Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock

Dellinger, R. Phillip; Carlet, Jean; Masur, Henry; Gerlach, Herwig; Calandra, Thierry; Cohen, Jonathan; Gea-Banacloche, Juan; Keh, Didier; Marshall, John C.; Parker, Margaret M.; Ramsay, Graham; Zimmerman, Janice L.; Vincent, Jean‐Louis; Levy, Mitchell M.

doi:10.1097/01.ccm.0000117317.18092.e4

Cited by 3,103 publications

(2,186 citation statements)

References 126 publications

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“…Table 4) should be rapidly referred to an intensive care unit (ICU) In 2004, the "Surviving Sepsis Campaign" guidelines recommended the use of EGDT [147] based on one large randomized trial [93]. These guidelines were updated in 2008 [148], successively in 2012 [70], and were further supported by several subsequent trials that corroborated the benefit of EGDT in severe sepsis and septic shock [149].…”

Section: The Empirical Treatment Must Be Optimized When Microbiologymentioning

confidence: 99%

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Mirabile

Numico²,

Russi

et al. 2015

Critical Reviews in Oncology/Hematology

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The reporting of infection/sepsis in chemo/radiation-treated head and neck cancer patients is sparse and the problem is underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met with the aim of reaching a consensus on a clinical definition and management of infections and sepsis. The Delphi appropriateness method was used for this consensus. External expert reviewers then evaluated the conclusions carefully according to their area of expertise. The paper contains seven clusters of statements about the clinical definition and management of infections and sepsis in head and neck cancer patients, which had a consensus. Furthermore, it offers a review of recent literature in these topics

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Section: The Empirical Treatment Must Be Optimized When Microbiologymentioning

confidence: 99%

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Mirabile

Numico²,

Russi

et al. 2015

Critical Reviews in Oncology/Hematology

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“…In the EGDT group, central venous catheterization occurred in only 60 % of the patients at 1 h, in 85 % at 2 h and in 93.6 % at 6 h. Moreover, central venous catheterization occurred in 56.5 and 57.9 % of the patients at 6 h in the other two treatment groups. At last, to be eligible, the study sites had to comply with the Surviving Sepsis Campaign guidelines [5] for non-resuscitation aspects of care. We wonder if these factors might have diluted the treatment differences in the three groups.…”

Section: Question Marksmentioning

confidence: 99%

Is there a benefit for a care protocol in the treatment of septic shock?

et al. 2014

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“…3,4 Based on this evidence, use of IIT to achieve TGC has been advocated to improve outcomes for critically ill patients. 7,8 There have, however, been concerns regarding the broad application of IIT and TGC in critical illness. [9][10][11][12] Specifically, concerns have been raised about the methodology and overall generalizability of the two highest profile IIT trials reported by Van den Berghe et al 3,4 In particular, these trials were both single centre open-label trials where 87% of patients received parenteral nutrition.…”

Section: Commentarymentioning

confidence: 99%

Intensive vs conventional blood glucose control in critically ill patients

Bagshaw

Hoste

Jacka

2009

Can J Anesth/J Can Anesth

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Article appraised Critical care issueHyperglycemia is common during critical illness and has been identified as a modifiable risk factor for increased morbidity and mortality in critically ill patients. Data from selected clinical trials suggest that intensive insulin therapy (IIT) and tight glycemic control (TGC) achieve a clinical benefit when targeting blood glucose (BG) in the range of 4.4-6.1 mmol Á L -1 . However, reports of recently conducted randomized trials have shown conflicting results. Consequently, the NICE-SUGAR (Normoglycaemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation) trial was designed as a pragmatic multi-national multi-centre randomized ''effectiveness'' trial to evaluate the impact of IIT to achieve TGC on 90-day all cause mortality and several secondary morbidity outcomes. The NICE-SUGAR trial aimed to resolve existing concerns about the applicability of IIT to achieve TGC in critical illness. This article considers the NICE-SUGAR trial and discusses its key findings in the context of the published literature.As the optimum target range for blood glucose (BG) in critically ill patients remains unclear, the objective of this study was to evaluate whether intensive glucose control in critical illness is associated with improved clinical outcomes. The design was a multi-national multi-centre randomized controlled trial. The setting involved 42 participating intensive care units (ICUs) across Australia, New Zealand, Canada, and the United States. Critically ill adult subjects met the eligibility requirements if, within 24 hr after admission to an ICU, they were expected to require treatment in the ICU for three or more consecutive days. Subjects were randomized to receive either intensive glucose control with a target blood glucose range of 4.5-6.0 mmol Á L -1 or conventional glucose control with a target blood glucose range of 10.0 mmol Á L -1 or less. The primary endpoint was allcause mortality 90 days after randomization. Of the 6,104 subjects who were randomized, 3,054 patients were randomized to undergo intensive glucose control and 3,050 patients received conventional glucose management. Data with regard to the primary outcome at day 90 were available for over 98% of the subjects evaluated. The two groups had similar characteristics at baseline. The authors reported that 829 patients (27.5%) in the intensive-control group and 751 (24.9%) patients in the conventional-control group died (odds ratio [OR] for intensive control, 1.14; 95% confidence intervals [CI], 1.02-1.28; P = 0.02). The treatment effect was similar when comparing operative (surgical) patients and non-operative (medical) patients (odds ratio for death in the intensive-control group, 1.31 and 1.07, respectively; P = 0.10). Severe hypoglycemia, defined as a blood glucose level \2.2 mmol Á L -1 was reported in 206 (6.8%) of patients in the intensive-control group and 15 (0.5%) of patients in the conventional-control group (P \ 0.001). The groups were found to be similar regarding the median

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Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock

Cited by 3,103 publications

References 126 publications

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Is there a benefit for a care protocol in the treatment of septic shock?

Intensive vs conventional blood glucose control in critically ill patients

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