical practice [67].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [67] Rowan KM, Angus DC, Bailey M et al (2017) Early, goal-directed therapy for septic shock—a patient-level meta-analysis. N Engl J Med 376(23):2223–2234 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“28-day mortality was 34.9% in the peripheral perfusion group and 43.4% in the lactate group, but this difference did not reach statistical significance (HR 0.75; 95% CI 0.55–1.02).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [58] Hernandez G, Ospina-Tascon GA, Damiani LP et al (2019) Effect of a resuscitation strategy targeting peripheral perfusion status vs serum lactate levels on 28-day mortality among patients with septic shock: the ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA 321(7):654–664 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A recent RCT, monitored to ensure protocol and MAP target compliance, compared a “permissive hypotension” (MAP 60–65 mm Hg) group with a “usual care” group that received vasopressors and MAP targets set by the treating physician in patients aged 65 years and older with septic shock [82, 83]. The intervention group in this study achieved a mean MAP of 66.7 mm Hg, compared with 72.6 mm Hg in the”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [82] Lamontagne F, Meade MO, Hebert PC et al (2016) Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial. Intensive Care Med 42(4):542–550 source
- Not checked yetcites [83] Lamontagne F, Richards-Belle A, Thomas K et al (2020) Effect of reduced exposure to vasopressors on 90-day mortality in older critically ill patients with vasodilatory hypotension: a randomized clinical trial. JAMA 323(10):938–949 source
plainn = 2,463- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In summary, the presence of an elevated or normal lactate level significantly increases or decreases, respectively, the likelihood of a final diagnosis of sepsis in patients with suspected sepsis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [50] Contenti J, Corraze H, Lemoel F et al (2015) Effectiveness of arterial, venous, and capillary blood lactate as a sepsis triage tool in ED patients. Am J Emerg Med 33(2):167–172 source
- Not checked yetcites [51] Karon BS, Tolan NV, Wockenfus AM et al (2017) Evaluation of lactate, white blood cell count, neutrophil count, procalcitonin and immature granulocyte count as biomarkers for sepsis in emergency department patients. Clin Biochem 50(16–17):956–958 source
- Not checked yetcites [52] Ljungstrom L, Pernestig AK, Jacobsson G et al (2017) Diagnostic accuracy of procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis. PLoS One 12(7):e0181704 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Studies showed an association between the use of point-of-care lactate measurements at presentation and reduced mortality; however, the results are inconsistent [53].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [53] Morris E, McCartney D, Lasserson D et al (2017) Point-of-care lactate testing for sepsis at presentation to health care: a systematic review of patient outcomes. Br J Gen Pract 67(665):e859–e870 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The panel recognises that normal serum lactate levels are not achievable in all patients with septic shock, but these studies support resuscitative strategies that decrease lactate toward normal.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [74] Gu WJ, Zhang Z, Bakker J (2015) Early lactate clearance-guided therapy in patients with sepsis: a meta-analysis with trial sequential analysis of randomized controlled trials. Intensive Care Med 41(10):1862–1863 source
- Not checked yetcites [75] Simpson SQ, Gaines M, Hussein Y et al (2016) Early goal-directed therapy for severe sepsis and septic shock: a living systematic review. J Crit Care 36:43–48 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the original derivation study, authors found that only 24% of infected patients had a qSOFA score 2 or 3, but these patients accounted for 70% of poor outcomes [5].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [5] Seymour CW, Liu VX, Iwashyna TJ et al (2016) Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 315(8):762–774 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Neither SIRS nor qSOFA are ideal screening tools for sepsis and the bedside clinician needs to understand the limitations of each.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [40] Fernando SM, Tran A, Taljaard M et al (2018) Prognostic accuracy of the quick sequential organ failure assessment for mortality in patients with suspected infection: a systematic review and meta-analysis. Ann Intern Med 168(4):266–275 source
- Not checked yetcites [41] Herwanto V, Shetty A, Nalos M et al (2019) Accuracy of quick sequential organ failure assessment score to predict sepsis mortality in 121 studies including 1,716,017 individuals: a systematic review and meta-analysis. Crit Care Explor. 1(9):e0043 source
- Not checked yetcites [42] Serafim R, Gomes JA, Salluh J et al (2018) A comparison of the Quick-SOFA and systemic inflammatory response syndrome criteria for the diagnosis of sepsis and prediction of mortality: a systematic review and meta-analysis. Chest 153(3):646–655 source
- Not checked yetcites [43] Cinel I, Kasapoglu US, Gul F et al (2020) The initial resuscitation of septic shock. J Crit Care 57:108–117 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Similarly, another study of 12,380 ward patients in 48 UK hospitals showed that [88] delayed admission to ICU led to higher 90-day mortality and further physiological deterioration.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [88] Harris S, Singer M, Sanderson C et al (2018) Impact on mortality of prompt admission to critical care for deteriorating ward patients: an instrumental variable analysis using critical care bed strain. Intensive Care Med 44(5):606–615 source
plaindirectn = 12,380- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There is also evidence of improved patient satisfaction, increased patient safety, better patient flow and improved staff morale [89].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [89] Montgomery A, Panagopoulou E, Kehoe I et al (2011) Connecting organisational culture and quality of care in the hospital: is job burnout the missing link? J Health Organ Manag 25(1):108–123 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Procalcitonin is undetectable in healthy states, but rises rapidly in response to pro-inflammatory stimuli, especially bacterial infections [127].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [127] Peng F, Chang W, Xie JF et al (2019) Ineffectiveness of procalcitonin-guided antibiotic therapy in severely critically ill patients: a meta-analysis. Int J Infect Dis 85:158–166 source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“It should be noted that all the aforementioned studies were observational analyses and hence at risk of bias due to insufficient sample size, inadequate risk-adjustment, blending together the effects of large delays until antibiotics with short delays, or other study design issues [118].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [118] Weinberger J, Rhee C, Klompas M (2020) A critical analysis of the literature on time-to-antibiotics in suspected sepsis. J Infect Dis 222(Supplement_2):S110–S118 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Delayed admissions of critically ill patients from ED are associated with decreased sepsis bundle compliance and increased mortality, ventilator duration, and ICU and hospital length of stay [84].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [84] Mohr NM, Wessman BT, Bassin B et al (2020) Boarding of critically ill patients in the emergency department. Crit Care Med 48(8):1180–1187 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The signs and symptoms of sepsis are nonspecific and often mimic multiple other diseases [90–92].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [90] Klein Klouwenberg PM, Cremer OL, van Vught LA et al (2015) Likelihood of infection in patients with presumed sepsis at the time of intensive care unit admission: a cohort study. Crit Care 19:319 source
- Not checked yetcites [91] Levin PD, Idrees S, Sprung CL et al (2012) Antimicrobial use in the ICU: indications and accuracy—an observational trial. J Hosp Med 7(9):672–678 source
- Not checked yetcites [92] Minderhoud TC, Spruyt C, Huisman S et al (2017) Microbiological outcomes and antibiotic overuse in Emergency Department patients with suspected sepsis. Neth J Med 75(5):196–203
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Finally, in a study of 10,811 patients treated in four Utah hospitals, each hour delay in time from ED arrival to administration of antimicrobials was associated with 1.16 increased odds of in-hospital and 1.10 increased odds of 1-year mortality (1.13 in patients with”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [111] Peltan ID, Brown SM, Bledsoe JR et al (2019) ED door-to-antibiotic time and long-term mortality in sepsis. Chest 155(5):938–946 source
plaincorrelationaln = 10,811- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one. The quote only partly states this claim.
None of the sources cited for this claim have been checked yet.
In the paper
“The imperative to provide antimicrobials as early as possible, however, must be balanced against the potential harms associated with administering unnecessary antimicrobials to patients without infection [99, 100].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [99] Klompas M, Calandra T, Singer M (2018) Antibiotics for sepsis-finding the equilibrium. JAMA 320(14):1433–1434 source
- Not checked yetcites [100] Prescott HC, Iwashyna TJ (2019) Improving sepsis treatment by embracing diagnostic uncertainty. Ann Am Thorac Soc 16(4):426–429 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Accurately diagnosing sepsis is challenging as sepsis can present in subtle ways, and some presentations that first appear to be sepsis turn out to be non-infectious conditions [90, 93, 107, 108].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [90] Klein Klouwenberg PM, Cremer OL, van Vught LA et al (2015) Likelihood of infection in patients with presumed sepsis at the time of intensive care unit admission: a cohort study. Crit Care 19:319 source
- Not checked yetcites [93] Heffner AC, Horton JM, Marchick MR et al (2010) Etiology of illness in patients with severe sepsis admitted to the hospital from the emergency department. Clin Infect Dis 50(6):814–820 source
- Not checked yetcites [107] Contou D, Roux D, Jochmans S et al (2016) Septic shock with no diagnosis at 24 hours: a pragmatic multicenter prospective cohort study. Crit Care 20(1):360 source
- Not checked yetcites [108] Rhee C, Kadri SS, Danner RL et al (2016) Diagnosing sepsis is subjective and highly variable: a survey of intensivists using case vignettes. Crit Care 20:89 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Among hospital survivors, the delayed admission group had a longer hospital stay, higher mortality, and higher rates of mechanical ventilation and central venous catherisation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Screening and early treatment > Rationale
What the sources say
- Not checked yetcites [87] Chalfin DB, Trzeciak S, Likourezos A et al (2007) Impact of delayed transfer of critically ill patients from the emergency department to the intensive care unit. Crit Care Med 35(6):1477–1483 source
plaincorrelationaln = 50,322- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The mortality reduction associated with early antimicrobials appears strongest in patients with septic shock, where a number of studies have reported a strong association between time-to-antibiotics and death in patients with septic shock but weaker associations in patients without septic shock [98, 109, 110].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [98] Seymour CW, Gesten F, Prescott HC et al (2017) Time to treatment and mortality during mandated emergency care for sepsis. N Engl J Med 376(23):2235–2244 source
- Not checked yetcites [109] Kumar A, Roberts D, Wood KE et al (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34(6):1589–1596 source
- Not checked yetcites [110] Liu VX, Fielding-Singh V, Greene JD et al (2017) The timing of early antibiotics and hospital mortality in sepsis. Am J Respir Crit Care Med 196(7):856–863 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a study of 35,000 patients treated at Kaiser Permanente Northern California, each additional hour of time from ER arrival to administration of antimicrobials was associated with 1.09 increased odds of in-hospital mortality (1.07 for patients with “severe” sepsis (lactate ≥ 2, at least one episode of hypotension, required non-invasive or invasive mechanical ventilation or has organ dysfunction)”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [110] Liu VX, Fielding-Singh V, Greene JD et al (2017) The timing of early antibiotics and hospital mortality in sepsis. Am J Respir Crit Care Med 196(7):856–863 source
plaincorrelationaln = 35,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“In a study of 49,331 patients treated at 149 New York hospitals, each additional hour of time from ED arrival to administration of antimicrobials was associated with 1.04 increased odds of in-hospital mortality, p < 0.001 (1.07 (95% CI 1.05–1.09) for patients receiving vasopressors vs. 1.01 (95% CI 0.99–1.04) for patients not on vasopressors) [98].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [98] Seymour CW, Gesten F, Prescott HC et al (2017) Time to treatment and mortality during mandated emergency care for sepsis. N Engl J Med 376(23):2235–2244 source
plaincorrelationaln = 49,331 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Limited data from resource-limited settings suggest that timely administration of antimicrobials in patients with sepsis and septic shock is beneficial and potentially feasible [121–126].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [121] Chalya PL, Mabula JB, Koy M et al (2012) Typhoid intestinal perforations at a University teaching hospital in Northwestern Tanzania: a surgical experience of 104 cases in a resource-limited setting. World J Emerg Surg 7:4 source
- Not checked yetcites [122] Phua J, Koh Y, Du B et al (2011) Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study. BMJ 342:d3245 source
- Not checked yetcites [123] Thwaites CL, Lundeg G, Dondorp AM et al (2016) Recommendations for infection management in patients with sepsis and septic shock in resource-limited settings. Intensive Care Med 42(12):2040–2042 source
- Not checked yetcites [124] Urayeneza O, Mujyarugamba P, Rukemba Z et al (2018) Increasing evidence-based interventions in patients with acute infections in a resource-limited setting: a before-and-after feasibility trial in Gitwe, Rwanda. Crit Care Med 46(8):1357–1366 source
- Not checked yetcites [125] Urayeneza O, Mujyarugamba P, Rukemba Z et al (2018) Increasing evidence-based interventions in patients with acute infections in a resource-limited setting: a before-and-after feasibility trial in Gitwe, Rwanda. Intensive Care Med 44(9):1436–1446 source
- Not checked yetcites [126] Yokota PK, Marra AR, Martino MD et al (2014) Impact of appropriate antimicrobial therapy for patients with severe sepsis and septic shock—a quality improvement study. PLoS One 9(11):e104475 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“while in patients with a low risk for MDR organisms, we suggest using a single agents for empiric treatment, as there are no apparent benefits of using two agents and the a risk of antimicrobial-associated undesirable effects, including direct toxicity, Clostridioides difficile infection and development of antibiotic resistance [165].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [165] Arulkumaran N, Routledge M, Schlebusch S et al (2020) Antimicrobial-associated harm in critical care: a narrative review. Intensive Care Med 46(2):225–235 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The desirable effects of empiric antiviral therapy are unknown, and as for other antimicrobial agents there is a risk of undesirable effects [165].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [165] Arulkumaran N, Routledge M, Schlebusch S et al (2020) Antimicrobial-associated harm in critical care: a narrative review. Intensive Care Med 46(2):225–235 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Effective therapies are lacking for most zoonotic viruses that can manifest with clinical signs of sepsis.
None of the sources cited for this claim have been checked yet.
In the paper
“Among patients with documented MRSA infections, delays of > 24–48 h until antibiotic administration are associated with increased mortality in some studies [143–147], but not in others [148–154].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [143] Gasch O, Camoez M, Dominguez MA et al (2013) Predictive factors for early mortality among patients with methicillin-resistant Staphylococcus aureus bacteraemia. J Antimicrob Chemother 68(6):1423–1430 source
- Not checked yetcites [144] Gasch O, Camoez M, Dominguez MA et al (2013) Predictive factors for mortality in patients with methicillin-resistant Staphylococcus aureus bloodstream infection: impact on outcome of host, microorganism and therapy. Clin Microbiol Infect 19(11):1049–1057 source
- Not checked yetcites [145] Lodise TP, McKinnon PS, Swiderski L et al (2003) Outcomes analysis of delayed antibiotic treatment for hospital-acquired Staphylococcus aureus bacteremia. Clin Infect Dis 36(11):1418–1423 source
- Not checked yetcites [146] Paul M, Kariv G, Goldberg E et al (2010) Importance of appropriate empirical antibiotic therapy for methicillin-resistant Staphylococcus aureus bacteraemia. J Antimicrob Chemother 65(12):2658–2665 source
- Not checked yetcites [147] Schramm GE, Johnson JA, Doherty JA et al (2006) Methicillin-resistant Staphylococcus aureus sterile-site infection: the importance of appropriate initial antimicrobial treatment. Crit Care Med 34(8):2069–2074 source
- Not checked yetcites [148] Fang CT, Shau WY, Hsueh PR et al (2006) Early empirical glycopeptide therapy for patients with methicillin-resistant Staphylococcus aureus bacteraemia: impact on the outcome. J Antimicrob Chemother 57(3):511–519 source
- Not checked yetcites [149] Gomez J, Garcia-Vazquez E, Banos R et al (2007) Predictors of mortality in patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia: the role of empiric antibiotic therapy. Eur J Clin Microbiol Infect Dis 26(4):239–245 source
- Not checked yetcites [150] Griffin AT, Peyrani P, Wiemken TL et al (2013) Empiric therapy directed against MRSA in patients admitted to the intensive care unit does not improve outcomes in community-acquired pneumonia. Infection 41(2):517–523 source
- Not checked yetcites [151] Kett DH, Cano E, Quartin AA et al (2011) Implementation of guidelines for management of possible multidrug-resistant pneumonia in intensive care: an observational, multicentre cohort study. Lancet Infect Dis 11(3):181–189 source
- Not checked yetcites [152] Khatib R, Saeed S, Sharma M et al (2006) Impact of initial antibiotic choice and delayed appropriate treatment on the outcome of Staphylococcus aureus bacteremia. Eur J Clin Microbiol Infect Dis 25(3):181–185 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Immunocompromised patients are particularly vulnerable to viral infections, including patients with neutropenia, human immunodeficiency virus (HIV) infection, haematological malignancies and haematopoietic stem cell transplantation or solid organ transplants”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [229] Lin GL, McGinley JP, Drysdale SB et al (2018) Epidemiology and immune pathogenesis of viral sepsis. Front Immunol 9:2147 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Patient-related risk factors for MRSA include prior history of MRSA infection or colonisation, recent IV antibiotics, history of recurrent skin infections or chronic wounds, presence of invasive devices, haemodialysis, recent hospital admissions and severity of illness [136, 138–142].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [136] Aliberti S, Reyes LF, Faverio P et al (2016) Global initiative for meticillin-resistant Staphylococcus aureus pneumonia (GLIMP): an international, observational cohort study. Lancet Infect Dis 16(12):1364–1376 source
- Not checked yetcites [138] Callejo-Torre F, Eiros Bouza JM, Olaechea Astigarraga P et al (2016) Risk factors for methicillin-resistant Staphylococcus aureus colonisation or infection in intensive care units and their reliability for predicting MRSA on ICU admission. Infez Med 24(3):201–209
- Not checked yetcites [139] Epstein L, Mu Y, Belflower R et al (2016) Risk factors for invasive methicillin-resistant Staphylococcus aureus infection after recent discharge from an acute-care hospitalization, 2011–2013. Clin Infect Dis 62(1):45–52 source
- Not checked yetcites [140] Shorr AF, Myers DE, Huang DB et al (2013) A risk score for identifying methicillin-resistant Staphylococcus aureus in patients presenting to the hospital with pneumonia. BMC Infect Dis 13:268 source
- Not checked yetcites [141] Torre-Cisneros J, Natera C, Mesa F et al (2018) Clinical predictors of methicillin-resistant Staphylococcus aureus in nosocomial and healthcare-associated pneumonia: a multicenter, matched case-control study. Eur J Clin Microbiol Infect Dis 37(1):51–56 source
- Not checked yetcites [142] Wooten DA, Winston LG (2013) Risk factors for methicillin-resistant Staphylococcus aureus in patients with community-onset and hospital-onset pneumonia. Respir Med 107(8):1266–1270 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Importantly, the decision to start empiric antifungal therapy depends on the type and number of risk factors, along with the local epidemiology of fungal infections.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Rests on an assumption: The risk of Candida sepsis or septic shock in immunosuppressed populations other than febrile neutropenia is highly disease- and therapy-specific.
None of the sources cited for this claim have been checked yet.
In the paper
“Some observational studies suggested that prompt initiation of appropriate empiric antifungal therapy may be associated with a reduction in mortality, however these studies do not prove a causal relationship between antifungal therapy and outcome, nor do they clarify the role of timing of treatment, and some other studies have failed to show this association [167, 171–173].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [167] Kollef M, Micek S, Hampton N et al (2012) Septic shock attributed to Candida infection: importance of empiric therapy and source control. Clin Infect Dis 54(12):1739–1746 source
- Not checked yetcites [171] Garey KW, Rege M, Pai MP et al (2006) Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis 43(1):25–31 source
- Not checked yetcites [172] Marriott DJ, Playford EG, Chen S et al (2009) Determinants of mortality in non-neutropenic ICU patients with candidaemia. Crit Care 13(4):R115 source
- Not checked yetcites [173] Morrell M, Fraser VJ, Kollef MH (2005) Delaying the empiric treatment of candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality. Antimicrob Agents Chemother 49(9):3640–3645 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Failure to cover for MRSA in a patient with MRSA may be harmful, but unnecessary MRSA coverage in a patient without MRSA may also be harmful.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Sepsis and septic shock due to fungi are most commonly observed in ICUs and are associated with poor outcomes [166–170].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [166] Bassetti M, Righi E, Ansaldi F et al (2014) A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality. Intensive Care Med 40(6):839–845 source
- Not checked yetcites [167] Kollef M, Micek S, Hampton N et al (2012) Septic shock attributed to Candida infection: importance of empiric therapy and source control. Clin Infect Dis 54(12):1739–1746 source
- Not checked yetcites [168] Magill SS, Edwards JR, Bamberg W et al (2014) Multistate point-prevalence survey of health care-associated infections. N Engl J Med 370(13):1198–1208 source
- Not checked yetcites [169] Mean M, Marchetti O, Calandra T (2008) Bench-to-bedside review: Candida infections in the intensive care unit. Crit Care 12(1):204 source
- Not checked yetcites [170] Pappas PG, Kauffman CA, Andes DR et al (2016) Clinical practice guideline for the management of candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis 62(4):e1-50 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Empiric double coverage of gram-negative bacilli is most important in patients at high risk for resistant organisms with severe illness, particularly septic shock.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Factors to guide this decision include: proven infection or colonisation with antibiotic-resistant organisms within the preceding year, local prevalence of antibiotic-resistant organisms, hospital-acquired/healthcare associated (versus community-acquired infection), broad-spectrum antibiotic use within the preceding 90 days”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [162] Alevizakos M, Karanika S, Detsis M et al (2016) Colonisation with extended-spectrum beta-lactamase-producing Enterobacteriaceae and risk for infection among patients with solid or haematological malignancy: a systematic review and meta-analysis. Int J Antimicrob Agents 48(6):647–654 source
- Not checked yetcites [163] Rottier WC, Bamberg YR, Dorigo-Zetsma JW et al (2015) Predictive value of prior colonization and antibiotic use for third-generation cephalosporin-resistant enterobacteriaceae bacteremia in patients with sepsis. Clin Infect Dis 60(11):1622–1630 source
- Not checked yetcites [164] Rottier WC, van Werkhoven CH, Bamberg YRP et al (2018) Development of diagnostic prediction tools for bacteraemia caused by third-generation cephalosporin-resistant enterobacteria in suspected bacterial infections: a nested case-control study. Clin Microbiol Infect 24(12):1315–1321 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“and may be decreasing according to some reports [134, 135]”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [134] Jernigan JA, Hatfield KM, Wolford H et al (2020) Multidrug-resistant bacterial infections in U.S. hospitalized patients, 2012–2017. N Engl J Med 382(14):1309–1319 source
- Not checked yetcites [135] Jones M, Jernigan JA, Evans ME et al (2019) Vital Signs: trends in Staphylococcus aureus infections in veterans affairs medical centers—United States, 2005–2017. MMWR Morb Mortal Wkly Rep 68(9):220–224 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“While there appears to be no overall effect of neuraminidase inhibitors on mortality in patients with influenza-related pneumonia, there may be an effect when administered early in the course of the disease [225].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [225] Muthuri SG, Venkatesan S, Myles PR et al (2014) Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data. Lancet Respir Med 2(5):395–404 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Long-term mortality, readmission rates and hospital-free days were not reported in any of the trials, and no relevant studies on the costs associated with use of procalcitonin were found.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [129] Jensen JU, Hein L, Lundgren B et al (2011) Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial. Crit Care Med 39(9):2048–2058 source
- Not checked yetcites [130] Layios N, Lambermont B, Canivet JL et al (2012) Procalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients. Crit Care Med 40(8):2304–2309 source
- Not checked yetcites [131] Najafi A, Khodadadian A, Sanatkar M et al (2015) The comparison of procalcitonin guidance administer antibiotics with empiric antibiotic therapy in critically ill patients admitted in intensive care unit. Acta Med Iran 53(9):562–567
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Antibiotics are subject to changes in PK/PD parameters in sepsis and septic shock where resultant concentrations may be too low risking clinical failure, or too high leading to toxicity (Table 3) [237–239].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [237] Roberts JA, Abdul-Aziz MH, Lipman J et al (2014) Individualised antibiotic dosing for patients who are critically ill: challenges and potential solutions. Lancet Infect Dis 14(6):498–509 source
- Not checked yetcites [238] Roberts JA, Paul SK, Akova M et al (2014) DALI: defining antibiotic levels in intensive care unit patients: are current beta-lactam antibiotic doses sufficient for critically ill patients? Clin Infect Dis 58(8):1072–1083 source
- Not checked yetcites [239] Veiga RP, Paiva JA (2018) Pharmacokinetics-pharmacodynamics issues relevant for the clinical use of beta-lactam antibiotics in critically ill patients. Crit Care 22(1):233 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Over the course of therapy, both extended and continuous infusions will occupy a venous catheter/lumen more than an intermittent infusion and drug-stability and drug-drug compatibility considerations are important to ensure effectiveness of antibiotic and other IV drug therapies [235].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [235] Roberts JA, Paratz J, Paratz E et al (2007) Continuous infusion of beta-lactam antibiotics in severe infections: a review of its role. Int J Antimicrob Agents 30(1):11–18 source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, it is also possible that reducing the duration of unnecessary therapy may account for at least part of the benefit.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“In many of the trials, the shorter course was just as effective as the longer course but associated with fewer adverse consequences.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [286] Chastre J, Wolff M, Fagon JY et al (2003) Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA 290(19):2588–2598 source
- Not checked yetcites [287] Choudhury G, Mandal P, Singanayagam A et al (2011) Seven-day antibiotic courses have similar efficacy to prolonged courses in severe community-acquired pneumonia—a propensity-adjusted analysis. Clin Microbiol Infect 17(12):1852–1858 source
- Not checked yetcites [288] Kalil AC, Metersky ML, Klompas M et al (2016) Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the infectious diseases society of America and the American Thoracic Society. Clin Infect Dis 63(5):e61–e111 source
- Not checked yetcites [289] Vaughn VM, Flanders SA, Snyder A et al (2019) Excess antibiotic treatment duration and adverse events in patients hospitalized with pneumonia: a multihospital cohort study. Ann Intern Med 171(3):153–163 source
- Not checked yetcites [290] Eliakim-Raz N, Yahav D, Paul M et al (2013) Duration of antibiotic treatment for acute pyelonephritis and septic urinary tract infection—7 days or less versus longer treatment: systematic review and meta-analysis of randomized controlled trials. J Antimicrob Chemother 68(10):2183–2191 source
- Not checked yetcites [291] Runyon BA, McHutchison JG, Antillon MR et al (1991) Short-course versus long-course antibiotic treatment of spontaneous bacterial peritonitis. A randomized controlled study of 100 patients. Gastroenterology 100(6):1737–1742 source
- Not checked yetcites [292] Yahav D, Franceschini E, Koppel F et al (2019) Seven versus 14 days of antibiotic therapy for uncomplicated gram-negative bacteremia: a noninferiority randomized controlled Trial. Clin Infect Dis 69(7):1091–1098 source
- Not checked yetcites [293] Sawyer RG, Claridge JA, Nathens AB et al (2015) Trial of short-course antimicrobial therapy for intraabdominal infection. N Engl J Med 372(21):1996–2005 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Most studies were observational, and there are concerns that de-escalation is used primarily in patients who are getting better, which is why the reported improved short-term mortality should be interpreted with caution [277, 279].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [277] Tabah A, Bassetti M, Kollef MH et al (2020) Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP). Intensive Care Med 46(2):245–265 source
- Not checked yetcites [279] Tabah A, Cotta MO, Garnacho-Montero J et al (2016) A systematic review of the definitions, determinants, and clinical outcomes of antimicrobial de-escalation in the intensive care unit. Clin Infect Dis 62(8):1009–1017 source
plaincorrelationaln = 1,968- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The reduction in short-term mortality from prolonged infusion of beta-lactams is significant with the intervention being feasible with negligible cost implications and no data suggesting inferior outcomes with prolonged infusion.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“De-escalation is in generally safe, may offer cost savings when unnecessary antibiotics are discontinued, and reduced risk of antimicrobial resistance and reduced toxicity and side-effects may be important [280].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [280] De Bus L, Depuydt P, Steen J, et al (2020) Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study. Intensive Care Med 46(7):1404–1417 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Restricting antimicrobial therapy to the shortest course associated with better outcomes is an important part of antimicrobial stewardship [281–285].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [281] Fernandez-Lazaro CI, Brown KA, Langford BJ et al (2019) Late-career physicians prescribe longer courses of antibiotics. Clin Infect Dis 69(9):1467–1475 source
- Not checked yetcites [282] Hanretty AM, Gallagher JC (2018) Shortened courses of antibiotics for bacterial infections: a systematic review of randomized controlled trials. Pharmacotherapy 38(6):674–687 source
- Not checked yetcites [283] Royer S, DeMerle KM, Dickson RP et al (2018) shorter versus longer courses of antibiotics for infection in hospitalized patients: a systematic review and meta-analysis. J Hosp Med 13(5):336–342 source
- Not checked yetcites [284] Spellberg B (2016) The new antibiotic mantra-"Shorter Is Better". JAMA Intern Med 176(9):1254–1255 source
- Not checked yetcites [285] Wald-Dickler N, Spellberg B (2019) Short-course antibiotic therapy-replacing constantine units with “Shorter Is Better.” Clin Infect Dis 69(9):1476–1479 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Very few trials, however, focussed exclusively on critically ill patients with sepsis or septic shock, and the overall quality of evidence was very low.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plain- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, catheter removal with adequate antimicrobial therapy is definitive and is the preferred treatment in most cases.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Antimicrobial exposure is linked to the development of antimicrobial resistance and efforts to reduce both the number of antibiotics administered and their spectrum of therapy are therefore important strategies in patients with sepsis and septic shock [165].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [165] Arulkumaran N, Routledge M, Schlebusch S et al (2020) Antimicrobial-associated harm in critical care: a narrative review. Intensive Care Med 46(2):225–235 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Also, the algorithms for antimicrobial therapy, frequency of procalcitonin monitoring and the thresholds (or percentage change in procalcitonin concentration) for discontinuation differed across the trials.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The SMART trial was a single-centre study without individual patient randomisation and no blinded assignment of the intervention, it exposed participants to moderate amount of fluid volume, identification of sepsis subgroups was based on ICD-10 codes, and it used a composite outcome which may not be as relevant as a patient-centered outcome [336].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [336] Myburgh J (2018) Patient-Centered Outcomes and Resuscitation Fluids. N Engl J Med 378(9):862–863 source
hedged- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“potential adverse effects that include hyperchloremic metabolic acidosis, renal vasoconstriction, increased cytokine secretion and concern about acute kidney injury (AKI) have led to increased interest in chloride-restrictive solutions, known as balanced or buffered solutions [326–330].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [326] Chowdhury AH, Cox EF, Francis ST et al (2012) A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and plasma-lyte(R) 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers. Ann Surg 256(1):18–24 source
- Not checked yetcites [327] Kellum JA (2002) Fluid resuscitation and hyperchloremic acidosis in experimental sepsis: improved short-term survival and acid-base balance with Hextend compared with saline. Crit Care Med 30(2):300–305 source
- Not checked yetcites [328] Kellum JA, Song M, Almasri E (2006) Hyperchloremic acidosis increases circulating inflammatory molecules in experimental sepsis. Chest 130(4):962–967 source
- Not checked yetcites [329] Waters JH, Gottlieb A, Schoenwald P et al (2001) Normal saline versus lactated Ringer’s solution for intraoperative fluid management in patients undergoing abdominal aortic aneurysm repair: an outcome study. Anesth Analg 93(4):817–822 source
- Not checked yetcites [330] Williams EL, Hildebrand KL, McCormick SA et al (1999) The effect of intravenous lactated Ringer’s solution versus 0.9% sodium chloride solution on serum osmolality in human volunteers. Anesth Analg 88(5):999–1003
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although there was no difference with respect to kidney injury (RR 0.89; 95% CI 0.72–1.11), vasopressin use reduced the risk of RRT (RR 0.71; 95% CI 0.53–0.97) [354].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [354] Gordon AC, Mason AJ, Thirunavukkarasu N et al (2016) Effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock: the VANISH randomized clinical trial. JAMA 316(5):509–518 source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A meta-analysis of studies including septic patients did not show a significant difference in mortality (RR 0.98; 95% CI 0.89–1.08). In addition, the risk of new organ failures (RR 1.02; 95% CI 0.93–1.11), ventilator-free days or vasopressor-free days did not differ.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plain- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The suggestion to consider albumin in patients who received large volumes of crystalloids is informed by evidence showing higher blood pressure at early and later time points [339], higher static filling pressures [340], and lower net fluid balance [339] with albumin.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [339] Caironi P, Tognoni G, Gattinoni L (2014) Albumin replacement in severe sepsis or septic shock. N Engl J Med 371(1):84 source
- Not checked yetcites [340] Martin GS, Bassett P (2019) Crystalloids vs. colloids for fluid resuscitation in the Intensive Care Unit: a systematic review and meta-analysis. J Crit Care 50:144–154 source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The undesirable effects of using procalcitonin along with clinical evaluation to decide when to discontinue antimicrobials are considered minimal, and do not outweigh the potential benefits [322].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
What the sources say
- Not checked yetcites [322] Arulkumaran N, Khpal M, Tam K et al (2020) Effect of antibiotic discontinuation strategies on mortality and infectious complications in critically ill septic patients: a meta-analysis and trial sequential analysis. Crit Care Med 48(5):757–764 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although albumin is theoretically more likely to maintain oncotic pressure than crystalloids [339]”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [339] Caironi P, Tognoni G, Gattinoni L (2014) Albumin replacement in severe sepsis or septic shock. N Engl J Med 371(1):84 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although albumin use resulted in a larger treatment effect in the septic shock subgroup (RR 0.88; 95% CI 0.77–0.99) than in the sepsis subgroup (RR 1.03; 95% CI 0.91–1.17), the subgroup analysis did not detect a subgroup effect (P-interaction = 0.19).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, gelatins may affect haemostasis and the effect on blood transfusions was unclear (RR 1.10; 95% CI 0.86–1.41).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“a recent individual patient data meta-analysis of patients with septic shock from 4 RCTs showed that vasopressin alone or in combination with norepinephrine led to higher risk of digital ischaemia (risk difference [RD] 1.7%; 95% CI 0.3–3.2) but lower risk of arrhythmia (RD −2.8%; 95% CI −0.2 to −5.3) compared to norepinephrine alone [359].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [359] Nagendran M, Russell JA, Walley KR et al (2019) Vasopressin in septic shock: an individual patient data meta-analysis of randomised controlled trials. Intensive Care Med 45(6):844–855 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a systematic review and meta-analysis of 11 RCTs, norepinephrine resulted in a lower mortality (RR 0.89; 95% CI 0.81–0.98) and lower risk of arrhythmias (RR 0.48; 95% CI 0.40–0.58) compared with dopamine [347].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [347] Avni T, Lador A, Lev S et al (2015) Vasopressors for the treatment of septic shock: systematic review and meta-analysis. PLoS One 10(8):e0129305 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A second meta-analysis, which also included critically ill patients, found lower static filling pressures (MD −2.3 cm H2O; 95% CI 3.02–1.05) and mean arterial pressure (MAP) (MD −3.53 mmHg; 95% CI −6.71 to −0.36) with crystalloid use, but no difference in mortality at 28 days (RR 1.0; 95% CI 0.92–1.10) or 90 days (RR 1.32; 95% CI 0.76–2.29) [340].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [340] Martin GS, Bassett P (2019) Crystalloids vs. colloids for fluid resuscitation in the Intensive Care Unit: a systematic review and meta-analysis. J Crit Care 50:144–154 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A Cochrane review including RCTs with 12,492 patients comparing albumin versus crystalloids found no difference in 30-day (RR 0.98; 95% CI 0.92–1.04) or 90-day mortality (RR 0.98; 95% CI 0.92–1.04) or need for RRT between groups (RR 1.11; 95% CI 0.96–1.27) [324].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [324] Lewis SR, Pritchard MW, Evans DJ et al (2018) Colloids versus crystalloids for fluid resuscitation in critically ill people. Cochrane Database Syst Rev 8:CD000567
plainn = 12,492- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, for adults with an initial diagnosis of sepsis or septic shock and adequate source control, we suggest a shorter course of antibiotics, as this is less costly, has fewer undesirable effects without impacting adversely on outcomes (see Table 4).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, the overall quality of evidence was judged to be low.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Infection > Rationale
plainn = 4,499- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“The study was stopped for futility after enrolment of 828 patients, with no significant differences between any of the key endpoints [ventilator- and vasopressor-free days, 15.0 (selepressin) versus 14.5 (placebo), p = 0.30; 90-day all-cause mortality, 40.6% vs 39.4%, p = 0.77; 30-day RRT-free days, 18.5 vs 18.2, p = 0.85; 30-day ICU-free days, 12.6 vs 12.2, p = 0.41]; adverse event rates were als”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [364] Laterre PF, Berry SM, Blemings A, et al (2019) Effect of selepressin vs placebo on ventilator- and vasopressor-free days in patients with septic shock: the SEPSIS-ACT randomized clinical trial. JAMA 322(15):1476–1485 source
plainn = 828- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A randomised blinded study comparing epinephrine with norepinephrine in patients with shock showed no difference in 90-day mortality (HR 0.88; 95% CI 0.63–1.25) and vasopressor-free days [351].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [351] Myburgh JA, Higgins A, Jovanovska A et al (2008) A comparison of epinephrine and norepinephrine in critically ill patients. Intensive Care Med 34(12):2226–2234 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies show that vasopressin concentration is elevated in early septic shock but decreases to normal range in the majority of patients between 24 and 48 h as shock continues [352, 353].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [352] Holmes CL, Patel BM, Russell JA et al (2001) Physiology of vasopressin relevant to management of septic shock. Chest 120(3):989–1002 source
- Not checked yetcites [353] Landry DW, Levin HR, Gallant EM et al (1997) Vasopressin deficiency contributes to the vasodilation of septic shock. Circulation 95(5):1122–1125 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“After a small, short-term pilot of 20 patients with vasodilatory (septic) shock 10 patients in each group which showed physiological efficacy without obvious safety issues [365]”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [365] Chawla LS, Busse L, Brasha-Mitchell E et al (2014) Intravenous angiotensin II for the treatment of high-output shock (ATHOS trial): a pilot study. Crit Care 18(5):534 source
plaindirectn = 20- Asserted: passes — The authors put it forward as true.
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In the paper
“A previous meta-analysis of RCTs in septic patients showed a higher risk of RRT with the use of HES 130/0.38–0.45 (RR 1.36; 95% CI 1.08–1.72) and a higher risk of death in a pre-defined analysis of low risk of bias trials (RR 1.11; 95% CI 1.0–1.2) [343].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [343] Haase N, Perner A, Hennings LI et al (2013) Hydroxyethyl starch 130/0.38–0.45 versus crystalloid or albumin in patients with sepsis: systematic review with meta-analysis and trial sequential analysis. BMJ 346:f839 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Sepsis-induced myocardial dysfunction is recognised as a major contributor to the haemodynamic instability and is associated with worse outcomes of patients with septic shock [368].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [368] Walley KR (2018) Sepsis-induced myocardial dysfunction. Curr Opin Crit Care 24(4):292–299 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Recent data emerging from Africa showed that higher volume fluid resuscitation in adults was associated with increased mortality, but the generalizability of these data is limited due to the high prevalence of HIV/AIDS and malnutrition in the patients enrolled and the resource-scarce conditions with limited access to ICUs [69].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [69] Andrews B, Semler MW, Muchemwa L et al (2017) Effect of an early resuscitation protocol on in-hospital mortality among adults with sepsis and hypotension: a randomized clinical trial. JAMA 318(13):1233–1240 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Insertion of an arterial catheter permits safe, reliable and continuous measurement of arterial pressure and allows real time analysis so that therapeutic decisions can be based on immediate and accurate blood pressure information [380].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [380] Vincent J (2019) Arterial, central venous, and pulmonary artery catheters. In: JE P (ed) Critical care medicine: principles and diagnosis and management in the adult, 5th edn. Elsevier, Philadelphia, pp 40–49
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Data from the LeoPARDS trial (n = 515) showed that levosimendan versus no inotropic agents was associated with a lower likelihood of successful weaning from mechanical ventilation and a higher risk of supraventricular tachyarrythmia [373].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [373] Gordon AC, Perkins GD, Singer M et al (2016) Levosimendan for the prevention of acute organ dysfunction in sepsis. N Engl J Med 375(17):1638–1648 source
plaincorrelationaln = 515- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Ultrasound guidance may increase the first attempt success rate and decrease the complication rate [382, 383].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [382] Bhattacharjee S, Maitra S, Baidya DK (2018) Comparison between ultrasound guided technique and digital palpation technique for radial artery cannulation in adult patients: an updated meta-analysis of randomized controlled trials. J Clin Anesth 47:54–59 source
- Not checked yetcites [383] Gu WJ, Wu XD, Wang F et al (2016) Ultrasound guidance facilitates radial artery catheterization: a meta-analysis with trial sequential analysis of randomized controlled trials. Chest 149(1):166–179 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The 28-day mortality in the two groups was 40% for terlipressin and 38% for norepinephrine (OR 0.93; 95% CI 0.55–1.56, p = 0.80), and there were no differences in SOFA score at day 7 or vasopressor free days.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [367] Liu ZM, Chen J, Kou Q et al (2018) Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre, randomised, double-blinded trial. Intensive Care Med 44(11):1816–1825 source
plainn = 617- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Most of the studies reported no need for active treatment of the extravasation, and a systematic review concluded that most patients who experience extravasation events have no long-term sequelae [389].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [389] Loubani OM, Green RS (2015) A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters. J Crit Care 30(3):653e9-17 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“More patients who received terlipressin had serious adverse events; 33 of 260 (12%) patients experienced digital ischaemia after receiving terlipressin, versus only one patient who received norepinephrine (p < 0.0001); diarrhea was also more common in the terlipressin group (2.7% versus 0.35%, p = 0.037).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [367] Liu ZM, Chen J, Kou Q et al (2018) Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre, randomised, double-blinded trial. Intensive Care Med 44(11):1816–1825 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“ProCESS[64], ARISE [65] and ProMISe [66] administered approximately 7–8 L in the usual care groups with a reported low mortality rate.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [64] Investigators P, Yealy DM, Kellum JA et al (2014) A randomized trial of protocol-based care for early septic shock. N Engl J Med 370(18):1683–1693 source
- Not checked yetcites [65] Peake SL, Delaney A, Bellomo R et al (2015) Goal-directed resuscitation in septic shock. N Engl J Med 372(2):190–191
- Not checked yetcites [66] Mouncey PR, Osborn TM, Power GS et al (2015) Trial of early, goal-directed resuscitation for septic shock. N Engl J Med 372(14):1301–1311 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“A systematic review of observational studies showed that the risk of limb ischaemia and bleeding was less than 1% for radial catheters, and the risk of limb ischaemia and bleeding was less than 1% and 1.58%, respectively, for femoral catheters. The most common complication was localised haematoma, 14% for radial and 6% for femoral catheters [381].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [381] Scheer B, Perel A, Pfeiffer UJ (2002) Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. Crit Care 6(3):199–204 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“recent evidence suggests that IV fluids used to restore organ perfusion may damage vascular integrity and lead to organ dysfunction [394].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [394] Alphonsus CS, Rodseth RN (2014) The endothelial glycocalyx: a review of the vascular barrier. Anaesthesia 69(7):777–784 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Dobutamine infusion may produce severe vasodilation and result in lower MAP.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Estimation of blood pressure using a non-invasive cuff tends to be inaccurate and the discrepancy more pronounced in shock states [375–379].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [375] Araghi A, Bander JJ, Guzman JA (2006) Arterial blood pressure monitoring in overweight critically ill patients: invasive or noninvasive? Crit Care 10(2):R64 source
- Not checked yetcites [376] Bur A, Hirschl MM, Herkner H et al (2000) Accuracy of oscillometric blood pressure measurement according to the relation between cuff size and upper-arm circumference in critically ill patients. Crit Care Med 28(2):371–376 source
- Not checked yetcites [377] Kaur B, Kaur S, Yaddanapudi LN et al (2019) Comparison between invasive and noninvasive blood pressure measurements in critically ill patients receiving inotropes. Blood Press Monit 24(1):24–29 source
- Not checked yetcites [378] Lehman LW, Saeed M, Talmor D et al (2013) Methods of blood pressure measurement in the ICU. Crit Care Med 41(1):34–40 source
- Not checked yetcites [379] Riley LE, Chen GJ, Latham HE (2017) Comparison of noninvasive blood pressure monitoring with invasive arterial pressure monitoring in medical ICU patients with septic shock. Blood Press Monit 22(4):202–207 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Data from observational studies have shown an association of high-volume fluid resuscitation and increased mortality, but these studies are likely affected by unmeasured variables (i.e. the administration of higher amounts of fluids to sicker patients) [395, 396].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [395] Boyd JH, Forbes J, Nakada TA et al (2011) Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med 39(2):259–265 source
- Not checked yetcites [396] Marik PE, Linde-Zwirble WT, Bittner EA et al (2017) Fluid administration in severe sepsis and septic shock, patterns and outcomes: an analysis of a large national database. Intensive Care Med 43(5):625–632 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“A small study (n = 263) randomly allocated patients to receive peripheral vascular access or a central access [386]. The need for vasopressor was the indication for venous access in 70% of the patients. The incidence of major catheter-related complications was higher in those randomised to peripheral venous lines with no significant difference in the incidence of minor catheter-related complicatio”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [386] Ricard JD, Salomon L, Boyer A et al (2013) Central or peripheral catheters for initial venous access of ICU patients: a randomized controlled trial. Crit Care Med 41(9):2108–2115 source
plaindirectn = 263- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one. The quote only partly states this claim.
In the paper
“A post-hoc analysis of the ARISE trial showed that 42% of patients had vasopressors initiated via a peripheral catheter with a shorter time to initiation of vasopressors (2.4 [1.3–3.9] vs. 4.9 h [3.5–6.6], p < 0.001) [385].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [385] Delaney A, Finnis M, Bellomo R et al (2020) Initiation of vasopressor infusions via peripheral versus central access in patients with early septic shock: a retrospective cohort study. Emerg Med Australas 32(2):210–219 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“A systematic review showed higher risk of infections when femoral arterial catheters were used compared to radial artery catheters (RR 1.93; 95% CI 1.32–2.84), and the overall pooled incidence of bloodstream infection was 0.96 per 1000 catheter days [384].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [384] O’Horo JC, Maki DG, Krupp AE et al (2014) Arterial catheters as a source of bloodstream infection: a systematic review and meta-analysis. Crit Care Med 42(6):1334–1339 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the analysis adjusted only to baseline characteristics, without accounting for time-varying confounders including the patient condition at the time of initiating inotropes which may explain the association with mortality.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
hedgedconditionaln = 420- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Extravasation may occur more frequently if vasopressors are infused distally to the antecubital fossa; a meta-analysis showed that 85% of reported extravasation events occurred when vasopressors were infused by a catheter that was located distal to the antecubital fossa [389].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [389] Loubani OM, Green RS (2015) A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters. J Crit Care 30(3):653e9-17 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Physiologic studies demonstrate that dobutamine increases CO and oxygen transport, increases splanchnic perfusion and tissue oxygenation, improves intramucosal acidosis and hyperlactatemia [369].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
What the sources say
- Not checked yetcites [369] Cunha-Goncalves D, Perez-de-Sa V, Larsson A et al (2009) Inotropic support during experimental endotoxemic shock: part II. A comparison of levosimendan with dobutamine. Anesth Analg 109(5):1576–1583 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Of note, the 3 RCTs that guide this recommendation [424, 426, 427] enrolled patients using the criteria from the American-European Consensus Criteria Definition for Acute Lung Injury and ARDS [422] whereas the current document use the 2012 Berlin definition and the terms mild, moderate, and severe ARDS (PaO2/FiO2 ≤ 300, ≤ 200, and ≤ 100 mm Hg, respectively) [423].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [424] Brower RG, Matthay MA, Acute Respiratory Distress Syndrome N et al (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342(18):1301–1308 source
- Not checked yetcites [426] Brochard L, Roudot-Thoraval F, Roupie E et al (1998) Tidal volume reduction for prevention of ventilator-induced lung injury in acute respiratory distress syndrome. The Multicenter Trail Group on Tidal Volume reduction in ARDS. Am J Respir Crit Care Med 158(6):1831–1838 source
- Not checked yetcites [427] Brower RG, Shanholtz CB, Fessler HE et al (1999) Prospective, randomized, controlled clinical trial comparing traditional versus reduced tidal volume ventilation in acute respiratory distress syndrome patients. Crit Care Med 27(8):1492–1498 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The plateau pressure is only truly valuable if the patient is passive during the inspiratory hold.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“These three RCTS compared a strategy of low tidal volume and limited plateau pressure with a strategy using higher tidal volume and plateau pressure; pooled data suggest reduced mortality (RR 0.83; 95% CI 0.70–0.97) and more ventilator-free days (MD 1.8 days; 95% CI 0.35–3.25) in patients managed with low plateau pressures.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [424] Brower RG, Matthay MA, Acute Respiratory Distress Syndrome N et al (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342(18):1301–1308 source
- Not checked yetcites [426] Brochard L, Roudot-Thoraval F, Roupie E et al (1998) Tidal volume reduction for prevention of ventilator-induced lung injury in acute respiratory distress syndrome. The Multicenter Trail Group on Tidal Volume reduction in ARDS. Am J Respir Crit Care Med 158(6):1831–1838 source
- Not checked yetcites [427] Brower RG, Shanholtz CB, Fessler HE et al (1999) Prospective, randomized, controlled clinical trial comparing traditional versus reduced tidal volume ventilation in acute respiratory distress syndrome patients. Crit Care Med 27(8):1492–1498 source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Volume- and pressure-limited ventilation may lead to hypercapnia even with these maximum-tolerated set respiratory rates; this appears to be tolerated and safe in the absence of contraindications (e.g., high intracranial pressure, sickle cell crisis).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Patients with sepsis-induced hypoxemic respiratory failure may or may not have a competing chronic respiratory disease (ex. COPD, obesity) and the use of NIV for the rescue of patients with exclusively acute hypoxic respiratory failure (“de novo respiratory failure”) is less well studied, but not uncommon.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, the NIV technique was not standardised and the experience of the centers varied.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A retrospective study suggested that tidal volumes should be lowered even with plateau pressures ≤ 30 cm H2O [431] because lower plateau pressures were associated with reduced hospital mortality [432].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [431] Hager DN, Krishnan JA, Hayden DL et al (2005) Tidal volume reduction in patients with acute lung injury when plateau pressures are not high. Am J Respir Crit Care Med 172(10):1241–1245 source
- Not checked yetcites [432] Checkley W, Brower R, Korpak A et al (2008) Effects of a clinical trial on mechanical ventilation practices in patients with acute lung injury. Am J Respir Crit Care Med 177(11):1215–1222 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Although the primary outcome of intubation rate at 28 days was not different, this study demonstrated improved 90-day survival with HFNC compared with NIV (OR 0.42; 95% CI 0.21–0.85) and HFNC patients experienced significantly more days free of mechanical ventilation during a 28-day study period [411].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [411] Frat JP, Thille AW, Mercat A et al (2015) High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med 372(23):2185–2196 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Acute hypoxemic respiratory failure can result from causes of sepsis such as pneumonia or non-pulmonary infections resulting in ARDS.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Moreover, the primary outcomes were mostly related to IV fluid volumes administered during the study period and given the small sample sizes, they were not powered to identify differences in patient-centered outcomes.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In addition to improving gas exchange, NIV may help to reduce work of breathing in select patients.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Complications with HFNC are possible; however, they are usually self-limited and do not require discontinuing therapy.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In contrast, NIV can cause mask-related discomfort, unrecognised patient-ventilator asynchrony due to leaks, and gastric insufflation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When directly compared to invasive positive pressure ventilation, NIV may be able to achieve similar physiologic benefits including improved gas exchange and reduced work of breathing in select patients, while avoiding complications associated with intubation, invasive ventilation, and accompanying sedation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies have suggested that NIV failure is an independent risk factor for mortality specifically in this population, although careful patient selection may reduce this risk [415, 416].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [415] Demoule A, Chevret S, Carlucci A et al (2016) Changing use of noninvasive ventilation in critically ill patients: trends over 15 years in francophone countries. Intensive Care Med 42(1):82–92 source
- Not checked yetcites [416] Demoule A, Girou E, Richard JC et al (2006) Benefits and risks of success or failure of noninvasive ventilation. Intensive Care Med 32(11):1756–1765 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“LUNGSAFE, a large international observational study, which reported that plateau pressure correlated with mortality; however, the relationship between the two was not evident when plateau pressure was below 20 cm H2O [435].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [435] Laffey JG, Bellani G, Pham T et al (2016) Potentially modifiable factors contributing to outcome from acute respiratory distress syndrome: the LUNG SAFE study. Intensive Care Med 42(12):1865–1876 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The conservative use of oxygen may reduce oxygen exposure and diminish lung and systemic oxidative injury.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Patients who are undergoing mechanical ventilation in the ICU often receive a high fraction of inspired oxygen and have a high arterial oxygen tension.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The main risk of NIV for the indication of acute respiratory failure is the potential for delaying needed intubation and increasing the risk of an interval aspiration events.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“High flow nasal cannula (HFNC) is a non-invasive, high concentration oxygen delivery interface that confers warming and humidification of secretions, high flow rates to better match patient demand, washout of nasopharyngeal dead space, and modest positive airway pressure effect.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“These studies showed differing results, which may have been caused by differences in airway pressures in the treatment and control groups [423, 424, 428].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [423] Force ADT, Ranieri VM, Rubenfeld GD et al (2012) Acute respiratory distress syndrome: the Berlin Definition. JAMA 307(23):2526–2533
- Not checked yetcites [424] Brower RG, Matthay MA, Acute Respiratory Distress Syndrome N et al (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342(18):1301–1308 source
- Not checked yetcites [428] Eichacker PQ, Gerstenberger EP, Banks SM et al (2002) Meta-analysis of acute lung injury and acute respiratory distress syndrome trials testing low tidal volumes. Am J Respir Crit Care Med 166(11):1510–1514 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The LOCO-2 study was terminated early by the data safety and monitoring board and reported no difference in 28-day survival in ARDS patients managed with a conservative oxygenation strategy [409].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [409] Barrot L, Asfar P, Mauny F et al (2020) Liberal or conservative oxygen therapy for acute respiratory distress syndrome. N Engl J Med 382(11):999–1008 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Due to small number of patients studied, low quality of evidence, uncertainty regarding whether clinicians can identify hypoxic patients in respiratory failure in whom NIV might be beneficial, and observational data that suggest the potential for harm with NIV in this setting, no clear recommendation can be made.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The single inspiratory limb of HFNC allows for airflows as high as 60 L per minute to achieve inspired oxygen fractions (FiO2) as high as 95–100%.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Mortality at 90 and 180 days did not differ.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [405] Investigators I-R, the A, New Zealand Intensive Care Society Clinical Trials G et al (2020) Conservative Oxygen Therapy during Mechanical Ventilation in the ICU. N Engl J Med 382(11):989–998 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A systematic review and meta-analysis of nine RCTs [2] showed that HFNC reduces intubation compared with conventional oxygen (RR 0.85; 95% CI 0.74–0.99) but does not affect the risk of death or ICU length of stay [412–414].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [2] Fleischmann C, Scherag A, Adhikari NK et al (2016) Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med 193(3):259–272 source
- Not checked yetcites [412] Ni YN, Luo J, Yu H et al (2018) The effect of high-flow nasal cannula in reducing the mortality and the rate of endotracheal intubation when used before mechanical ventilation compared with conventional oxygen therapy and noninvasive positive pressure ventilation. A systematic review and meta-analysis. Am J Emerg Med 36(2):226–233 source
- Not checked yetcites [413] Ou X, Hua Y, Liu J et al (2017) Effect of high-flow nasal cannula oxygen therapy in adults with acute hypoxemic respiratory failure: a meta-analysis of randomized controlled trials. CMAJ 189(7):E260–E267 source
- Not checked yetcites [414] Rochwerg B, Granton D, Wang DX et al (2019) High-flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: author’s reply. Intensive Care Med 45(8):1171 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients with profound metabolic acidosis, high minute ventilation, or short stature may require additional manipulation of tidal volumes.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, NIV use can be associated with development of complications including increased risk of gastric insufflation and aspiration, facial skin breakdown, excessively high tidal volumes as well as patient discomfort related to inability to eat or effectively phonate during therapy.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The clinician should keep in mind that very low tidal volumes may result in significant patient-ventilatory dyssynchrony and patient discomfort.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Both therapies avoid the complications of intubation and invasive mechanical ventilation and promote patient interaction.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, sepsis is an independent risk factor for the development of ARDS, and delays in diagnosing ARDS may result in delayed use of low tidal volumes.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“Many strategies exist for treating refractory hypoxemia in patients with severe ARDS [451].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [451] Pipeling MR, Fan E (2010) Therapies for refractory hypoxemia in acute respiratory distress syndrome. JAMA 304(22):2521–2527 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Selected patients with severe hypoxemia may benefit from recruitment maneuvers in conjunction with higher levels of PEEP, but little evidence supports the routine use in all ARDS patients, so we have focused our recommendations to patients with moderate-to-severe ARDS [453].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [453] Fan E, Wilcox ME, Brower RG et al (2008) Recruitment maneuvers for acute lung injury a systematic review. Am J Respir Crit Care Med 178(11):1156–1163 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“This recommendation was based on a meta-analysis of 3 trials that examined the role of NMBAs in ARDS [465–467], showing reduced risks of death (RR 0.72; 95% CI 0.58–0.91) and barotrauma (RR 0.43; 95% CI 0.20–0.90) with the use of cisatracurium infusion [468].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [465] Forel JM, Roch A, Marin V et al (2006) Neuromuscular blocking agents decrease inflammatory response in patients presenting with acute respiratory distress syndrome. Crit Care Med 34(11):2749–2757 source
- Not checked yetcites [466] Gainnier M, Roch A, Forel JM et al (2004) Effect of neuromuscular blocking agents on gas exchange in patients presenting with acute respiratory distress syndrome. Crit Care Med 32(1):113–119 source
- Not checked yetcites [467] Papazian L, Forel JM, Gacouin A et al (2010) Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 363(12):1107–1116 source
- Not checked yetcites [468] Alhazzani W, Alshahrani M, Jaeschke R et al (2013) Neuromuscular blocking agents in acute respiratory distress syndrome: a systematic review and meta-analysis of randomized controlled trials. Crit Care 17(2):R43 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The most common indication for neuromuscular blocking agents (NMBAs) use in the ICU is to facilitate mechanical ventilation [462].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [462] Klessig HT, Geiger HJ, Murray MJ et al (1992) A National Survey on the practice patterns of anesthesiologist intensivists in the use of muscle-relaxants. Crit Care Med 20(9):1341–1345 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“A patient-level analysis of two of the randomised PEEP trials [440, 441] suggested that patients with ARDS who respond to increased PEEP with improved oxygenation have a lower risk of death; this association was stronger in patients with more severe ARDS (PaO2/FiO2 < 150 mmHg) compared with patients with less severe ARDS [444].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [440] Meade MO, Cook DJ, Guyatt GH et al (2008) Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 299(6):637–645 source
- Not checked yetcites [441] Mercat A, Richard JC, Vielle B et al (2008) Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 299(6):646–655 source
- Not checked yetcites [444] Goligher EC, Kavanagh BP, Rubenfeld GD et al (2014) Oxygenation response to positive end-expiratory pressure predicts mortality in acute respiratory distress syndrome. A secondary analysis of the LOVS and ExPress trials. Am J Respir Crit Care Med 190(1):70–76 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“One option is to titrate PEEP according to bedside measurements of thoracopulmonary compliance with the objective of obtaining the best compliance or lowest driving pressure, reflecting a favourable balance of lung recruitment and overdistension [445].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [445] Amato MB, Barbas CS, Medeiros DM et al (1995) Beneficial effects of the “open lung approach” with low distending pressures in acute respiratory distress syndrome. A prospective randomized study on mechanical ventilation. Am J Respir Crit Care Med 152(6 Pt 1):1835–1846 source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Most patients respond to the prone position with improved oxygenation and may also have improved lung compliance [457–459].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [457] Jolliet P, Bulpa P, Chevrolet JC (1998) Effects of the prone position on gas exchange and hemodynamics in severe acute respiratory distress syndrome. Crit Care Med 26(12):1977–1985 source
- Not checked yetcites [458] Lamm WJ, Graham MM, Albert RK (1994) Mechanism by which the prone position improves oxygenation in acute lung injury. Am J Respir Crit Care Med 150(1):184–193 source
- Not checked yetcites [459] Stocker R, Neff T, Stein S et al (1997) Prone postioning and low-volume pressure-limited ventilation improve survival in patients with severe ARDS. Chest 111(4):1008–1017 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Applying higher PEEP in patients with ARDS may open lung units to participate in gas exchange and may increase PaO2.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A third option is to use a PEEP/FiO2 titration table that titrates PEEP based on the combination of FiO2 and PEEP required to maintain adequate oxygenation [439–441].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [439] Brower RG, Lanken PN, MacIntyre N et al (2004) Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med 351(4):327–336 source
- Not checked yetcites [440] Meade MO, Cook DJ, Guyatt GH et al (2008) Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 299(6):637–645 source
- Not checked yetcites [441] Mercat A, Richard JC, Vielle B et al (2008) Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 299(6):646–655 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Since then, several RCTs have been published [469–471], the largest of which is the ROSE Trial [471].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [469] Guervilly C, Bisbal M, Forel JM et al (2017) Effects of neuromuscular blockers on transpulmonary pressures in moderate to severe acute respiratory distress syndrome. Intensive Care Med 43(3):408–418 source
- Not checked yetcites [470] Lyu G, Wang X, Jiang W et al (2014) Clinical study of early use of neuromuscular blocking agents in patients with severe sepsis and acute respiratory distress syndrome. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 26(5):325–329
- Not checked yetcites [471] National Heart L, Blood Institute PCTN, Moss M et al (2019) Early Neuromuscular Blockade in the Acute Respiratory Distress Syndrome. N Engl J Med 380(21):1997–2008 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The optimal method of selecting a higher PEEP level is not clear.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“While the pilot study suggested benefit [448], the subsequent 200 patient multicentre RCT that compared PEEP titration guided by esophageal (PES) measurement versus empirical high PEEP-FiO2 titration, showed no significant difference in a composite outcome of death and days free from mechanical ventilation through day 28 [449].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [448] Talmor D, Sarge T, Malhotra A et al (2008) Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med 359(20):2095–2104 source
- Not checked yetcites [449] Turbil E, Galerneau LM, Terzi N et al (2019) Positive-end expiratory pressure titration and transpulmonary pressure: the EPVENT 2 trial. J Thorac Dis 11(Suppl 15):S2012–S2017 source
plainn = 200- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Two RCTs [437, 438] were published since the 2016 Guidelines [12, 13], but we did not include these trials in the meta-analyses because both studies applied recruitment maneuvers to titrate PEEP levels.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [437] Hodgson CL, Cooper DJ, Arabi Y et al (2019) Maximal recruitment open lung ventilation in acute respiratory distress syndrome (PHARLAP). A phase II, multicenter randomized controlled clinical trial. Am J Respir Crit Care Med 200(11):1363–1372 source
- Not checked yetcites [438] Cavalcanti AB, Suzumura EA, Writing Group for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial I et al (2017) Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 318(14):1335–1345 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“While prone position may be associated with potentially life-threatening complications including accidental removal of the endotracheal tube, this was not evident in pooled analysis (RR 1.09; 95% CI 0.85–1.39).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [454] Munshi L, Del Sorbo L, Adhikari NKJ et al (2017) Prone position for acute respiratory distress syndrome. A systematic review and meta-analysis. Ann Am Thorac Soc 14(Supplement_4):S280-s8 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although the effects of recruitment maneuvers improve oxygenation initially, the effects can be transient [453].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [453] Fan E, Wilcox ME, Brower RG et al (2008) Recruitment maneuvers for acute lung injury a systematic review. Am J Respir Crit Care Med 178(11):1156–1163 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Meta-analysis including this study demonstrated reduced mortality in severe ARDS patients treated with prone compared with supine position (RR 0.74; 95% CI 0.56–0.99) as well as improved oxygenation as measured by change in PaO2/FiO2 ratio (median 23.5 higher; 95% CI 12.4–34.5 higher) [454].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [454] Munshi L, Del Sorbo L, Adhikari NKJ et al (2017) Prone position for acute respiratory distress syndrome. A systematic review and meta-analysis. Ann Am Thorac Soc 14(Supplement_4):S280-s8 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In the SSC 2016 guidelines, we issued a weak recommendation for using NMBA infusion for 48 h in sepsis-induced moderate to severe ARDS [12, 13].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [12] Rhodes A, Evans LE, Alhazzani W et al (2017) Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med 45(3):486–552 source
- Not checked yetcites [13] Rhodes A, Evans LE, Alhazzani W et al (2017) surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 43(3):304–377 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“However, prone position was associated with an increase in pressure sores (RR 1.22; 95% CI 1.05–1.41) [460, 461], and some patients have contraindications to the prone position [460, 461].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [460] Gattinoni L, Tognoni G, Pesenti A et al (2001) Effect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med 345(8):568–573 source
- Not checked yetcites [461] Guerin C, Gaillard S, Lemasson S et al (2004) Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial. JAMA 292(19):2379–2387 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Temporarily raising transpulmonary pressure may facilitate opening atelectatic alveoli to permit gas exchange [446], but could also over distend aerated lung units leading to ventilator-induced lung injury and transient hypotension.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [446] Gattinoni L, Caironi P, Cressoni M et al (2006) Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med 354(17):1775–1786 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“These drugs may improve chest wall compliance, prevent respiratory dyssynchrony, and reduce peak airway pressures [463].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [463] Murray MJ, Cowen J, DeBlock H et al (2002) Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient. Crit Care Med 30(1):142–156 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The second option is to titrate PEEP upward while the patient is receiving a tidal volume of 6 mL/kg PBW, until the plateau airway pressure is 28 cm H2O [441].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [441] Mercat A, Richard JC, Vielle B et al (2008) Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 299(6):646–655 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Since the publication of the previous SSC Guidelines, two important RCTs were published both of which utilised a “non-traditional” approach to recruitment maneuvers.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In 2017, a meta-analysis was published [454] that was updated from a previous meta-analysis published in 2010 [455], to which only 1 study, the PROSEVA trial, published in 2013 [456] was added.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [454] Munshi L, Del Sorbo L, Adhikari NKJ et al (2017) Prone position for acute respiratory distress syndrome. A systematic review and meta-analysis. Ann Am Thorac Soc 14(Supplement_4):S280-s8 source
- Not checked yetcites [455] Sud S, Friedrich JO, Taccone P et al (2010) Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Med 36(4):585–599 source
- Not checked yetcites [456] Guérin C, Reignier J, Richard JC et al (2013) Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 368(23):2159–2168 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A patient-level meta-analysis showed no benefit of higher PEEP in all patients with ARDS; however, patients with moderate or severe ARDS (PaO2/FiO2 ≤ 200 mmHg) had decreased mortality with the use of higher PEEP, whereas those with mild ARDS did not [443].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [443] Briel M, Meade M, Mercat A et al (2010) Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 303(9):865–873 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The overall balance of effects is uncertain and does not favour either the intervention or comparator.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Polymyxin B haemoperfusion is expensive, resource intensive, potentially reduces health equity, and is infeasible in low-income economies.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In APROCCHSS [478] the dose of vasopressor was ≥ 0.25 µg/kg/min or ≥ 1 mg/h of norepinephrine or epinephrine, or any other vasopressor for at least 6 h to maintain a MAP ≥ 65 mmHg.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [478] Annane D, Renault A, Brun-Buisson C et al (2018) Hydrocortisone plus Fludrocortisone for Adults with Septic Shock. N Engl J Med 378(9):809–818 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The three trials [354, 478, 479] also used different inclusion criteria: in ADRENAL [479] eligible patients were those on any dose of vasopressor or inotrope for ≥ 4 h to maintain a MAP > 60 mmHg, and present at the time of randomisation.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [479] Venkatesh B, Finfer S, Cohen J et al (2018) Adjunctive glucocorticoid therapy in patients with septic shock. N Engl J Med 378(9):797–808 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Randomised trials of this technique have been previously summarised in a systematic review and meta-analysis [482].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [482] Zhou F, Peng Z, Murugan R et al (2013) Blood purification and mortality in sepsis: a meta-analysis of randomized trials. Crit Care Med 41(9):2209–2220 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In clinical practice, patient selection is important and usually discussed prior to initiation of ECMO at an ECMO centre.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cost and equity are substantial issues; and registry data will be very important to document longer-term outcomes in these patients outside of the clinical trial context.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The evidence for the use of VV-ECMO in sepsis-induced ARDS is limited, with two RCTs completed in the last 10 years to assess the potential efficacy of VV ECMO for severe ARDS [476, 477].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [476] Combes A, Hajage D, Capellier G et al (2018) Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. N Engl J Med 378(21):1965–1975 source
- Not checked yetcites [477] Peek GJ, Mugford M, Tiruvoipati R et al (2009) Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 374(9698):1351–1363 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The previous guidelines made no recommendation regarding the use of blood purification techniques [12, 13].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [12] Rhodes A, Evans LE, Alhazzani W et al (2017) Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med 45(3):486–552 source
- Not checked yetcites [13] Rhodes A, Evans LE, Alhazzani W et al (2017) surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 43(3):304–377 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The updated literature search for guideline identified one new relevant RCT [481].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [481] Dellinger RP, Bagshaw SM, Antonelli M et al (2018) Effect of targeted polymyxin B hemoperfusion on 28-day mortality in patients with septic shock and elevated endotoxin level: the EUPHRATES Randomized Clinical Trial. JAMA 320(14):1455–1463 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In one trial, all intervention participants were treated at one centre, which may have inflated the effect size because the centre specialised in ECMO management [477].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
What the sources say
- Not checked yetcites [477] Peek GJ, Mugford M, Tiruvoipati R et al (2009) Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 374(9698):1351–1363 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The results showed similar 90-day mortality, ischaemic events, and use of life support in the two treatment groups with fewer transfusions in the lower-threshold group.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [484] Hébert PC, Wells G, Blajchman MA et al (1999) a multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 340(6):409–417 source
- Not checked yetcites [485] Holst LB, Haase N, Wetterslev J et al (2014) Lower versus higher hemoglobin threshold for transfusion in septic shock. N Engl J Med 371(15):1381–1391 source
plainn = 1,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The optimal dose, timing of initiation, and duration of corticosteroids remain uncertain; recent RCTs used 200 mg per day of IV hydrocortisone in divided doses [354, 479].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [354] Gordon AC, Mason AJ, Thirunavukkarasu N et al (2016) Effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock: the VANISH randomized clinical trial. JAMA 316(5):509–518 source
- Not checked yetcites [479] Venkatesh B, Finfer S, Cohen J et al (2018) Adjunctive glucocorticoid therapy in patients with septic shock. N Engl J Med 378(9):797–808 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The dose of hydrocortisone is typically 200 mg/day.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Intravenous immunoglobulin is also relatively expensive, possibly not cost-effective and may reduce health equity.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, a restrictive strategy was determined likely beneficial with regards to resources required, cost effectiveness, and health equity considerations.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Stress ulcers develop in the gastrointestinal (GI) tract of critically ill patients and can be associated with significant morbidity and mortality [493].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [493] Cook DJ, Fuller HD, Guyatt GH et al (1994) Risk factors for gastrointestinal bleeding in critically ill patients. Canadian Critical Care Trials Group. N Engl J Med 330(6):377–381 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Substantial uncertainty as to any beneficial effect exists and the frequency of undesirable effects is reported in few trials.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“however the quality of evidence is low with many of the included studies at high risks of bias including single-centre trials with small sample size, undefined randomisation, allocation and blinding procedures, different dosing regimens and durations of treatment, different controls and few studies reported adverse events.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“However, it was noted that the most recent (and largest) RCT did not demonstrate any effect of pantoprazole versus placebo on 90-day mortality and a composite outcome of clinically important events [494].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [494] Krag M, Marker S, Perner A et al (2018) Pantoprazole in patients at risk for gastrointestinal bleeding in the ICU. N Engl J Med 379(23):2199–2208 source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“At 28 days after randomisation, the mortality rate in the liberal group was 45% 67 patients versus 56% 84 patients in the restrictive group (HR 0.74; 95% CI 0.53–1.04; p = 0.08) with no differences in ICU and hospital length of stay.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [487] Bergamin FS, Almeida JP, Landoni G et al (2017) Liberal versus restrictive transfusion strategy in critically ill oncologic patients: the transfusion requirements in critically ill oncologic patients randomized controlled trial. Crit Care Med 45(5):766–773 source
plainn = 67- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In the ADRENAL [479] study, hydrocortisone was administered for a maximum of seven days or until ICU discharge or death; in APROCCHSS [478] hydrocortisone was administered for seven days; in VANISH [354] 200 mg of hydrocortisone was administered daily for 5 days and then tapered over further 6 days.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [479] Venkatesh B, Finfer S, Cohen J et al (2018) Adjunctive glucocorticoid therapy in patients with septic shock. N Engl J Med 378(9):797–808 source
- Not checked yetcites [478] Annane D, Renault A, Brun-Buisson C et al (2018) Hydrocortisone plus Fludrocortisone for Adults with Septic Shock. N Engl J Med 378(9):809–818 source
- Not checked yetcites [354] Gordon AC, Mason AJ, Thirunavukkarasu N et al (2016) Effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock: the VANISH randomized clinical trial. JAMA 316(5):509–518 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“While no adverse effects were observed, the quality of evidence for these outcomes was low.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The trial, which randomised 3000 participants, demonstrated no difference in mortality in those allocated to an accelerated strategy of RRT compared to those allocated to a “standard” strategy.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [508] Investigators S-A, Canadian Critical Care Trials G, Australian et al (2020) Timing of Initiation of Renal-Replacement Therapy in Acute Kidney Injury. N Engl J Med 383(3):240–251 source
boostedn = 3,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It was acknowledged that the resources required for the interventions vary.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is acknowledged that in some patents with sepsis and septic shock pharmacologic prophylaxis may be contraindicated.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
In the paper
“Vitamin C is known to have anti-inflammatory properties [520].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [520] Kuhn SO, Meissner K, Mayes LM et al (2018) Vitamin C in sepsis. Curr Opin Anaesthesiol 31(1):55–60 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In low- and middle-income economies, the specialised equipment, expertise and personal required for continuous modalities may not be available.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Further, LMWH may have greater consumer acceptance as it requires only one subcutaneous injection daily.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This is driven by a modest reduction in gastrointestinal haemorrhage for which there is moderate quality of evidence (Supplementary Appendix 5).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In 2017, a single centre before and after study reported shorter duration of vasopressor therapy and lower mortality following the administration of combination of high dose vitamin C, hydrocortisone, and thiamine to patients with sepsis and septic shock [521].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [521] Marik PE, Khangoora V, Rivera R et al (2017) Hydrocortisone, vitamin C, and thiamine for the treatment of severe sepsis and septic shock: a retrospective before-after study. Chest 151(6):1229–1238 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The cost of intervention is not large, and it is likely feasible in countries with low- and middle-income economies.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In a single centre study, targeting blood glucose to 80-110 mg/dL reduced ICU mortality [513], however this finding was not reproduced in subsequent multi-centre RCTs [514, 515].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [513] van den Berghe G, Wouters P, Weekers F et al (2001) Intensive insulin therapy in critically ill patients. N Engl J Med 345(19):1359–1367 source
- Not checked yetcites [514] Brunkhorst FM, Engel C, Bloos F et al (2008) Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 358(2):125–139 source
- Not checked yetcites [515] Preiser JC, Devos P, Ruiz-Santana S et al (2009) A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Med 35(10):1738–1748 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The American Diabetes Association, in its most recent recommendations for glycemic control of critically ill patients, recommended the initiation of insulin therapy for persistent hyperglycemia > 180 mg/dL and thereafter a target glucose range of 140–180 mg/dL [512].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [512] Diabetes Care in the Hospital (2018) Standards of Medical Care in Diabetes—2018. Diabetes Care 41(Supplement 1):S144–S151
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Prior research has suggested benefit [505] or harm [506] for “early” versus “delayed” initiation of RRT.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [505] Zarbock A, Kellum JA, Schmidt C et al (2016) Effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury: the ELAIN Randomized Clinical Trial. JAMA 315(20):2190–2199 source
- Not checked yetcites [506] Gaudry S, Hajage D, Schortgen F et al (2016) Initiation strategies for renal-replacement therapy in the intensive care unit. N Engl J Med 375(2):122–133 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The certainty of evidence for the key outcomes of mortality, renal recovery and CVAD infection was a least moderate and was only downgraded for imprecision (Supplementary Appendix 5).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These patients may benefit from mechanical VTE prophylaxis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“The incidence of DVT acquired in the ICU may be as high as 10% [497], the incidence of acquired PE may be 2–4% [498, 499].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [497] Cook D, Crowther M, Meade M et al (2005) Deep venous thrombosis in medical-surgical critically ill patients: prevalence, incidence, and risk factors. Crit Care Med 33(7):1565–1571 source
- Not checked yetcites [498] Alhazzani W, Lim W, Jaeschke RZ et al (2013) Heparin thromboprophylaxis in medical-surgical critically ill patients: a systematic review and meta-analysis of randomized trials. Crit Care Med 41(9):2088–2098 source
- Not checked yetcites [499] Kahn SR, Lim W, Dunn AS et al (2012) Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl):e195S-e226S source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The overall quality of evidence was rated as moderate (Supplementary Appendix 5).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Hyperglycemia (> 180 mg/dL), hypoglycemia and increased glycemic variability are associated with increased mortality in critically ill patients [509–511].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [509] Badawi O, Waite MD, Fuhrman SA et al (2012) Association between intensive care unit-acquired dysglycemia and in-hospital mortality. Crit Care Med 40(12):3180–3188 source
- Not checked yetcites [510] Krinsley JS (2008) Glycemic variability: a strong independent predictor of mortality in critically ill patients. Crit Care Med 36(11):3008–3013 source
- Not checked yetcites [511] Siegelaar SE, Hermanides J, Oudemans-van Straaten HM et al (2010) Mean glucose during ICU admission is related to mortality by a U-shaped curve in surgical and medical patients: a retrospective cohort study. Crit Care 14(6):R224 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, there are resource implications and costs associated with the use of mechanical VTE prophylaxis.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study was downgraded during the quality assessment for imprecision. For the outcome of mortality, the quality was assessed as moderate; for other outcomes it was further downgraded for risk of bias.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Any difference in resources required between the two interventions was considered to be negligible, and LMWH administration was feasible and applicable in countries with low- and middle-income economies.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Stress ulcer prophylaxis is relatively inexpensive, requires limited resources and is applicable to countries with low-income economies.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“No difference in mortality (RR 0.98 95% CI 0.84–1.13), or the rates of DVT and PE were observed.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [500] Arabi YM, Al-Hameed F, Burns KEA et al (2019) Adjunctive intermittent pneumatic compression for venous thromboprophylaxis. N Engl J Med 380(14):1305–1315 source
plainn = 2,003- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is broad consensus that the current healthcare system is likely falling short of what optimal care during the recovery period might look like for this patient population.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Given the variety of triggers used in these studies and the lack of superiority of any single trigger, no recommendation can be made for specific criteria to initiate a goals of care discussion.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“A discussion of goals of care and prognosis is essential to determine which treatments are acceptable and those interventions that are not desired [536].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [536] Ely EW (2017) The ABCDEF Bundle: science and philosophy of how ICU liberation serves patients and families. Crit Care Med 45(2):321–330 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“The previous guidance was based on two small, blinded crossover RCTs that compared equimolar saline vs sodium bicarbonate in patients with lactic acidosis and failed to reveal any difference in haemodynamic variables or vasopressor requirements [526, 527].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
What the sources say
- Not checked yetcites [526] Cooper DJ, Walley KR, Wiggs BR et al (1990) Bicarbonate does not improve hemodynamics in critically ill patients who have lactic acidosis. A prospective, controlled clinical study. Ann Intern Med 112(7):492–498 source
- Not checked yetcites [527] Mathieu D, Neviere R, Billard V et al (1991) Effects of bicarbonate therapy on hemodynamics and tissue oxygenation in patients with lactic acidosis: a prospective, controlled clinical study. Crit Care Med 19(11):1352–1356 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Despite lack of evidence, the panel recognised that discussion of prognosis and exploration of goals of care with patients and/or family is a necessary precondition to determine patient treatment preferences and providing value-concordant care.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Some patients may accept any and all treatment for their condition, but others may consider limitations depending on prognosis, invasiveness of interventions, and predicted quality of life (QoL).”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Patients with sepsis or septic shock are at high risk of multi-organ failure, long-term functional sequelae, and death.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Patients who survive a protracted period of ICU care for sepsis typically face a long and complicated road to recovery.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“While advance care planning in patients with life-limiting illness may reduce use of life-sustaining treatments, it may also increase use of hospice and palliative care, and improve concordance between treatment and patient values [537].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [537] Brinkman-Stoppelenburg A, Rietjens JA, van der Heide A (2014) The effects of advance care planning on end-of-life care: a systematic review. Palliat Med 28(8):1000–1025 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The intervention itself requires limited resources and is feasible in low- and middle-income economies.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The relevance of advance care planning for future health needs to goals of care discussions at the time of a critical illness is unclear.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Transitions of care are prone to communication errors, which have been identified as a barrier to the timely detection and management of sepsis [567].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [567] Matthaeus-Kraemer CT, Thomas-Rueddel DO, Schwarzkopf D et al (2016) Crossing the handover chasm: Clinicians’ perceptions of barriers to the early detection and timely management of severe sepsis and septic shock. J Crit Care 36:85–91 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Screening for economic and social support may help reduce these inequities.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
- Rests on an assumption: Non-medical social needs and modifiable factors such as economic and social support largely influence health outcomes.
- Rests on an assumption: Long-term health requires survivors to have the resources to recover and thrive.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, it is unlikely that many research studies would be conducted, since locally available social needs and supports vary.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Peer support groups have been used to enhance recovery from illness when survivors have long-lasting disability but have only recently been used in critical care and sepsis [549–551].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
What the sources say
- Not checked yetcites [549] Clark E, MacCrosain A, Ward NS et al (2020) The key features and role of peer support within group self-management interventions for stroke? A systematic review. Disabil Rehabil 42(3):307–316 source
- Not checked yetcites [550] Govindan S, Iwashyna TJ, Watson SR et al (2014) Issues of survivorship are rarely addressed during intensive care unit stays. Baseline results from a statewide quality improvement collaborative. Ann Am Thorac Soc 11(4):587–591 source
- Not checked yetcites [551] Wobma R, Nijland RH, Ket JC et al (2016) Evidence for peer support in rehabilitation for individuals with acquired brain injury: a systematic review. J Rehabil Med 48(10):837–840 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Lessons learned in post-critical care clinics could be adapted to other, more-scalable interventions such as telehealth.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Follow-up with a provider after hospital discharge is one-step in the recovery process.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In centers where cognitive therapy is used, it could reasonably be continued as it is likely acceptable and feasible, but there is insufficient evidence to change practice in centers without such therapy.”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Long-term outcomes and goals of care > Rationale
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper relies on this without support.
Early identification and appropriate management in the initial hours after sepsis onset improve outcomes.
“Early identification and appropriate management in the initial hours after the development of sepsis improve outcomes.”
The paper relies on this without support.
Timely, effective fluid resuscitation is crucial for stabilisation of sepsis-induced tissue hypoperfusion in sepsis and septic shock.
“Timely, effective fluid resuscitation is crucial for the stabilisation of sepsis-induced tissue hypoperfusion in sepsis and septic shock.”
The paper relies on this without support.
Most patients require continued fluid administration following initial resuscitation.
“Most patients require continued fluid administration following initial resuscitation.”
The paper relies on this without support.
Fluid administration beyond initial resuscitation must be balanced against risk of fluid accumulation and potential harm, including prolonged ventilation, progression of acute kidney injury, and increased mortality.
“Such administration needs to be balanced with the risk of fluid accumulation and potential harm associated with fluid overload, in particular, prolonged ventilation, progression of acute kidney injury (AKI) and increased mortality.”
The paper relies on this without support.
Heart rate, central venous pressure, and systolic blood pressure alone are poor indicators of fluid status.
“Heart rate, central venous pressure (CVP) and systolic blood pressure alone are poor indicators of fluid status.”
The paper relies on this without support.
Dynamic measures have better diagnostic accuracy at predicting fluid responsiveness than static techniques.
“Dynamic measures have demonstrated better diagnostic accuracy at predicting fluid responsiveness compared with static techniques.”
The paper relies on this without support.
Most data on fluid resuscitation arise from high-income settings, and evidence is scarce in resource-limited settings to guide optimal titration and safety endpoints.
“Most data arise from high income settings and a paucity of evidence exists in resource-limited settings to guide optimal titration of fluid resuscitation as well as the appropriate safety end- points.”
The paper relies on this without support.
MAP is a key determinant of mean systemic filling pressure, which is the major driver of venous return and cardiac output.
“MAP is a key determinant of mean systemic filling pressure, which in turn, is the major driver of venous return and CO.”
The paper relies on this without support.
Increasing MAP usually results in increased tissue blood flow and augments the supply side of tissue perfusion.
“Increasing MAP therefore usually results in increased tissue blood flow and augments the supply side of tissue perfusion.”
The paper relies on this without support.
The outcome of critically ill patients depends on timely application of critical care interventions in an appropriate environment.
“The outcome of critically ill patients depends on timely application of critical care interventions in an appropriate environment.”
The paper relies on this without support.
The availability and turn-around time for laboratory testing, rapid infectious diagnostic, imaging, etc. varies widely by regions and settings.
“The availability and turn-around time for laboratory testing, rapid infectious diagnostic, imaging, etc. varies widely by regions and settings.”
The paper relies on this without support.
The risk of Candida sepsis or septic shock in immunosuppressed populations other than febrile neutropenia is highly disease- and therapy-specific.
“The risk of Candida sepsis or septic shock for other immunosuppressed populations is highly disease- and therapy-specific.”
The paper relies on this without support.
Effective therapies are lacking for most zoonotic viruses that can manifest with clinical signs of sepsis.
“Unfortunately, effective therapies are lacking for most of these viruses.”
The paper relies on this without support.
Procalcitonin testing may not be available in all countries and healthcare settings, including LMICs.
“Procalcitonin testing may not be available in all countries and healthcare settings, including LMICs.”
The paper relies on this without support.
The direct costs of antibiotics can increase with routine use of multiple agents, particularly in resource-limited settings.
“The overall quality of evidence was very low, and the direct costs of antibiotics can increase with the routine use of multiple agents for treatment. This may specifically have an impact in resource-limited settings.”
The paper relies on this without support.
Treatment with empiric antifungals may be associated with increased costs.
“The overall quality of evidence was low, and treatment with empiric antifungals may be associated with increased costs.”
The paper relies on this without support.
Clinical experience indicates that without adequate source control, many severe presentations will not stabilise or improve despite rapid resuscitation and appropriate antimicrobials.
“Clinical experience suggests that without adequate source control, many severe presentations will not stabilise or improve despite rapid resuscitation and provision of appropriate antimicrobials.”
The paper relies on this without support.
Crystalloids are inexpensive and widely available.
“Crystalloids have the advantage of being inexpensive and widely available.”
The paper relies on this without support.
Albumin is more costly than crystalloids.
“it is more costly and there is no clear benefit with its routine use.”
The paper relies on this without support.
Norepinephrine is more potent than dopamine as a vasoconstrictor.
“Norepinephrine is more potent than dopamine as a vasoconstrictor.”
The paper relies on this without support.
Dopamine's beta-1 adrenergic receptor activity can lead to dose-limiting arrhythmias.
“its β-1 adrenergic receptor activity can lead to dose-limiting arrhythmias.”
The paper relies on this without support.
Availability of and experience with norepinephrine may vary.
“The panel also recognised that availability of, and experience with, norepinephrine may vary.”
The paper relies on this without support.
The results of clinical trials conducted in general critically ill or ARDS populations are applicable to patients with sepsis-induced ARDS.
“Of note, the studies that guide the recommendations in this section enrolled patients using criteria from the American-European Consensus Criteria Definition for Acute Lung Injury and ARDS [422].”
The paper relies on this without support.
The 2012 Berlin definition of ARDS does not materially alter the applicability of trial results that used the older American-European Consensus Criteria.
“For the current document, we used the 2012 Berlin definition and the terms mild, moderate, and severe ARDS (PaO2/FiO2 ≤ 300, ≤ 200, and ≤ 100 mm Hg, respectively) [423].”
The paper relies on this without support.
Non-medical social needs and modifiable factors such as economic and social support largely influence health outcomes.
“Non-medical social needs and potentially modifiable factors such as economic and social support largely influence health outcomes.”
The paper relies on this without support.
Long-term health requires survivors to have the resources to recover and thrive.
“While survival from sepsis is improving, long-term health requires survivors to have the resources to recover and thrive.”
The paper relies on this without support.
Socioeconomic screening is considered part of standard clinical practice.
“Although socioeconomic screening is considered part of standard clinical practice, all clinical teams in many settings may not do it.”
The paper relies on this without support.
Shared decision making is less routinely used in post-ICU and hospital discharge planning than in other aspects of acute patient care.
“This patient-centered approach may be less routinely used in post-ICU and hospital discharge planning than in other aspects of acute patient care.”
The paper relies on this without support.
Medication reconciliation is broadly recognised to be important during patient transitions.
“Medication reconciliation is broadly recognised to be important during patient transitions.”
The paper relies on this without support.
Individuals who receive referral to peer support have the choice to participate or not.
“As individuals who receive referral to peer support have the choice to participate or not (based on personal preference, timing, location, functional status, and resources required) a weak recommendation provides an opportunity to access support for sepsis survivors who otherwise may not know where to turn [552].”
The paper relies on this without support.
Many sepsis interventions and tests are time-dependent, and communication failures may increase the chances of critical medical errors.
“While it is unclear whether structured handoffs impact important patient outcomes, many sepsis interventions and tests are time-dependent and communication failures may increase the chances of critical medical errors.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Early and effective inhibition or killing of pathogens is essential for the prevention and treatment of sepsis.12”
From Identification of heptapeptides targeting a lethal bacterial strain in septic mice through an integrative approach (2022) · cites this paper as [12]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
“One study reported reduced vasopressor use at 168 h [523].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
“Of the patients alive at 7 days, 22% (16/72) administered vitamin C remained on vasopressor therapy compared to 10% (6/59) of controls.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
“MD −2.3 cm H2O”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
“95% CI 3.02–1.05”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
“A 2015 systematic review and meta-analysis found a reduction in the risk of a composite endpoint of ARDS or pneumonia during the hospital stay in the low tidal volume ventilation group compared to the high tidal volume ventilation group (RR 0.72; 95% CI 0.52–0.98) [450].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > References
“450. Serpa Neto A Cardoso SO Manetta JA Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis JAMA 2012”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
“days on mechanical ventilation (RR = 0.00;”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Ventilation > Rationale
“95% CI −1.02 to 1.02”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“33 of 260 (12%) patients experienced digital ischaemia after receiving terlipressin”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Haemodynamic management > Rationale
Reported 12 · recomputed 12.692308
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
“Our literature search identified one new RCT that compared the combination of mechanical and pharmacological prophylaxis to pharmacological prophylaxis alone [500].”
§ Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 > Additional therapies > Rationale
“The PREVENT study randomised 2003 critically ill patients to intermittent pneumatic calf compression alone or in combination with pharmacological prophylaxis [500].”
Citations
Cites
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552
The third international consensus definitions for sepsis and septic shock (Sepsis-3).
Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G. R., Chiche, J.-D., Coopersmith, C. M., et al. (2016) · JAMA · doi:10.1001/jama.2016.0287 · Cited by 28,250
Self-citationGRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305
(2000) · New England Journal of Medicine · doi:10.1056/nejm200005043421801 · Cited by 12,941
Early goal-directed therapy in the treatment of severe sepsis and septic shock
Rivers, E., Nguyen, B., Havstad, S., Ressler, J., Muzzin, A., Knoblich, B., Peterson, E., & Tomlanovich, M. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa010307 · Cited by 10,743
Intensive insulin therapy in critically ill patients.
Van den Berghe, G., Wouters, P., Weekers, F., Verwaest, C., Bruyninckx, F., Schetz, M., Vlasselaers, D., Ferdinande, P., Lauwers, P., & Bouillon, R. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa011300 · Cited by 9,977
Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J. E., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e31827e83af · Cited by 9,694
Self-citationGRADE guidelines: 3. Rating the quality of evidence
Balshem, H., Helfand, M., Schünemann, H. J., Oxman, A. D., Kunz, R., Brozek, J., Vist, G. E., Falck-Ytter, Y., Meerpohl, J., & Norris, S. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.07.015 · Cited by 8,285
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Intensive Care Medicine · doi:10.1007/s00134-012-2769-8 · Cited by 7,371
Self-citationBernard, G. R., Artigas, A., Brigham, K. L., Carlet, J., Falke, K., Hudson, L., Lamy, M., Legall, J. R., Morris, A., & Spragg, R. (1994) · American journal of respiratory and critical care medicine · doi:10.1164/ajrccm.149.3.7509706 · Cited by 6,746
Research works printed but not linked: 6
- Liu G, An Y, Yi X et al (2017) Early lactate levels for prediction of mortality in patients with sepsis or septic shock: a meta-analysis. Int J Exp Med 10:37–47
- Vincent J (2019) Arterial, central venous, and pulmonary artery catheters. In: JE P (ed) Critical care medicine: principles and diagnosis and management in the adult, 5th edn. Elsevier, Philadelphia, pp 40–49
- Belenguer-Muncharaz A, Cubedo-Bort M, Blasco-Asensio D et al (2017) Non-invasive ventilation versus invasive mechanical ventilation in patients with hypoxemic acute respiratory failure in an Intensive Care Unit. A randomized controlled study. Minerva Pneumologica 56:1–10
- Force ADT, Ranieri VM, Rubenfeld GD et al (2012) Acute respiratory distress syndrome: the Berlin Definition. JAMA 307(23):2526–2533
- Cavalcanti AB, Suzumura ÉA, Laranjeira LN et al (2017) Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 318(14):1335–1345 · DOI · Paper page
- Diabetes Care in the Hospital (2018) Standards of Medical Care in Diabetes—2018. Diabetes Care 41(Supplement 1):S144–S151
Cited by
Sorted by citations
Restriction of Intravenous Fluid in ICU Patients with Septic Shock
Meyhoff, T. S., Hjortrup, P. B., Wetterslev, J., Sivapalan, P., Laake, J. H., Cronhjort, M., Jakob, S. M., Cecconi, M., Nalos, M., Ostermann, M., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2202707 · Cited by 427
Self-citationHow can assessing hemodynamics help to assess volume status?
De Backer, D., Aissaoui, N., Cecconi, M., Chew, M. S., Denault, A., Hajjar, L., Hernandez, G., Messina, A., Myatra, S. N., Ostermann, M., et al. (2022) · Intensive Care Medicine · doi:10.1007/s00134-022-06808-9 · Cited by 199
Self-citationQian, E. T., Casey, J. D., Wright, A., Wang, L., Shotwell, M. S., Siemann, J. K., Dear, M. L., Stollings, J. L., Lloyd, B. D., Marvi, T. K., et al. (2023) · JAMA · doi:10.1001/jama.2023.20583 · Cited by 150
Self-citationDark, P., Hossain, A., McAuley, D. F., Brealey, D., Carlson, G., Clayton, J. C., Felton, T. W., Ghuman, B. K., Gordon, A. C., Hellyer, T. P., et al. (2025) · JAMA · doi:10.1001/jama.2024.26458 · Cited by 114
Self-citationZhang, S., Yu, J., Xu, X., Yin, C., Lu, Y., Yao, B., Tory, M., Padilla, L. M., Caterino, J., Zhang, P., et al. (2024) · Proceedings of the CHI Conference on Human Factors in Computing Systems · doi:10.1145/3613904.3642343 · Cited by 99
“The patient’s data and lab test results (if any) are fed into the ESM module, generating a risk score.”
BackgroundMethod
Metadata
- Authors
- Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., Schorr, C., Simpson, S., Wiersinga, W. J., Alshamsi, F., Angus, D. C., Arabi, Y., Azevedo, L., Beale, R., Beilman, G., Belley-Cote, E., Burry, L., Cecconi, M., Centofanti, J., Coz Yataco, A., De Waele, J., Dellinger, R. P., Doi, K., Du, B., Estenssoro, E., Ferrer, R., Gomersall, C., Hodgson, C., Møller, M. H., Iwashyna, T., Jacob, S., Kleinpell, R., Klompas, M., Koh, Y., Kumar, A., Kwizera, A., Lobo, S., Masur, H., McGloughlin, S., Mehta, S., Mehta, Y., Mer, M., Nunnally, M., Oczkowski, S., Osborn, T., Papathanassoglou, E., Perner, A., Puskarich, M., Roberts, J., Schweickert, W., Seckel, M., Sevransky, J., Sprung, C. L., Welte, T., Zimmerman, J., & Levy, M.
- Affiliations
- University of Washington (US)
- St George's, University of London (GB)
- McMaster University (CA)
- Agostino Gemelli University Polyclinic (IT)
- Emory University (US)
- Western Health (AU)
- Hospital São Paulo (BR)
- Ottawa Hospital (CA)
- Guy's Hospital (GB)
- University of Michigan (US)
- Cooper Norcross Health (US)
- University of Kansas Medical Center (US)
- Amsterdam University Medical Centers (NL)
- United Arab Emirates University (AE)
- University of Pittsburgh (US)
- King Saud bin Abdulaziz University for Health Sciences (SA)
- Universidade de São Paulo (BR)
- University of Minnesota (US)
- Mount Sinai Hospital (CA)
- Humanitas University (IT)
- The University of Tokyo (JP)
- Peking Union Medical College Hospital (CN)
- Vall d'Hebron Institut de Recerca (ES)
- Prince of Wales Hospital (CN)
- Monash University (AU)
- Copenhagen University Hospital (DK)
- Michigan Medicine (US)
- Liverpool School of Tropical Medicine (GB)
- Vanderbilt University (US)
- Brigham and Women's Hospital (US)
- Asan Medical Center (KR)
- University of Manitoba (CA)
- Makerere University (UG)
- Faculdade de Medicina de São José do Rio Preto (BR)
- National Institutes of Health (US)
- Alfred Health (AU)
- Medanta The Medicity (IN)
- University of the Witwatersrand (ZA)
- New York University (US)
- Washington University in St. Louis (US)
- University of Alberta (CA)
- Rigshospitalet (DK)
- The University of Queensland (AU)
- University of Pennsylvania (US)
- Hebrew University of Jerusalem (IL)
- Medizinische Hochschule Hannover (DE)
- Brown University (US)
- Corresponding author
- Evans, Laura
- ORCID
- Evans, Laura
- Rhodes, Andrew
- Alhazzani, Waleed
- Antonelli, Massimo
- Coopersmith, Craig M.
- French, Craig
- Machado, Flávia R.
- Mcintyre, Lauralyn
- Ostermann, Marlies
- Prescott, Hallie C.
- Schorr, Christa
- Simpson, Steven
- Wiersinga, W. Joost
- Alshamsi, Fayez
- Angus, Derek C.
- Arabi, Yaseen
- Azevedo, Luciano
- Beilman, Gregory
- Burry, Lisa
- Cecconi, Maurizio
- Centofanti, John
- Doi, Kent
- Du, Bin
- Estenssoro, Elisa
- Ferrer, Ricard
- Gomersall, Charles
- Hodgson, Carol
- Møller, Morten Hylander
- Iwashyna, Theodore
- Jacob, Shevin
- Kleinpell, Ruth
- Klompas, Michael
- Koh, Younsuck
- Kumar, Anand
- Kwizera, Arthur
- Lobo, Suzana
- Masur, Henry
- Mehta, Sangeeta
- Mehta, Yatin
- Mer, Mervyn
- Nunnally, Mark
- Oczkowski, Simon
- Osborn, Tiffany
- Papathanassoglou, Elizabeth
- Perner, Anders
- Puskarich, Michael
- Roberts, Jason
- Schweickert, William
- Seckel, Maureen
- Sprung, Charles L.
- Welte, Tobias
- Levy, Mitchell
- Venue
- Intensive Care Medicine
- Published
- 2021-10-02
- Volume
- 47
- Issue
- 11
- Pages
- 1181-1247
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- PMC
- PMC8486643
- OpenAlex
- W3202964273
- Cited by
- 5,082
- References
- 645
- Citations by year
- 2026: 903 · 2025: 1227 · 2024: 1203 · 2023: 1080 · 2022: 614 · 2021: 44
- FWCI
- 532.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Intensive Care Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (acceptedVersion, cc-by)
- LSTM Online Archive (Liverpool School of Tropical Medicine) (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Funders
- American Thoracic Society
- Society for Academic Emergency Medicine
- European Respiratory Society
- American Association of Critical-Care Nurses
- National Institute for Health and Care Research (17/63/42)
- Intensive Care Society
- European Society of Clinical Microbiology and Infectious Diseases
- European Society of Intensive Care Medicine
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Abdominal Surgery and Complications
- Health Sciences › Medicine › Pharmacology (medical) › Antibiotics Pharmacokinetics and Efficacy
- Keywords
- sepsis, septic shock, Surviving Sepsis Campaign, sepsis screening, early sepsis treatment, fluid resuscitation, vasoactive drugs, antimicrobial therapy, mechanical ventilation, goals of care, long-term outcomes, adults
- MeSH terms
- Critical Care, Humans, Shock, Septic, Sepsis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-01, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-01 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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